CHICAGO — With the soaring use of GLP-1 receptor agonists (RAs), popular terms for potential negative effects associated with treatment, such as “Ozempic face,” have been coursing through social media, feeding stigma and confusion for patients.
Addressing this issue, researchers presented patient survey data on how GLP-1s affect the skin to bridge the gap between anecdotal conversations and reported aesthetic outcomes at the American Society for Dermatologic Surgery (ASDS) Annual Meeting.
Adverse and Beneficial Effects
They found that while patients experience improvements in conditions such as psoriasis, acne, and eczema after weight loss with GLP-1s, hair shedding, skin laxity, and facial volume may worsen.
The survey included 1226 people prescribed weight-loss medications, including GLP-1s, through a national telemedicine platform that provided evidence-based obesity care to employers and health systems, said Eryn Patin, BS, a clinical research fellow in the Division of Dermatology at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, both in Boston. Participants were asked about dermatologic changes and aesthetic concerns after initiating therapy.
“Dermatologic effects, particularly changes in hair and nails, were reported,” Patin said at the meeting. Patients were also asked about changes in preexisting dermatologic conditions, such as psoriasis and alopecia. Outcomes were stratified by percentage weight reduction since treatment initiation to evaluate trends across weight loss categories.
Generally, reported dermatologic effects, both adverse and beneficial, increased linearly with the percentage of weight loss with higher weight loss associated with greater frequency of reported change, co-author Saroja Rao, BS, a medical student at Wake Forest School of Medicine, Winston-Salem, North Carolina, said in the presentation.
Hair Loss, Brittle Nails Got Worse
“Preexisting inflammatory conditions and hormonally driven dermatoses often improved with the use of at least one GLP-1 agonist while aesthetic concerns, such as hair loss and brittle nails, developed or worsened with the use of at least one GLP-1,” she said.
Their data showed a larger effect with higher weight-loss percentages. For example, among those who lost at least 20% of body weight, “71.7% noted skin sagging,” Rao said. “And 50.1% reported decreased facial volume.” Among those who lost < 10% of their body weight, however, 15% experienced skin sagging and 12.6% reported decreased facial volume.
Most Reported Benefits
The proportion of participants with skin diseases who reported disease-specific improvements after starting GLP-1s was highest among those with hidradenitis suppurativa (86.7% reported improvement), followed by acanthosis nigricans (75%), psoriasis (46.8%), acne (41.5%), hirsutism (28.6%), eczema (26.65%), seborrheic dermatitis (25%), and skin tags (24.6%).
These results, Rao said, “reinforce the importance of dermatology in obesity care.”
In a separate study, healthcare providers were surveyed about their patients’ aesthetic reports after weight loss with GLP-1s. The findings were presented at the meeting by Joely Kaufman, MD, a dermatologist who practices in Coral Gables, Florida.
An electronic survey was sent to healthcare providers in the US who have extensive experience treating patients for aesthetic concerns following treatment with GLP-1 agonists, she said. They included dermatologists, plastic surgeons, other physicians, and nurses/physician associates (average years in practice, 14.4 years).
“These providers agreed that multiple areas were affected by the GLP-1 agonist treatment,” and the primary, most common area affected was midface volume loss, Kaufman said. “Skin laxity, increases in facial wrinkles and folds, and jowling also were very common complaints.”
Most Providers Start With Hyaluronic Acid Dermal Fillers
Healthcare providers (n = 406) were also asked about the main nonsurgical modalities they use to address facial appearance after GLP-1-related weight loss.
The most common modality used, reported by 81% of the providers, was hyaluronic acid dermal fillers, followed by neurotoxins (69%), laser skin resurfacing (37%), cosmeceuticals/professional grade skin care (35%), and microneedling (33%).
About half of the patients (49%) who received GLP-1 treatment received multimodal aesthetic care, according to survey results.
Dermatologists’ role in addressing the effects of weight-loss drugs “is ever evolving,” Kaufman said, “as the explosion in GLP use is so recent, we are all learning on this path together,” she told Medscape Medical News.
Widespread use if reflected in the results of a KFF poll, reported on November 14, which found that overall, 1 in 5 (18%) adults say they have ever used a GLP-1 agonist drug either to lose weight or to treat a chronic condition. That includes 12% who say they are currently using them, which is an increase of 6% from May 2024.
Kaufman said the aesthetic specialists surveyed by her team agreed that “when evaluating these weight loss patients, the midface region seems to be the most affected and the first area” they treat with fillers.
“We will continue to evolve our thinking of how to approach the facial changes we see with GLP-1 use,” she said, adding that more questions need to be answered, such as, “Is this solely due to the weight loss? Or are we looking at other pathophysiologic mechanisms of action related to the fat cells?”
Patin and Rao reported no relevant financial relationships. One of their coauthors is a consultant for Allergan/AbbVie, L’Oreal, and ZO Skin Health. Funding source was not provided. The provider survey study was funded by Allergan. Kaufman is an investigator/researcher for AbbVie, Croma, Evolus, Galderma, Jetema Revance and Teoxane and is on the speakers bureau for Galderma.
Marcia Frellick is a Chicago-based healthcare journalist and a regular contributor to Medscape Medical News.
