The one thing I need to know before doing your lip injection
So the topic today is: The one thing I need to know before doing your lip filler injections with Juvederm or Restylane.
Have you ever had cold sores on the outside of your lips?
What is a cold sore? It is caused by the herpes simplex virus. I know now we’re all worried about some other virus right now – the coronavirus, but I still worry about an “older” virus. Cold sores are caused by the herpes simplex virus. There are 2 types and type 1 is the usual cause of the cold sores around the mouth. At least half of all adults are infected with herpes simplex virus type 1 which spreads easily from person to person. Once you have the infection, you have it permanently. The virus lies dormant inside the nerves causing no symptoms most of the time. But it can be woken up by triggers such as stress, sunburn, hormonal changes, exhaustion, fever – this is why they are sometimes called fever blisters, and any trauma around the area where the herpes simplex virus lives. An example of trauma would be needle trauma from lip injection procedure.
By knowing your history of cold sores and how easily you get them, we can have a plan of possibly pre-treating your risk of a flare up by having you take a prescription medication called acyclovir right before your lip procedure or even a few days before your procedure if you are really prone to cold sores. I have pills of acyclovir available in my office and you can take a tablet right before your procedure while numbing up those lips with topical numbing cream. Totally optional and we offer it for free. I joke with my patients when they try to chug down the pill of acyclovir while their lips are getting numb from my special formula numbing cream. When the water drips down the floor because you can’t feel your lips, I pretty much will say, “I see you have a drinking problem!”
I would also write you a prescription for acyclovir tablets to take at home to prevent the flare up.
On another note, cannulas for lip augmentation is something I also do if the risk of swelling and cold sores is severe.
The risk of flare ups with patients who have had previous coldsores is relatively low, but I think it may be 1 in 5 procedures and with pretreatment, perhaps we lower that risk to 1 in 20 procedures. So I would rather have a lower risk, because cold sores are unsightly and can lead sometimes to scars, and sometimes it can even push our lip filler off to the side.
The lip filler experience can be a bit of a roller coaster ride afterwards because of the swelling, and if we can eliminate the added aggravation of having a cold sore – that would be a good thing.
Also if you have a history of swelling a lot with hyaluronic acid fillers such as Juvederm and Restylane, it would be good for me to know too because we can consider an antihistamines or a prescription prednisone series of pills. Prednisone is a steroid which is like a big “off” switch for the body and part of what it can do is turn off the swelling mechanisms. So prednisone, antihistamine (like Zyrtec), and cannulas are options for patients with extreme risk of swelling and cold sores.
But in summary, I will ask before your filler appointment if you have a history of cold sores – mainly because it’s somewhat of a risk with lip fillers, but we can lessen that risk by being prepared. Come visit me for lip fillers in Modesto, CA.
