Intralesional injections are an office-based procedure that use to treat specific skin conditions. They can be extremely effective for a variety of reasons, but they can also have adverse effects. For example, long-term injections can cause hyperpigmentation, telangiectasia, or atrophy of the skin. It is always best to seek the advice of a provider before undergoing this procedure. Intralesional steroid injections are a common treatment option for many dermatologic conditions. This type of treatment uses corticosteroids in varying concentrations to relieve inflammation and improve appearance. Some providers also use them to treat conditions that cause the skin to become thinning or have epidermal atrophy. Although there are several indications for this procedure, it is also painful. Because of this, many patients opt to stop it. Some providers inject lidocaine in the injection site to alleviate the pain. Lidocaine’s acidic pH causes an unpleasant burning sensation. However, it doesn’t treat the underlying pathology, and it adds to the risk and cost of the procedure. If you don’t feel comfortable with lidocaine, consider removing it. There are several different types of corticosteroid that use in intralesional injections. Three of the most common ones include triamcinolone acetonide, triamcinolone diacetate, and betamethasone. These steroids are typically available in micronized suspensions and can easily mixed in the injection site.