Viewpoint Highlights



JAMA Dermatology Viewpoint Highlight



When Is “Too Early” to Start Cosmetic Procedures? Heather K. Hamilton, M.D., and Kenneth A. Arndt, M.D., both of SkinCare Physicians, Chestnut Hill, Mass., write: “‘Is it too early?’ is often asked when use of an appearance-enhancing procedure is considered, such as neuromodulators [injections that block impulses to small facial muscles], fillers, and light or laser treatments. Our feeling is that there is rarely ‘too early.’”


“If the action of the muscles of facial expression is diminished, the lines on the face that are interpreted as aging, tiredness or anger will simply not form. Initiating regular treatment with a neuromodulator in an individual’s 20s or 30s will have a dramatic effect on the appearance of the face as seen in the person’s 40s or 50s. There will be few, if any, lines of facial expression present.”


“Similar to our advocacy for the early use of other strategies to avoid or diminish the evolution of age-related changes such as sunscreens and topical retinoids, the initiation of conservative and thoughtful use of neuromodulators, fillers, and noninvasive energy-based treatments, alone or in combination, will keep patients looking young and their skin looking healthier. So there really is rarely a time that is too early. Perhaps the better question is, ‘When is it too late?’”

(JAMA Dermatol. Published September 18, 2013. doi:10.1001/jamadermatol.2013.5399. Available pre-embargo to the media at


Editor’s Note: An author reports a conflict of interest disclosure. Please see the articles for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.


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