Aesthetic Dermatology Update

Wedding dermatology


Planning a wedding doesn’t just involve decisions on venues, vows, guests, food, and décor, but also on the betrothed couple’s appearance. Memories and photographs from this day last a lifetime, so it is understandable that people may want to and feel pressured to look their best on this important day – which along with the pressures of planning a wedding, can lead to unnecessary stress, increased cortisol, and unexpected acne and other skin issues.


Because of a complete absence of wedding skin recommendations in the dermatology literature, Winklemann R et al. recently published a paper titled “Wedding Dermatology: A proposed timeline to optimize skin clearance and the avoidance of a true dermatologic emergency” (SKIN The Journal of Cutaneous Medicine 2019 Mar;3[2]:159-60). He focused on acne, using the American Academy of Dermatology acne treatment guidelines and expert opinion, they point out that other than intralesional corticosteroids (which take 0-14 days to have an effect), the majority of acne treatments require at least 3-12 months to achieve clearance or improvement.

Timeline for treatment of acne before the big day

This proposed treatment timeline makes sense given that skin cell turnover on the face takes about 6-8 weeks; therefore, it may take that long for acne lesions to resolve or for treatment to have an effect.

Besides acne treatment, cosmetic treatments also have varying healing times and may require multiple sessions with time in between treatments for optimal results. For instance, treatment of photoaging with intense pulsed light or nonablative fractionated resurfacing may require three to six treatments, typically spaced 1 month apart.

Dr. Naissan O. Wesley, a dermatologist who practices in Beverly Hills, Calif.

Dr. Naissan O. Wesley

Botulinum toxin treatments may take up to 2 weeks to kick in fully, then last 3-4 months. While the lead time for botulinum toxin to kick in is relatively short, I advise people not to get their first botulinum toxin 2 weeks before their wedding. Sometimes, having this treatment 4-6 weeks prior to the wedding date provides enough time for botulinum toxin to kick in – and to start wearing off to the point that the patient has the desired cosmetic effect, but still has some movement for the desired emotional facial expressions on the wedding day. Some patients also may require touch-ups, optimally at the 2-week window, once the botulinum toxin effect has fully kicked in.

With any injectable, there may be bruising and swelling that can take a week or so to heal, even when the bruises are treated with pulse dye laser used to make bruises resolve more quickly. Even a facial may result in blemishes that take a few days to 1-2 weeks to heal, especially with extractions. As such, a facial, especially a hydrafacial, may be beneficial before one’s wedding, but I would recommend having them done at least once or twice to assess an individual’s recovery time (if any) prior to the actual wedding date.

Dr. Lily Talakoub, McLean (Va.) Dermatology and Skin Care Center

Dr. Lily Talakoub

Treatment needs will vary considerably depending on the patient’s baseline skin health. As dermatologists, our patients depend greatly on us to help them look and feel their best, especially during a time when they are about to embark on a new journey like marriage. Patients need to be given realistic treatment options and time frames to achieve their goals. Whether the goal is treating acne or acne scars, starting or fine-tuning cosmetic treatments, or deciding on a skin-care regimen, the bottom line is making an appointment with the dermatologist early – 6-12 months in advance, if possible – to figure out the right plan.

Dr. Wesley and Dr. Talakoub are co-contributors to this column. Dr. Wesley practices dermatology in Beverly Hills, Calif. Dr. Talakoub is in private practice in McLean, Va. This month’s column is by Dr. Wesley. Write to them at They had no relevant disclosures.

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