Kenalog Injection Dose for Dermatitis Skin Lesions
For dermatitis skin lesions, use intralesional triamcinolone acetonide at a concentration of 2.5 mg/mL, injecting 0.05 mL per lesion into the center of the inflammatory lesion. 1, 2
Concentration and Volume
The standard concentration is 2.5 mg/mL, which represents the most commonly used dilution among dermatologists (52.5% of practitioners) and has demonstrated virtually 100% effectiveness in localized inflammatory dermatoses 2, 3
Inject 0.05 mL per lesion, which is the most frequently used volume (42.3% of practitioners) and provides adequate therapeutic effect while minimizing adverse events 2
The original formulation comes at 10 mg/mL and should be diluted with sterile normal saline to achieve the 2.5 mg/mL concentration 1
Injection Technique
Inject into the center of the lesion at the dermal level, as practiced by 61.6% of dermatologists surveyed 2
Use low-pressure injection technique to minimize risk of complications 3
Avoid injecting at sites of active infection such as impetigo or herpes 1
Total Dosing Limits
Maximum safe dose is 15-20 mg (6-8 cc at 2.5 mg/mL concentration) every 3-4 weeks for patients over 50 kg 3
The usual maximum per session is 7.5 mg (3 cc at 2.5 mg/mL) for most patients 3
Multiple lesions can be treated in one session as long as total dose remains within these limits 3
Expected Response and Follow-up
Reassess after 2 weeks to evaluate treatment response 1
Most inflammatory dermatitis lesions respond within this timeframe with significant improvement in erythema, induration, and pruritus 4
If no improvement occurs after 2 weeks, consider alternative diagnoses or treatment modalities 1
Critical Safety Considerations
Counsel patients about hypopigmentation and atrophy risk before every injection, as recommended by 50.5% of practitioners 2
Atrophy, when it occurs, typically lasts over 6 months (48.4% of cases), though the overall incidence is extremely low (<1% of patients) 2
Contraindications include hypersensitivity to triamcinolone, active tuberculosis, uncontrolled diabetes, severe hypertension, and active peptic ulcer disease 1
Monitor for signs of hypothalamic-pituitary-adrenal axis suppression with repeated injections, particularly when approaching maximum dosing limits 1, 3
Common Pitfalls to Avoid
Do not use concentrations higher than 2.5 mg/mL for dermatitis lesions, as higher concentrations (such as the 10-40 mg/mL used for keloids and hypertrophic scars) significantly increase atrophy risk 1
Avoid superficial injection, which increases risk of visible atrophy and hypopigmentation 2
Do not inject into areas with impaired wound healing or recent facial surgery with extensive undermining 1
Ensure proper dilution technique, as using the wrong concentration is a frequent source of adverse events 1, 2