What are experts doing differently now that they’ve treated more GLP-1 patients?

Glucagon-like peptide-1 (GLP-1) medications went mainstream as a weight-loss tool, and dermatologists are noticing something nobody quite expected along the way.

Our healthcare professionals across the Vos Collection network share the patterns, surprises and treatment strategies that have emerged from caring for GLP-1 patients in real time.

Here’s what they’ve found.

Should aesthetic treatment wait until you’ve lost the weight?

Patients were once advised to wait until their weight stabilized before pursuing aesthetic treatments. In some cases that remains true, but experience treating people on GLP-1 medications has led practitioners toward a more proactive approach.

Supporting collagen, muscle and skin quality during weight loss may help soften the visible effects as they develop, moving the conversation from correction to prevention.

“The most important thing with these [GLP-1] patients is letting them know that we should be present during the entire journey, so that we can anticipate changes in their musculature and in their skin and their fat levels, in areas where they want the fat, so that we can keep them looking good as they’re losing weight,” says Dr. Ava Shamban, board-certified dermatologist and founder of Ava MD.

Biostimulators are injectables designed to prompt the skin to produce more of its own collagen.

“People are losing facial volume,” notes Dr. Steven Dayan, co-founder of Impressions Face + Body in Chicago. “What’s the best way to treat them? Biostimulators, because we think the biostimulators work via the adipose-derived stem cells. … So biostimulators seem to be the answer, along with HAs (hyaluronic acid fillers) early on.”

What dermatologists mean when they say “Ozempic Face”

“I’m noticing more GLP-1 patients today complaining about sagging and crepiness,” says Dr. Shannon Humphrey, founder & medical director of Humphrey & Beleznay Cosmetic Dermatology in British Columbia.

You’ve heard of “Ozempic face,” and with good reason: rapid weight loss can make the visible signs of aging appear at an accelerated pace. A clinical review found that participants taking GLP-1–based medications lost 10 percent or more of their muscle mass over 68 to 72 weeks. These staggering results are comparable to roughly two decades of age-related muscle loss.

And usually, this visible impact isn’t the same for everyone. For example, a 32-year-old has more stores of collagen, facial volume and muscle, on average; at 52, some of that structural support has typically declined.

But GLP-1 accelerates that dynamic regardless of demographic.

“I’m seeing a lot of younger people who need filler [and] who look very gaunt,” said Dr. Paul Cohen, dermatologist at SpaMedica, emphasizing the need to treat while on the medication. “We know that weight in the face makes people look young.”

This shifts the goalpost for GLP-1 treatments. It’s no longer about simply losing weight, but to also preserve the strength and support that help the face and body maintain their vitality along the way.

Experts weigh in on hair loss and GLP-1s

According to Novo Nordisk Canada Inc., clinical trials of Wegovy reported hair loss in 3.3 percent of participants, compared with 1.4 percent of those receiving a placebo, but researchers have not established that the medication directly damages hair follicles. Instead, clinicians increasingly point to telogen effluvium, a temporary shedding response that can follow rapid weight loss, reduced calorie or protein intake, nutritional deficiencies and other forms of physical stress. Because shedding often begins months after the initial trigger, patients may not immediately connect it to the speed or scale of their weight loss.

For most patients, the shedding is temporary. Telogen effluvium typically settles within about six months once its triggers are addressed, and hair grows back on its own. The exception is pattern hair loss: in people already predisposed, rapid weight loss can bring androgenetic alopecia forward, and that type does not reverse without treatment. That is why it helps to have a dermatologist identify which kind of shedding is happening early, rather than waiting for noticeable thinning.

“That usually, to me, is just a telogen effluvium,” says Dr. Sheetal Sapra, co-founder of Oakville Skin in Ontario. “I usually do supplements with that… We do PRP. And then the usual, oral minoxidil…to make hair grow.”

What exactly is “microdosing” a GLP-1?

Patients are not necessarily using GLP-1s the way you might expect.

Clinicians are seeing a wide range of ways people use GLP-1 medications, including growing interest in “microdosing,” which means taking smaller amounts than standard treatment protocols. Patients who do this often hope to reduce side effects or to gain other benefits they believe the medication offers, such as support for longevity, heart health and impulse control.

Others use the medications temporarily or pair them with nutrition, strength training and aesthetic treatments designed to support the body through rapid change.

“If you take a lower dose, is that as effective? Is it safe for people who are underweight, who are already thin, who don’t need to lose weight,” questions Dr. Dayan. “There’s no trials yet to prove that it works as a microdosing agent…”

While microdosing and temporary use is not standardized, and off-label use is not approved by governing bodies, the individual GLP-1 plan journey is becoming less about losing as much weight as possible and more about prioritizing skin quality, muscle preservation and well-being.

What treatments are paired with GLP-1 use?

As the face and body evolve throughout a GLP-1 journey, strategically timed treatments can help preserve collagen, restore volume and support healthy hair growth.

Dr. Cohen expects devices to play a bigger role: “A lot of machines I think are going to be put to increased use because a lot of people will be dealing with lax skin.”

In practice, these approaches tend to fall into three areas. Which ones come first depends on the person and on how quickly their weight is changing.

1. Boost collagen: Biostimulator injectables, such as Sculptra (poly-L-lactic acid) or Radiesse (Calcium Hydroxylapatite) can be gradually introduced to improve skin quality and reinforce areas beginning to lose support. Energy-based treatments such as radiofrequency (RF) microneedling may also help address laxity by stimulating collagen.

Dr. Humphrey describes how she approaches patients on GLP-1 medications: “We’re really targeting skincare but also collagen stimulating treatments, energy-based tightening treatments and also collagen injectable stimulators to offset some of those tissue changes we are seeing.”

2. Restore facial volume: Hyaluronic acid filler can soften pronounced hollows in the temples, cheeks or under-eye area during active weight loss. Because facial volume and proportions may continue to change, a gradual approach can create a more natural result and reduce the risk of overfilling a face that has not yet settled.

3. Address hair shedding: Hair shedding has more than one possible cause, so the first step is an evaluation by a dermatologist or other qualified medical provider. Depending on the diagnosis, a clinician may recommend topical or oral minoxidil, while platelet-rich plasma injections (PRP) or low-level light therapy may be considered as supportive treatments.

Who to talk to when you want to understand your options

According to Dr. Humphrey, practitioners’ understanding of GLP-1s continues to evolve. “The science is not definitive. We are learning every day from publications and clinical experiments, but it’s an exciting time in GLP-1s and medicine.”

Ultimately, the most valuable treatment is a coordinated plan advised by a clinical aesthetic professional. Tracking the rate of weight loss, nutrition, muscle health, skin quality and facial volume allows treatments to be timed around what the body is experiencing and ensures balanced and beautiful results.

Every face and every timeline is different, and the physicians of the Vos Collection network are there for anyone who’d like to talk it through.