A Beverly Hills Dermatologist talks Chemo Skin Care
The #1 complaint listed in our FB group was post chemo/ menopausal skin care. Beverly Hills dermatologist, Michael Bontekoe, MS, PA-C, answered our questions.
The physical and emotional effects of breast cancer can take a toll on the skin. During and after treatments, people may notice their skin becoming dull, dry, rough and suffer a loss of facial volume. Chemotherapy kills the cancerous cells but it will also affect the healthy skin cells from growing and replenishing themselves. This is one of the reasons why hair falls out and nails become cracked and brittle.
For the average consumer, it can be confusing which skin care products to choose from. Most products found at the department stores rely on marketing tactics but lack clinical studies. Incorporating a scientific skin care regimen is important to repair some of the damage from breast cancer treatments. The products I recommend are considered “cosmeceuticals” because they’re cosmetic products with high levels of active ingredients and have been proven to improve the skin. Most cosmeceutical products are found through a dermatology or medical office. They contain antioxidants, peptides, retinols, growth factors or DNA repair enzymes.
In addition to at home skin care products, there are minimal or no downtime dermatological procedures that can improve your appearance and self-confidence.
•Fraxel and Clear and Brilliant laser uses specific wavelengths of light to create microthermal columns into the skin. This will help resurface the skin to improve fine lines, abnormal pigmentation, scars and enlarged pores.
•Excel V laser is a vascular laser which helps reduce redness in the skin, shrinks broken capillaries and it helps even out the complexion in people with rosacea.
•Gel fillers, containing hyaluronic acid, can be injected into areas of the face to restore volume and plump wrinkles and folds. Many of these fillers can last 6 months up to 2 years in duration.
•Botox injections can relax the frown lines, crow’s feet and forehead lines. Botox lasts up to 4 months in length.
•Ultherapy and Thermage are popular devices used to help tighten or firm the skin of the face and neck. Ultherapy uses micro focused ultrasound and Thermage uses radiofrequency to stimulate collagen and elastin in the skin. It can be helpful for people who complain of crepey or saggy skin and don’t want to undergo surgery.
•Microneedling is a novel procedure which uses a pen or roller device containing sterile needles. When used over the skin the needles create thousands of microscopic channels into the skin. Once the channels heal, the body stimulates collagen creating improvements in texture and tone of the skin.
•Platelet Rich Plasma (PRP) is a new procedure being performed in dermatology. Previously used often in orthopedics for injured knees and backs, PRP can be added to various dermatology procedures to enhance results. A person’s own blood is drawn and spun in a centrifuge to isolate platelets and growth factors. The plasma of the blood is either injected into the skin or applied to the skin immediately after treatments, like Microneedling. New research has found PRP injections beneficial for hair thinning or alopecia.
Is laser hair removal the best way to deal with unwanted facial hair?
Laser hair removal is the most effective way of combating unwanted hair. At this time, people with brown and black hair are the best candidates for laser hair removal. Red, blonde or grey hair does not respond the best to laser. Prescription creams, like Vaniqa 3.9% cream, can help slow down the growth of unwanted hair but do not produce the results that laser can.
Does ingesting collagen powder actually help?
Collagen is a protein which binds tissues together. There are some studies that showed ingesting collagen supplements improved skin dryness, wrinkles and elasticity. However, these were small studies without quality control and some had conflicts of interest. In reality, the stomach acids break down collagen before they reach the skin so it’s unlikely a person would notice improvement.
What is the best treatment for mastectomy scars?
Scars tend to improve over the course of one year. If the scar is still unsightly there are treatments to help. Vascular lasers, like the Excel V laser, can decrease the scar’s redness. Fraxellaser can help improve the texture of the scar. If the scar has thickened becoming hypertrophic or keloid, injections of cortisone into the scar can flatten the scar over time. Topical scar gels containing silicone can also be used at home for 3-4 months to improve the appearance of mastectomy scars.
Although a woman may feel she’s aged one hundred years after breast cancer treatment, the hormone changes can leave her skin looking like she’s in puberty again. Any recommendations for acne prevention or treatment?
First, schedule an appointment with a dermatology office. Acne is the most common condition we treat on a daily basis. Everyone’s acne can be different so not one treatment is going to be effective for everyone. If acne is left untreated, it can lead to scarring which is more difficult and expensive to treat. There are topical prescription medications, like Retin-A, which can help acne and improve the signs of aging.
Lastly, if there was ONE THING you would recommend women do for their skin at home, talking the most bang for your buck, what would that be?
The answer is quite simple: Sunscreen. Using a sunscreen of at least SPF 30 every single day can help prevent the premature signs of aging like lines, wrinkles and brown spots. Sunscreen will also decrease the risk of skin cancer. I recommend using a sunscreen that contains a zinc oxide and reapplying every 80 minutes if outdoors.
Michael obtained his Master’s Degree in Medical Sciences from Central Michigan University and has completed multi-specialty medical training throughout the country including surgery at Cedars-Sinai Medical Center in Los Angeles. He has specialized in Dermatology for over 15 years and treats both medical and cosmetic dermatology patients. He has special areas of interest including treating the physiological and psychological impacts of acne, warts, pre-cancerous lesions and photoaging skin. He performs surgical procedures and also performs the latest injectable techniques using Botox and Dysport. Michael can be found at www.theroxburyinstitute.com
