How Dermatologists Are Approaching “Ozempic Face”

About 8 per cent of Canadians are currently taking GLP-1 drugs such as Ozempic and Mounjaro, and that figure is even higher in the U.S. The knock-on effect has been noteworthy: obesity rates are dropping, diabetes diagnoses are levelling off, and the death risk is lower for people with heart conditions. One group of experts who’ve noticed an impact is dermatologists, who are seeing a surge of patients experiencing a change in their faces as a result of the medication.

“At first, patients were not always naming the medications. They would say, “I’ve lost weight and my face looks different,’” says Dr. Julia Carroll, a dermatologist in Toronto. “Now, people are much more direct. They will say, ‘I’m on a GLP-1,’ or ‘I’ve lost weight on Ozempic (or a similar medication), and I don’t feel like my face matches my body anymore.’” Dr. Katie Beleznay, a cosmetic dermatologist practising in Vancouver, says that some patients are motivated because they feel much better after weight loss. “They may be receiving positive feedback and feel like they’re taking control of their health. Then they look in the mirror and feel like their face doesn’t reflect how good they feel.”

What does this change (sometimes dubbed “Ozempic face”) look like? “The primary concern for most people is facial volume loss, where the face looks deflated or gaunt,” says Dr. Aegean Chan, a dermatologist and dermatopathologist in California. “This is pretty pronounced, especially in people that are older—60 and up. They already have skin laxity, gravity is pulling down their facial volume, and that just becomes more pronounced as they lose weight or the underlying fat in their face.” Skin quality can also be a concern, Beleznay says. “Some patients feel their skin looks less radiant, glowy, or less healthy overall.”

There’s nothing particularly unique to GLP-1 weight loss. “‘Ozempic face’ is a clever term, but similar changes can occur after bariatric surgery, lifestyle-related weight loss, or any other situation where a person loses a large amount of weight,” she says. Carroll notes: “There is also the issue of body composition. Weight loss is mostly fat loss, but some people may also lose muscle or lean tissue, particularly if they are not prioritizing protein and resistance training. From an aesthetic perspective, that matters because structure and support are not only about fat. They are also about muscle tone, bone structure, and skin quality.”

Injectable fillers are one option for people who are experiencing loss of volume in their faces and want to plump out hollowness in areas like the cheeks and under eyes. Chan says that on older patients who have thinner skin, she typically steers away from hyaluronic acid options that pull in water. “I like to stick to collagen-stimulating fillers like Radiesse or Sculptra because that does give you more of that natural contour,” she says.

“For skin laxity and texture, we may use energy-based treatments such as microfocused ultrasound, radio frequency, or lasers, depending on the patient’s skin type, goals, and downtime availability,” Carroll says. “These treatments can help improve skin quality and create mild to moderate tightening.” But all the dermatologists caution that there are limitations to what these machines can do. “Typically, they can improve the situation in millimetres, but if you’re having significant loose skin or sagging, you’re not going to see a big improvement with these treatments, and it may be better to move towards surgical intervention because you have physically more skin with less underlying volume,” Chan sys. “So we’re talking lower facelifts, neck lifts, body lifts, and tummy tucks.”

Relatively speaking, GLP-1 drugs haven’t been available for that long, and things are changing rapidly. Oral versions became available at the beginning of the year, so needle-phobic folks can start using the drugs. The Canadian government recently approved a generic injection, which means prices will likely come down, and uptake may increase. And new benefits of the drugs are being explored all the time—including the possibility that they have an anti-inflammatory effect and may therefore be helpful for wound healing or for skin conditions like psoriasis.

All that means dermatologists are looking at how their existing treatments can be modified and new ones might develop in response to the new landscape. Beleznay says she’s looking closely at the literature around early, proactive intervention by dermatologists. “I’m interested in whether collagen-stimulating treatments used earlier in the weight-loss journey may help support skin remodelling as changes occur,” she says. Chan says we might see a resurgence of fat-transfer-type procedures, while Carroll says it might also all come down to how treatments are combined. “Rather than treating one line or one fold, we will be thinking more globally about support, skin quality, and tissue laxity,” she says. “I think the future is less about one ‘hero’ procedure and more about thoughtful sequencing.”

Zooming out and looking at the overall beauty picture, there may be a downside to the widespread use of GLP-1s: the erasure of the fat positivity movement and a culture shift back toward prizing thinness above all. “It is interesting overall to think about how these drugs are shifting beauty standards,” Chan says. “I feel like we are back in the ’90s era of the stick thin, gaunt, malnourished aesthetic ideal. And I think we’re definitely moving away from that cherub-like face.” Experts are watching closely to see how, as GLP-1s become cheaper and more available, they might affect not just our bodies and faces but also our ever-evolving perception of what is attractive.

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