As of this summer, approximately one in eight Americans, or around 15 million people, have used Ozempic or other GLP-1 drugs, according to survey data from KFF, a nonprofit that provides information on health policy and polling. While many GLP-1 drugs are FDA-approved to treat type 2 diabetes and other health issues, the survey found that two in five Americans using the drug are doing so “off label” solely to lose weight.
GLP-1s like Ozempic, Wegovy and Mounjaro were approved by the FDA in 2017, 2021 and 2022, respectively, and in just a few short years have become commonplace in popular culture. According to data released in February by the Pew Research Center, about 75% of Americans are familiar with GLP-1s and more than half believe they are good options to lose weight for those with obesity or weight-related health conditions.
GLP-1 drugs have also garnered great press: It’s been reported they help reduce urges to gamble or drink alcohol, and can help with sleep apnea, kidney disease and even nail-biting, albeit some of this is still anecdotal. But when it comes to the skin, GLP-1s are gaining mostly negative attention, for causing what’s often called “Ozempic face.”
“Patients are losing volume in their face, and this can impart an aged appearance for two reasons,” said Dr. Brian Hibler, MD, a board-certified and Harvard-fellowship-trained medical and cosmetic dermatologist at Schweiger Dermatology Group in NYC. “First, it is youthful to have ‘baby fat,’ or plump, rounded cheeks, so when this volume is lost, the face appears flatter, and lines and folds can deepen. Secondly, when you lose volume in the face, you have residual loose skin. This redundant, lax skin results in everything sagging and worsening of lines and wrinkles.”
Many doctors Glossy spoke to for this story said the changes are permanent — or for as long as the lost weight is kept off. “Many of our patients were on these medications well before they went viral, so we have had years to witness their effects on the skin and underlying tissues,” said Jason Diamond, MD, FACS, a double board-certified facial plastic surgeon in Beverly Hills. “With any extreme [or] rapid weight loss, the skin doesn’t bounce back. … It’s just permanently stretched out, looser, less resilient, crepey and saggy.” However, this is not universal, he said, and age plays a large factor. “I haven’t seen it happen to every patient on these medications; it is case-specific and depends on many factors,” he said.
In an article published by Allure last month, surgeons report finding significant changes to the skin of GLP-1 users. One surgeon, Dr. Julius Few, MD, a board-certified plastic surgeon in Chicago and Beverly Hills, compared the skin of GLP-1 users to an “old, overused rubber band,” while Dr. Mark Mofid, MD, a board-certified facial plastic surgeon in California, likened it to the elastic waistband on a pair of stretched out underwear.
While evocative in their comparisons, their peers — both the ones Allure interviewed and the doctors Glossy spoke to for this article — don’t disagree.
Glossy spoke with Dr. Mofid, who, for 20 years, has been treating the effects of rapid weight loss on gastric bypass patients. “You never really know what something’s going to look like until you’ve gone through it,” he told Glossy. “Many patients will go through a fairly significant amount of weight loss and not really have much in the way of facial changes, [but] some people will go through this kind of weight loss and they look like they’ve aged 20 years.”
His previous weight loss patients, who may have lost half their body weight through a gastric bypass in less than a year, were good candidates for a facelift or body lift, he said. But those who have lost closer to 40 pounds through a GLP-1 can be best served by fillers or radiofrequency firming treatments in-office.
Dr. Umbareen Mahmood, MD, a board-certified plastic surgeon in New York City, agreed that the speed of weight loss is a key factor for side effects like sagging skin or hollow eyes. “The skin’s collagen and elastin fibers are unable to accommodate the sudden change,” she told Glossy. She recommends GLP-1 patients monitor nutrition, take a multivitamin and weight train for longevity.
“Topically, the use of at-home retinol, moisturizer, hyaluronic acid and sunblock is very important,” Dr. Mahmood added. “In office, they can begin collagen-stimulating treatments like radiofrequency microneedling.” She told Glossy that biostimulator injections like Sculptra, as well as muscle toning, sculpting and preserving treatments like Truflex and Emsculpt, are also helpful during a patient’s GLP-1 treatment.
“As the body sheds weight, it is typical to see changes not only in the body but also in one’s face, especially if the weight loss is significant,” said Dr. Elizabeth Sharp, MD, IFMCP, CEO and medical director of Health Meets Wellness (HMW), a concierge medical practice for holistic well-being.
She told Glossy that those taking a GLP-1 off-label to lose weight could be more at risk for side effects in the face. “If a patient is at a low BMI when starting the medication — so, likely a lower BMI than the medication is FDA approved for — it’s possible that weight could be lost in a more atypical fashion and would also be more noticeable in areas such as the face,” said Dr. Sharp.
Dr. Saami Khalifian, MD, a double board-certified dermatologist and Mohs micrographic surgeon at Som Aesthetics, has also noticed changes in the skin of patients at his Encinitas, California practice. He describes them as “hollowing in areas such as the anterior face, under-eye area and jowls, along with increased laxity in the neck, arms and abdomen.” He told Glossy that these changes can result in volume loss and decreased skin quality, which can contribute to a more aged appearance. He also relies on fillers, radiofrequency and biostimulators to rebound facial volume, either during or after GLP-1 treatment.
Similar sentiments were echoed in Glossy’s interviews, showing a white space for topical OTC treatment plans that are approachable in price for those without the budget to see a dermatologist for treatment, which could run hundreds to thousands of dollars depending on the aesthetics plan.
“Brands can better serve these consumers by focusing on solutions that enhance skin elasticity and firmness,” said Lindsay Cameron, health and wellness analyst at Mintel market research company. “There’s a promising opportunity for beauty and personal care brands to tackle issues like loose skin, premature aging and hair loss, which frequently accompany rapid weight loss, despite users’ nutritional and supplemental efforts.”
Hair loss is a trend noticed by Prequel skin-care founder Dr. Samantha Ellis, who posted a video to social media last week sharing that GLP-1 users she’s treated have shown that users are likely to have around six months of hair shedding and loss. To wit: The scalp category has been soaring over the past year.
To determine how GLP-1s could impact the skin-care space, we look to the changes seen in the nutrition space.
The GLP-1 drug category’s popularity over the past year has shifted the supplement space, first with offerings marketed as alternatives for GLP-1 drugs, and then, more recently, with supplements that support GLP-1 users’ unique needs.
For example, earlier this year, Walter Faulstroh, CEO and co-founder of Hum Nutrition, told Glossy that the company’s Best of Berberine supplement was one of its best-sellers after the company published a blog post about its benefits just as the ingredient was trending on social media. Berberine was touted across social media in 2023 as “Nature’s Ozempic” and the drug was in short supply.
Many other brands have since released or focused marketing on their berberine supplements. Other companies, like Hims & Hers, Noom and The Vitamin Shoppe, have created oral GLP-1 drugs. Earlier this month, Kourtney Kardashian’s Lemme joined the GLP-1 alternative rush with a new supplement capsule called GLP-1 Daily, which is marketed as an appetite and weight management supplement.
However, as GLP-1s are becoming more commonplace, supplements to support GLP-1 users have become their own category. Last month, Dr. Alexandra Sowa MD, a New York-based internist and expert on obesity and weight loss, launched a GLP-1 Support System, a combination of protein, fiber, and electrolyte drink and shake mixes to help patients experiencing side effects of GLP-1 drugs like nausea, dehydration and diminished gut health. The system, as well as individual offerings, are available DTC.
The packaged food industry has also responded: This spring, Nestle announced it would soon launch small frozen meals catered to GLP-1 users called Vital Pursuit. They’re set to be priced at around $4.99 per meal and to hit stores in the fourth quarter of this year.
These notable responses, which have shifted from GLP-1 alternatives to complementary offerings, may serve as a preview of how the skin-care and body-care markets will respond in the coming quarters. While firming and plumping has long been a skin- and body-care category, normally focused on treating sagging undereye skin or cellulite with ingredients like hyaluronic acid or caffeine, a topical market for weight loss or GLP-1s has yet to spring up. However, not all doctors Glossy spoke to see this being an easy category for a skin-care brand to crack.
“It’s important to note that, with increased skin laxity and hollowing, topicals alone won’t suffice in restoring structure and volume. I recommend medical-grade skin care for hydration and maintenance,” said Dr. Khalifian. “Patients using GLP-1 drugs will need products that focus on improving skin quality and hydration, as well as tools that promote skin tightening. Given the hollowing and laxity associated with rapid weight loss, collagen- and elastin-stimulating products, like those containing retinoids, peptides and antioxidants, will be essential.”
Dr. Hibler agreed: “A topical skin-care routine can only get you so far,” he told Glossy. “We need better topical ingredients that restore elastin and collagen in the skin, which is essentially the scaffolding keeping the skin tight and lifted with a youthful bounce. … There are some retinoid alternatives that also may provide a little improvement, but ultimately, none of the topicals match what we are able to accomplish with lasers, injectables and energy-based devices.”
That is, not yet. As more and more Americans experiment with GLP-1s, the more their needs will impact the industry.
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