The adverse effects of systemic steroid medications are well known, whereas those of local steroid injections are unclear even to clinicians. We report two cases of localized lipoatrophy and depigmentation following local steroid injection. Although the incidence of soft tissue atrophy after local steroid injection is rare, it will increase in proportion to the frequency of the procedure. All clinicians, even those who do not perform steroid injections, should be aware of the occurrence of this cosmetically disturbing adverse effect.