Overview

Triamcinolone is a steroid. If you have mouth ulcers, or lip or face swelling, an intralesional injection of triamcinolone may help to ease it.

Intralesional means that the injection is given directly into the area that needs treatment. This makes the treatment more effective. Only a small amount of the steroid gets into the rest of the body, which means there is less chance of side effects.

This treatment can also ease pain, and reduce or remove the ulcer if you have one. It may not be suitable for multiple ulcerations.  

The number of injections you need will depend on the treatment you are having. You might need multiple visits to repeat the injections, depending on how you respond to the treatment.

Risks of triamcinolone injections

The risks are small, but having intralesional triamcinolone injections might cause:

• mild swelling to the treatment area (this can make your orofacial swelling worse temporarily)
• redness of the skin (this might look different on brown or black skin)
• thinning of your skin
• patches of pale skin (hypopigmentation)
• patches of darker skin (hyperpigmentation)
• bruising at the injection site
• headache

This treatment should not cause your face to swell. That is usually only seen when this type of medicine is used in high amounts (doses) for long periods of time.

You should not have this treatment if you:

• have had an allergic reaction to triamcinolone before
• currently have an infection (unless your doctor says it is safe to have this treatment)

Please tell the doctor if you are, or think you might be, pregnant, or if you are breastfeeding.  

Tell the doctor if you have, or have had, any of these conditions:

• tuberculosis (TB)
• bowel conditions, such as irritable bowel syndrome
• a stomach ulcer
• blood clots
• cancer
• thin (brittle) bones
• high blood pressure or heart failure
• mental health conditions, such as anxiety or depression
• epilepsy
• myasthenia gravis
• glaucoma (increased pressure in your eyes)
• kidney, liver or thyroid problems

• diabetes

Other treatment options

Steroids that affect the whole body (systemic), or other treatments that weaken your immune system might be offered.

Giving your permission (consent)

We want to involve you in decisions about your care and treatment. If you decide to go ahead, you will be asked to sign a consent form. This states that you understand what it involves and agree to have it.

If you would like more information about our consent process, please speak to a member of staff caring for you.

During the procedure

The procedure is usually done with an anaesthetic gel. Please tell the doctor if you are allergic to any anaesthetics or gels.

You will be awake during the procedure.

For lip swelling, a small needle is used to give injections. The number of injections you need depends on your lip, and your doctor will talk to you about this.

For ulcers, a small needle is used to give injections around each ulcer. The number of injections you need depends on your ulcers, and your doctor will talk to you about this.

The injected area is massaged to distribute the triamcinolone evenly throughout the tissue. The whole procedure takes about 15 minutes.

Pain during the procedure

You might feel a little discomfort when the area is injected, but we usually use an anaesthetic gel. This helps to numb the area, to try and reduce any discomfort.

After the procedure

After the procedure, you will be told how to keep your mouth comfortable for the next few days. You might also be given advice on how to ease any swelling.

After you leave hospital

 You can continue with your usual activities after you have left the hospital.  

If you have severe pain, or have any unexpected swelling that develops in the days after the procedure, please contact the oral medicine department to arrange a review. Out of hours you should contact NHS 111 for advice.

Follow-up appointment

You will be asked to make a follow-up appointment in the oral medicine department so we can see if the treatment has helped. Your doctor will tell you when this should be. This appointment will be made on the day of your procedure.