Subcutaneous atrophy and/or skin depigmentation

Subcutaneous atrophy and/or skin depigmentation - This is more likely to occur when superficial lesions are injected, especially in dark-skinned patients5 3 , 6 6 . Take care not to allow injected drugs to reflux back through the needle tract - pressure around the needle with cotton wool when withdrawing can help. In thin dark-skinned women especially, it might be preferable to use hydrocortisone for superficial lesions. These patients must always be advised of the possibility of this side-effect, and the fact recorded in the notes. Local atrophy appears within 1-4 months of injection and characteristically proceeds to resolution 6-24 months later, but may take longer