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Hannah Khymych
What happens at the doctor’s office has a way of influencing the beauty industry—and of all the forces that have influenced aesthetic medicine over the last five years, few have been as insanely influential as GLP-1 medications like Ozempic. Cue the skin care.
Brands are starting to market, even formulate, skin care especially for GLP-1 users. Clinique slyly nodded at “Ozempic face”—a gaunt sunken look— in an Instagram post this spring about “loss of facial volume from rapid weight loss,” alongside claims that their Smart Clinical Repair Lifting Face + Neck Cream will visibly lift and smooth skin on the face and neck. And two plastic surgeon-owned brands recently launched formulas specifically for GLP-1 users— Dr. Few DermaReverse was created by Julius Few, MD, a board-certified plastic surgeon in Chicago and Beverly Hills and Image Skincare Vol.U.Lift by Marc Ronert, MD, a, board-certified plastic surgeon in Florida. SkinCeuticals just dropped the A.G.E. Interrupter Ultra Serum, which addresses skin laxity and volume loss for Ozempic patients (more on that in a minute). Meanwhile, PR agencies are sending beauty editors like us pitches for “Ozempic face” facials and shampoos for GLP-1 users. (Studies have shown that semaglutide use may be associated with hair loss.) So… do you need a skin-care overhaul when you start taking a GLP-1 like Ozempic, Wegovy, or Mounjaro?
It’s not out of the realm of possibility. Doctors are hearing firsthand from patients that going on GLP-1s seems to change their skin—and they’re seeing it with their own eyes, too. While operating on GLP-1 patients (who might need body lifts or tummy tucks following rapid weight loss), plastic surgeons are noticing a marked difference in their skin quality, with collagen and elastin fibers that can be thinner and weaker than expected. On a more surface level, these skin changes might look like a general aging of the skin, that’s not always full-on Ozempic face: “People who are on GLP-1s have got new fine lines and wrinkles, brown spots, textural changes and roughness, and just have lost that glow,” says Ava Shamban, MD, a board-certified dermatologist in Los Angeles. In one study sponsored by Galderma, 48% of GLP-1 patients reported significant facial changes within three to six months of going on a GLP-1, including more wrinkles, duller skin, an overall tired appearance, and loose or sagging skin. We don’t know exactly what’s causing these signs of aging to creep up so quickly, but the ways in which GLP-1s may (or may not) impact the skin is an emerging field of research. There is some evidence that GLP-1s might decrease collagen and moisture levels in the skin, for example, by “turning off” adipose-derived stem cells which, would otherwise stimulate fibroblasts in the skin to produce collagen, elastin, and hyaluronic acid, Steven Dayan, MD, a board-certified plastic surgeon in Chicago who has researched the impact of GLP-1s on skin, has told Allure. This could be because GLP-1 patients lose some of the fat where adipose-derived stem cells reside: It’s called dermal white adipose tissue, and it comprises “little niblets of fat within the dermis—it’s previously underappreciated fat,” explains Saami Khalifian, MD, a board-certified dermatologist in Encinitas, California. When you lose this fat, you’re also losing a “reservoir of cell signaling” that’s supposed to help keep skin looking younger and firmer. This, alongside decreased cell support from nutrition, can compromise skin, he hypothesizes.
Brands are starting to market, even formulate, skin care specifically for GLP-1 users.
What we do know for sure, says Dr. Shamban, is that rapid weight loss and lack of nutrition can affect skin. As Dr. Shamban explains it, if your appetite is suppressed and you’re eating less protein and getting fewer vitamins, that lack of nutrients could potentially make skin duller and might impact collagen, our body’s structural protein that keeps skin looking young and firm. One study, published in the Journal of Biomedical Science and Engineering earlier this year, explains that “lifestyle changes that promote gradual weight loss tend to preserve skin integrity better, albeit with less dramatic weight reduction outcomes.” If you plan to go on a GLP-1, the study concludes, “ensuring supplementation, combining semaglutide with a nutrient-rich diet, can help preserve skin elasticity and overall health during weight loss. However, some patients may still experience a reduction in overall food intake, potentially leading to deficiencies in essential nutrients such as vitamin D, B12, and protein, all of which are crucial for maintaining skin health and elasticity.”
“If you look closely at those with Ozempic face, it’s not just that they’re hollowed out. It’s also that their skin is lackluster—it lacks radiance, it lacks hydration, it just seems like a desert,” says Dr. Khalifian. “Patients may be drinking plenty of water, but you wouldn’t know that from their skin quality.” Dr. Khalifian says physicians see an “absolute skin quality decrease” in GLP-1 patients, but it doesn’t necessarily happen right away. “Once they start really accelerating their weight loss, that’s when we start to see a decline in skin quality.”
No cream is going to fix jowling or significant sagging—only a scalpel can do that—but the right skin care can make a difference in your skin’s quality, firmness, and elasticity. So it makes sense to look at the skin-care products you’re using before you even start taking a GLP-1, says Dr. Shamban. “I do feel that people need to overhaul their skin-care routines and use specific ingredients. This is the time to really throw the kitchen sink at your skin.”
“People on GLP-1s have new fine lines and wrinkles, brown spots, roughness, and just have lost that glow.”
As long as that kitchen sink is full of solid skin-care ingredients, backed by actual data showing they can improve things like dullness (which is pretty easy to do) and firmness, a more difficult task that Dr. Shamban says is best left to the holiest of holy skin-care ingredients: retinoids. “We know from 30 years of research that that’s what works,” Dr. Shamban says. Melissa Doft, MD, a board-certified plastic surgeon in New York City, calls these vitamin A derivatives “the strongest ingredient that we have available” in the skin-care world. “Retinol (one type of retinoid) is going to pump up the skin and build up collagen,” she explains. Dr. Doft also recommends plumping ingredients like peptides and hyaluronic acid to ”make the skin look a little bit more alive.”
Alongside peptides, retinol is also an active ingredient in Dr. Few’s new serum, DermaReverse, which he tested specifically on GLP-1 users in a double-blind, peer-reviewed, six-week long study on seven patients, which was published in the Aesthetic Surgery Journal. The results showed significant improvement, versus the placebo, in hydration, pigmentation, wrinkles, and texture. “Listen, I’m a plastic surgeon. I don’t expect a cream to lift somebody’s face,” says Dr. Few. “But what we’ve devised is something that helps reverse these significant effects (of GLP-1s on) the skin that are so negative, while also helping restore the integrity of the skin.” Dr. Few says he was surprised to find that the serum also helped reduce redness. “One of the things that seems to happen with the GLP-1 subjects is they have a degree of redness,” explains Dr. Few, who has had an up-close-and-personal look at GLP-1 patients’ skin over the last few years, while performing face lifts. He’s seen changes in some GLP-1 patients’ skin, which he’s likened to an “old, worn-out rubber band”—the skin does not bounce back like you’d expect, he explains (this could be because of a loss of collagen and elastin). Even for those who lose minimal weight on the drug, he’s noticed a loss of elasticity.
Dr. Few got the idea to make and test skin care on GLP-1 users specifically based on the things he was seeing and hearing from patients who were on these medications. He began “combing through pretty much all the available literature on GLP-1s,” looking for “a plausible kind of process or pathway” for how GLP-1 medications could influence the skin. Some research suggests that GLP-1s might cause a thinning of the skin and “interrupt signals in the skin that are critical to skin cell turnover, collagen production, and elastin production,” he explains. It could explain why some patients notice a hollow, saggy, and/or dull look when they go on a GLP-1.
Dr. Shamban points to the “better-penetrating form of retinol” in Dr. Few DermaReverse as a standout ingredient, saying it looks like a “really nice formula” with potent antioxidants and peptides. “It would work for anybody,” she says, but thinks the $300 serum could be particularly appealing for some GLP-1 users: “Now that they are on a healthier path, they’re going to look for quality in everything they do.”
“This is the time to really throw the kitchen sink at your skin.”
The gentle retinol alternative bakuchiol is in Image Skincare Vol.U.Lift, alongside an amino acid called ornithine, which may help plump skin, says cosmetic chemist Kelly Dobos. Bakuchiol functions similar to a retinol without the potential for irritation, “increasing cell turnover thereby stimulating collagen production and diminishing fine lines, wrinkles, and skin laxity,” Sejal Shah, MD, a board-certified dermatologist in New York City, previously told Allure.
As for SkinCeuticals’ new offering, the A.G.E. Interruptor Ultra Serum wasn’t designed specifically for GLP-1 patients, but it was tested on them, says Stephen Lynch, head of Skincare Scientific Valorization for North America Research & Innovation at L’Oréal Groupe. (L’Oréal owns SkinCeuticals.) In a 12-week clinical trial of 76 subjects, “we observed visible tightening across four key facial zones—jawline, neck, cheek, and forehead—with the use of the serum alone, with up to an 18% improvement among top responders,” says Lynch. The serum is powered by a combination of proxylane, a molecule derived from birchwood, and wild fruit flavonoids, which Lynch explains are “known for their antioxidant and anti-glycation benefits.” Proxylane “has been shown in-vitro to help restore structural integrity and firmness by supporting dermal collagen.”
Alastin Restorative Skin Complex is a peptide-based product for firming, and the brand is currently conducting a study of its effects on people taking GLP-1s. “There’s an idea that these peptides can support that cell signaling, from the fat to the skin, that’s missing (in GLP-1 patients),” says Dr. Khalifian (who is a consultant for Alastin and working with them on the study). “It’s funny because peptides are the problem and peptides might also be the solution: The GLP-1 peptide is causing fat loss, and a different peptide—in this product—seems to have the solution.”
If a patient has visibly stretched-out skin, though, “there’s no skin care in the world that’s going to be able to fix that,” says Dr. Shamban. In-office treatments like Sofwave can help, but surgery is really the best option, she says. Dr. Doft agrees: “GLP-1 patients’ skin acts like that of an aging patient. Both groups of people lose fat in their cheeks, have laxity in their skin, lose elasticity and collagen, and have excess skin,” she says. And the fix for that is a facelift. “Sometimes when I’m doing a facelift, I’m taking out inches of skin (to correct sagging). How are you going to do that with a topical? That seems like a lot to ask from your skin care.”
From her plastic surgeon perspective, Dr. Doft explains the role of skin care thusly: If you take care of your skin today, it’ll be that much better for potential surgeries, like a face lift, down the road. “It’s like if you have a suit from Zara and a suit from Loro Piana. You can have each beautifully tailored, but the Loro Piana suit is going to look so much better, because the fabric is so much better,” she says. So, in the interest of preserving the skin’s quality as much as possible, she recommends “excellent skin care” as well as in-office treatments to help thicken the skin when patients go on a GLP-1—usually, that’s a combination of microneedling with radiofrequency, and CO2 laser or Fraxel. The cost of thickening skin isn’t negligible: Microneedling with radiofrequency costs $1,250 per session at her practice (patients tend to get three to four sessions spaced one month apart, with a booster at six months), CO2 laser or Fraxel costs $3,000 to $5,000 yearly, and a bottle of Dr. Doft’s retinol-, peptide-, and epidermal growth factor-powered serum Strategy by Doft New York is $300. When Dr. Shamban’s patients want to restore that bounce and youthful volume after losing weight on a GLP-1, she makes sure they’re on a prescription retinoid and also starts them on a program of energy treatments for skin tightening. Dr. Shamban likes to layer Sofwave with Fraxel IPL. “We try to do something every month for about a year to get (patients) back to where they should be,” she says. (Allure has previously reported that Sofwave typically costs about $7,000 per treatment and laser resurfacing with IPL can run $500 to $1,500 per session.)
“To me, the closest parallel is the emergence of menopause skin care.”
While Dobos thinks we’ll definitely see more at-home products targeted to GLP-1 users—she says “momentum is growing” in the beauty industry—she also wants to see more focused research and clinical studies. “To me, the closest parallel is the emergence of menopause skin care,” she shares. “As awareness grew around hormonal skin changes, brands began to formulate and market products for perimenopausal and menopausal women, focusing on dryness and loss of elasticity. But what’s different with GLP-1 users is that the skin changes are often more rapid and dramatic and there’s a broader demographic—not just older women—using these medications.”
Sometimes the marketing moves faster than the science. In Dobos’ opinion as a chemist, “we’re definitely not there yet” when it comes to skin care targeting elastin—and a lack of that elastin may be the reason behind that stretched-out-rubber-band texture some GLP-1 patients experience when it comes to their skin. Elastin is the protein that helps your skin snap back, and if the preliminary research is right, GLP-1 medication may be “turning off” elastin production signals. The elastin-building process is even harder to trigger than collagen, says Dobos, but one ingredient that studies show may have an impact is copper peptides, so Dobos predicts these will pop up in future skin-care formulas for GLP-1 users. Copper peptides are “signaling molecules” that have been shown to target the fibroblasts that produce collagen and elastin, Dobos explains. But she also notes that more research is needed to identify the ingredients that best align with the needs of GLP-1 users.
“I think this idea of talking about skin care and how going on a GLP-1 can age the skin faster is an interesting and important message,” says Dr. Doft. “It’s something we should be talking and educating about.”
Photographer: Hannah Khymych
Sittings Editors: Tchesmeni Leonard, Kat Thomas, Tascha Berkowitz
Set Design: Jenny Correa
Model: Rhenny Alade
Read more about GLP-1s:
Originally Appeared on Allure
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