How long does redness typically last after a steroid injection?

Duration of Redness After Steroid Injections

Redness after steroid injections typically resolves within 24-72 hours after reaching its peak, which usually occurs 8-10 days post-injection. 1

Normal Inflammatory Response vs. Complications

Normal Inflammatory Response

• Localized redness at the injection site is a common reaction and represents a normal inflammatory response 1
• This reaction is self-limiting and generally doesn't require specific treatment 1
• Peak inflammation typically occurs 8-10 days after injection, followed by improvement within 24-72 hours 1

Distinguishing Normal Reactions from Complications

Normal Reactions Include:

• Localized redness and warmth at the injection site 1
• Mild pain or discomfort 1
• Possible mild swelling 1

Warning Signs of Complications:

• Progressive worsening of symptoms beyond 72 hours after peak inflammation 1
• Severe pain that increases rather than decreases 1
• Significant swelling, warmth, and pain that extends beyond the injection site 1
• Systemic symptoms like fever (though fever can sometimes be a normal immunologic response) 1

Management of Post-Injection Redness

For Normal Inflammatory Responses:

• Vigilant observation and patient education 1
• Rest of the affected area 1
• Oral non-aspirin analgesics for discomfort 1
• Oral antipruritic agents if itching occurs 1

What to Avoid:

• Salves, creams, or ointments, including topical steroids or antibacterial medications, should not be applied to the injection site 1
• Avoid covering the area with occlusive dressings 1

Special Considerations

Allergic Reactions

• True hypersensitivity reactions to corticosteroids are rare (estimated prevalence 0.3-0.5%) but can occur 2
• These may present as:
  • Immediate reactions (within 1 hour): urticaria, angioedema, bronchospasm 2
  • Non-immediate reactions (after 1 hour): contact dermatitis, maculopapular eruptions 2
• Patients with atopic dermatitis may be at higher risk for developing allergic reactions 2

Infectious Complications

• Infection after steroid injections is rare but serious 3, 4
• Signs of infection include:
  • Progressive pain, redness, and swelling beyond 72 hours 1
  • Systemic symptoms like fever and malaise 3
  • Purulent drainage 4
• Bacterial infections typically occur within 5 days of injection or >30 days post-injection 1

When to Seek Medical Attention

• If redness persists beyond 72 hours after reaching its peak 1
• If symptoms worsen rather than improve 1
• If systemic symptoms develop (fever, chills, malaise) 3
• If there is significant pain that interferes with function 1

Prevention of Complications

• Proper antiseptic technique during injection reduces infection risk 4
• Avoiding touching or manipulating the injection site 1
• Following post-injection care instructions 1

Remember that while most post-steroid injection redness is benign and self-limiting, monitoring for signs of infection or allergic reaction is important for early intervention if complications develop.