Q & A With Dr. Herzog: Chemo and Cosmetic Procedures



A Family Savvy reader submitted the following question to Dr. Herzog regarding cosmetic procedures during chemotherapy.

Dear Dr. Jo,

I am in the middle of chemo that has been happening on and off for years. I know that I should be thankful just to be alive, but whenever I look in the mirror, I feel worn out and sick. Is it unhealthy and is it wrong for me to want to get rid of some of these wrinkles? 

Mrs. S.

Dr. Jo Herzog

Dear Mrs. S,

First of all, do not feel guilty about wanting to look your best while fighting cancer. It is hard enough feeling ill for several days at a time, worrying about your future, and losing your hair. There is nothing at all wrong with wanting to get up, get dressed, put on your make up and wig, and be beautiful. It might make you feel a lot better too, as a positive attitude is possibly beneficial to your immune system. It certainly couldn’t hurt.

When undergoing chemotherapy, I do think that we have to give some special consideration top the choice and timing of treatments. I also like to have my patients get the approval of their oncologists, many of whom just defer to the dermatologists’ recommendations.

Let’s start with timing. If you are in active chemotherapy and might have low platelet and white blood cell counts, you should wait for these counts to rise before having treatment.  Low platelet counts will allow for more bleeding and bruising. Although the risk of infection from injectables is very low, I feel it is advisable to avoid any increased risk that might occur from having a low white blood count, especially if this count might be up in a week or two.

Now, let’s look at several products. Botox, Dysport and Xeomin work by stopping muscle movement, so these have little to no relationship to what is happening with your chemotherapy regimen. With permission of your oncologist, any of these can be used for wrinkling that occurs with muscle movement.

During some active chemotherapy regimens, cell multiplication may be slowed down; therefore, it is possible that fillers that build collagen might be less effective, as they depend on fibroblast activity. I would not choose Sculptra at this time and would realize that if using Radiesse, it would work as an initial filler but might not do as well to build collagen. However, the hyaluronic acid fillers such as Restylane, Juvederm, Perlane, and Belatero should function as they would without chemo. These would be my top choices at this time.

Mrs. S, I hope that this helped answer your question and that you can feel better by being able to put your best face forward.  All the best for a long and healthy future.

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