New Beauty and The New York Times recently posted articles on skin care after weight loss from GLP-1 agonists. Patients who have experienced significant weight loss are seeking skincare products and treatments to address their loose skin. Dermatologists are reporting an increase in patients with these concerns, and influencers on TikTok and Instagram are pushing a variety of products geared toward this segment of consumers.
For expert tips in treating loose skin from weight loss, I interviewed Heather Woolery-Lloyd, MD, FAAD, director of the Skin of Color Division for the University of Miami Department of Dermatology. Dr. Woolery-Lloyd is also board certified in lifestyle medicine.
How often are you asked by patients about caring for their skin after rapid weight loss from GLP-1 agonists? What are these patients’ most common complaints?
Patients who lose weight in general are usually often concerned about loose skin and skin laxity. This can be on the body but it can also be on the face and neck. The same is true with weight loss from GLP-1 agonists. Most of my patients who have lost weight with GLP-1 agonists have had gradual weight loss over months. In my experience skin laxity is a common complaint when people lose a large amount of weight, independent of how quickly it is lost.
How should a person’s skincare routine change after a significant weight loss?
Basic skincare recommendations (gentle cleansing, moisturizer, and sunscreen) after significant weight loss is not very different than before the weight loss. The main difference is that, if skin laxity is a concern, the patient might be more interested in products that may help with mild skin laxity and textural changes. Adding ingredients like retinoids and alpha hydroxy acids to the skincare routine may be helpful for textural changes in the skin.
What are some in-office procedures that these patients should consider?
Skin tightening procedures can be helpful for mild skin laxity. This includes energy-based devices like Ultherapy, Thermage, and Sofwave.
Are there any differences in the skin issues experienced by those who lost weight via GLP-1 agonists in comparison with other weight loss approaches?
I have not observed significant differences in the skin issues experienced by people who lose weight via GLP-1 agonists versus other weight loss approaches. When people lose large amounts of weight in general they complain of skin laxity. Weight loss can also be associated with hair thinning. I have had patients complain of thinning hair and hair loss after significant weight loss.
What approach do you recommend dermatologists take with patients who are either currently on or are considering using GLP-1 agonists?
I think that dermatologists should be proactive and explain that skin laxity can occur with weight loss especially when losing larger amounts of weight. If a patient experiences skin laxity, I think it’s helpful to discuss in-office procedures that can help. I also think it’s equally important to have realistic expectations of what these procedures can achieve. For patients with excessive skin laxity, surgery may be the best option.
How should dermatologists counsel their patients about skin care before, during, and after weight loss?
Gentle cleansers, moisturizers and sunscreen are the pillars of any skin care routine. Sometimes certain rashes can be more common in these patients. Candidal infections under the breast or the pannus are common and can be treated with topical antifungals.
What else should dermatology clinicians know about caring for skin after a significant weight loss?
Hair loss is common after significant weight loss. After doing appropriate lab tests and ruling out other causes, I have used supplements in my practice to help address this issue. It is also important that the patient has a well-balanced diet that contains sufficient protein and other nutrients.
Have any of your patients been duped by influencers online hawking products and treatments that claim to help the skin after weight loss?
I have not had any patients who reported being duped by influencers. However, it is common for patients to try many different products for their skin concerns before they come to see a dermatologist.
What are the psycho-social impacts of skin concerns after weight loss that you’ve seen in your patients?
Some patients are very frustrated with the skin laxity. They’re happy with their weight loss but are frustrated that now there’s a new problem that needs to be addressed. Some patients have mixed feelings about their weight loss because facial fat loss can make them look older.
What are some indicators that a patient with skin concerns after weight loss should be referred to a plastic surgeon?
Any excessive skin laxity should be referred to a plastic surgeon if the patient is interested in surgical interventions. Unrealistic expectations can lead to disappointment with in-office procedures. These skin tightening devices can be helpful for very mild skin laxity, but once the skin laxity becomes moderate to severe, a plastic surgery consultation is most helpful.
