Information on Safe Herbal Supplements – is their use safe before and after the surgery?

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How safe are herbal supplements before Dermabrasion?

Many herbal remedies and herbal supplements possess significant pharmacological reactions. Plastic surgeons remain unaware of the herbal remedies that their patients are using because of general tendencies of patients to avoid telling them during the consultation. Indeed, few physicians question about the use of these herbal supplements, during the consultation that they offer before the surgery. But the use of these herbal supplements can have serious repercussions for the dermabrasion surgery as discussed below.

When patients are asked about the medications they are taking, many do not mention medicinal herbs because they assume that they are safe. What many unsuspecting patients don't know is that the natural herbs they are taking may cause serious complications during and after surgery. Most facial plastic surgeons question patients about the use of aspirin, but few or none question their patient about the use of certain herbal remedies they may be taking, like the use of feverfew, garlic, ginger, ginkgo, kava and or Asian ginseng. All these herbal remedies pose a threat of increasing the risk of bleeding during facial dermabrasion surgery. Even some of the herbal medications which themselves are thought not to cause bleeding are likely to be adulterated with synthetic agents which may result in increased bleeding.

Natural herbal supplements are supposed to help boost our immune systems, give us more energy and make us generally healthier. However, many of these "harmless" supplements could cause dangerous side effects during plastic surgery, as confirmed by a study reported in Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

In a recent study carried out by the ASPS, it was found that people often forget to mention about these herbal supplements to their surgeons. But in the light of the known effects of some herbs on bleeding, it is essential for any one considering dermabrasion surgery to tell their surgeon about the herbal supplements they have been using. The most popular herbal supplements that are commonly used and need to be mentioned to the surgeon are described below.

Commonly Used herbal supplements

According to a survey, the herbal supplements - chondroitin (18 percent), ephedra (18 percent), echinacea (14 percent) and glucosamine (10 percent) account for much of the total intake of herbal supplements. It has also been confirmed that it was very common for people to take more than one herbal supplement.

Herbal supplements and their use

Chondroitin is often used to treat osteoarthritis. People using chondroitin may suffer from bleeding complications during surgery, particularly when used in combination with doctor-prescribed blood-thinning medications.

Ephedra is known to promote weight loss, increase energy and treat respiratory tract conditions such as asthma and bronchitis. This agent has been banned by the U.S. Food and Drug Administration (FDA) because it can raise blood pressure, heart rate and metabolic rate, ultimately causing heart attacks, heart arrhythmia, stroke and even death.

Echinacea is often used for the prevention and treatment of viral, bacterial and fungal infections, as well as chronic wounds, ulcers and arthritis. However, it can trigger immunosuppression, causing poor wound healing and infection.

Glucosamine, often offered in conjunction with chondroitin, contains chemical elements that mimic human insulin, and may artificially cause hypoglycemia during surgery.

Other herbal remedies which are very common

Feverfew, which is used for migraine, must be avoided in patients using Sodium, Warfarin or other anticoagulants. Since the abrupt withdrawal of it can result in serious withdrawal symptoms, it is essential for people to mention its use during the consultation so that it can be withdrawn with a tapering dose.

People use garlic for a range of complaints ranging from simple coughs and colds to chronic bronchitis, mild hypertension, hyperlipidema and liver dysfunction. The effect of garlic affecting blood platelet aggregation is well documented. Prolonged use may result in increased bleeding or spontaneous hemorrhage caused due to increased clotting time. Its use should be discontinued before any surgery. Similarly, other herbal medicines in this category such as ginger for digestive problems, gingko for vertigo and Alzheimer disease, and use of Asian ginseng for mental and physical fatigue, should be discontinued for their possible adverse effect on platelet function.

The prolong use of the herbal supplement Kava, used as a tranquilizing agent in herbal tea, can result in dermatopathical conditions due to presence of pigments in it which may adversely affect the skin resurfacing therapy done by the cosmetic surgeon.

The use of St John’s Wort for depression or sleep disorders should be discontinued due to the increased risk of a photosensitive reaction. Use of retinoids, such as tretinoin, requires caution with the use of St John’s wort because of the possibility of photoxic affects.

Many phytoestrogen containing herbs like licorice, black cohosh, dong qui, alfalfa etc., if used in conjunction with estrogen replacement therapy, may result in serious side effects. Any doctors recommending estrogen therapy to their patients have to keep this in mind.

Herbal supplements helpful for surgery

But not all the herbal medicines have adverse effects on surgery. Aloe vera gel is an important cosmetic product which can help in wound healing after the dermabrasion surgery.

Aloe decreases surgical recovery time, according to a report in the Journal of Dermatologic Surgery and Oncology. Eighteen acne patients underwent facial dermabrasion surgery, in which lesions were scraped away. Dressings were applied to their faces, with half of each person's face receiving the standard dressing coated with surgical gel, and the other half with aloe added to this dressing. The half of the face treated with aloe healed approximately 72 hours faster than the other side.

The aloe vera gel is known to stimulate cell growth in monolayers of wounds. It is also known to augment wound healing due to contraction of wounds.

Though aloe vera herbal supplements help the patient after surgery, you need to exercise caution as there are substandard products claiming to contain aloe vera. Herbal supplements and other alternative health products are not held to manufacturing standards and the quality of products and their ingredients from different sources can be quite variable. Make sure to ask your doctor about using aloe vera and follow their advice.

The conclusion is that any herbal supplements that the patients are taking before and after the surgery need to be mentioned to the surgeon and taken only with his/her consultation.

Best luck with the dermabrasion surgery!!

Edmund D Azevedo, Gregory Boger, “Herbal Therapy- Every facial plastic surgeon must know”, Arch Facial Plastic Surgery, 2003, Apr-June, Vol 3,

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