As Ozempic gains popularity for weight loss, concerns about its impact on skin have emerged, with “Ozempic Face” becoming a common issue. Gregory Keller, MD, FACS, a UCLA clinical professor and expert in facial plastic surgery, addresses these effects, highlighting the facial deflation and aging seen in many patients using Semaglutide.

Gregory Keller, MD, FACS: Semaglutides are medications FDA-approved for type 2 diabetes. As “incretin mimetics,” they encourage the pancreas to release insulin. One of the side effects of using this drug for its intended purpose of lowering glucose was rapid weight loss, which caused the skin of the face (and body) to lose its turgor and sag. Since the face cannot be hidden with clothing, the facial sagging became the most apparent, leading to the side effect being known as “Ozempic Face.”

PSP: Can you explain the mechanisms behind the development of “Ozempic Face” and why it leads to facial deflation and aging?

Keller: Peptides are targeted signaling biologicals. GLP-1, a peptide hormone secreted in the gut and other areas, causes the release of serotonin from the hypothalamus, which appears to induce a sensation of ‘fullness,’ diminish appetite, lower blood glucose, and increase insulin sensitivity. This ultimately seems to result in weight loss, which is associated with the loss of fat that supports and fills out the skin, as well as a loss of skin elasticity and collagen.

PSP: How does the loss of elasticity and the appearance of crepey skin correlate with the use of weight loss drugs like Ozempic?

Keller: Weight loss drugs such as Ozempic are associated with a ‘loss of fat.’ Whether fat cells actually die or are simply depleted of their fat stores (similar to laser biostimulation fat loss) has not been studied. The loss of fat volume that supports the face produces gauntness, with an increase in wrinkles, sagging, hollowed cheeks, and loose skin (Ozempic Face). While no studies document the microscopic causes and progression of Ozempic Face, similar changes in the skin occur with aging and ultraviolet (sun) exposure, involving diminished collagen and poor organization of elastic tissue (elastosis).

PSP: What preventive measures can patients take to minimize the impact of Ozempic on their skin before noticeable effects occur?

Keller: Slowing down weight loss, as recommended by the physician providing the GLP-1 peptide agonist, appears to be helpful in slowing the progression of Ozempic Face. We recommend using DefenAge (which contains peptides—defensins that specifically counteract collagen loss and elastosis), collagen-inducing treatments such as microneedling and laser, fillers, strings, and surgical treatments to mask the changes. It is important to consult a specialist plastic or facial plastic surgeon who can provide patients with an array of options tailored to their individual needs. Patients with Ozempic Face progression have reported that DefenAge helped counteract their skin changes.

PSP: What role do defensins play in skin rejuvenation, and how effective are they compared to other anti-aging treatments?

Keller: While DefenAge contains a first-class array of skin-enhancing agents such as algae extract (similar to La Mer) and hyaluronic acids (popularized by influencers), it also features unique molecules called Defensins, which build new skin by stimulating dormant LgR6 stem cells. LgR6 stem cells generate new basal stem cells that create new keratinocytes, resulting in brand new skin. Studies also show that Defensins stimulate skin fibroblasts and promote the skin’s blood supply via angiogenesis. DefenAge uniquely has over 30 articles and papers documenting its efficacy.

Two double-blind, multi-center, IRB-approved studies (peer-reviewed in the Journal of Drugs in Dermatology) document its effectiveness in improving superficial and deep wrinkles, increasing the thickness of the epidermis, and enhancing collagen, as shown by patient satisfaction, ultrasound studies, histology, and other objective measures. This level of documentation and peer-reviewed studies is unique for skincare products.

Peptides are powerful stimulators of stem cell behavior. Interestingly, it is a peptide agonist, Ozempic (GLP-1), that is causing Ozempic Face in the first place. By contrast, there are no documented peer-reviewed studies in the Western world accepted by the FDA that demonstrate the efficacy of exosomes. Essentially, the FDA has placed exosomes in a ‘black box’ of disapproval. The FDA has defined the risks of exosomes as: 1. ‘Growth of tumors,’ and 2. ‘Infections.’ They note that there are NO approvals of exosomes for any uses, and that they are marketed illegally; any claims otherwise are false. Should a physician or company encounter a problem resulting from exosomes, little support would be available.

Other skin care products are helpful and useful. They help the skin and primarily (such as Retin-A) stimulate older, mature, and mutated basal cells, rather than build new ones.

PSP: Can the effects of “Ozempic Face” be fully reversed, or are there cases where some damage is permanent?

Keller: It is unknown whether Ozempic Face naturally reverses with subsequent weight gain. Changes to the face after Ozempic-induced weight loss can be improved with filler, laser treatment, surgery, microneedling, and skincare. It is important to consult a skilled plastic or facial plastic surgeon who has a full array of tools to improve and/or restore the Ozempic Face.

PSP: What advice would you give to someone considering Ozempic for weight loss but concerned about its impact on their skin?

Keller: Proceed gradually with your weight loss, condition your skin with [products like] DefenAge, and use non-invasive, minimally invasive, and surgical procedures to maintain your look as you progress.

Resources Cited

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