What unexpected consequences do new anti-obesity drugs have in dermatology?

Nora Ephron said, "Everything in my closet looks good on me... except my body." Today, the popular writer and screenwriter would be surprised by the efficacy and safety of these new drugs . It's true that side effects are described, but as a doctor, I don't trust a treatment that doesn't have any side effects. The key is not to trivialize the use of these drugs and to use them under appropriate medical supervision.

In our clinics at the International Dermatology Clinic and the Ruber International Hospital, we have seen that the increasing use of these medications has changed the type of aesthetic consultations we receive: there is currently a greater demand for firming treatments and those that improve the quality of skin on the body and face.

One of the most visible side effects of rapid weight loss is what has been popularly called "Ozempic face," due to the loss of subcutaneous fat that affects the facial area over time. Interestingly, what we're seeing now is that these patients aren't asking for the recovery of lost volume but rather for improvements in sagging skin , that is, a tightened effect. This is an example of the so-called "filler fatigue," which we discussed in a previous article due to the overuse of these products.

How cosmetic dermatology can help

Weight loss with GLP-1 can have visible effects on the skin of the face, neck, abdomen, arms, or thighs. By reducing adipose tissue, especially in people over 40 or with a genetic predisposition, the skin may show signs of sagging, loss of elasticity, and uneven texture .

The techniques we use to improve these side effects are 4:

• LASER MIX : combination of regenerative lasers (including the Ultraclear cold laser ) so that the patient produces their own hyaluronic acid, collagen and elastin .
• Collagen biostimulators (such as calcium hydroxyapatite ) to improve skin density and firmness .
• Non-invasive tightening technologies , such as microfocused ultrasound (Ultraformer, Ultherapy)
• Muscle stimulators to tone specific areas and prevent muscle loss ( EMFACE for the face and EMSCULPT for abs, glutes and arms).

Furthermore, it is important to support the patient throughout the weight loss process , emphasizing the importance of changing dietary habits and maintaining muscle mass.

What new anti-obesity drugs are on the horizon?

The future is promising. Oral formulations , monthly injectables, and molecules with triple hormonal action (such as retatrutide ) are being developed. Furthermore, one of the problems observed with weight loss is that it is sometimes accompanied by a loss of muscle mass that is difficult to regain. Some of the new drugs coming onto the market appear to preserve muscle mass , which is excellent news from a medical and aesthetic perspective.

In addition to weight loss, these drugs are being investigated for their anti-inflammatory and cardioprotective benefits . Therefore, it seems likely that in the near future, these drugs may be included in wellness and healthy longevity protocols.

Skin diseases that worsen with being overweight

On the other hand, these drugs can improve many skin conditions that worsen with excess weight, such as acanthosis nigricans (thickening and darkening of skin folds), psoriasis, hidradenitis suppurativa , fungal and bacterial infections in skin folds, stretch marks, and lymphedema. Furthermore, obesity impairs healing. Therefore, in dermatology, weight control is key as part of the comprehensive treatment of many skin conditions, not just at a cosmetic level.

Conclusion

The widespread use of GLP-1 medications is influencing our patients' aesthetic demands : they are requesting fewer fillers and seeking to improve sagging skin. Furthermore, all scientific data suggests that new anti-obesity medications will occupy an important place in comprehensive medical-aesthetic programs and healthy longevity protocols . Finally, these drugs will help improve many skin conditions that worsen with excess weight. The prudent and rigorous use of these drugs will help improve our patients' quality of life .