Are GLP-1s depleting your collagen?

GLP-1s have transformed how millions of people all over the world manage their weight. And as Ozempic and Mounjaro become household names, a conversation has been building within the world of beauty: what exactly are these peptides doing to the skin?

Beyond the well-documented ‘Ozempic face’, emerging research now suggests GLP-1s themselves may be interacting directly with the cells responsible for producing collagen, elastin and hyaluronic acid.

One of the most recent studies published in the journal Endocrine, reviewed the available evidence and proposed that GLP-1 receptors are present on fat-derived stem cells and fibroblasts. The theory is that activating those receptors through GLP-1 medication may reduce some of the biological signals that tell the skin to repair and renew itself.

So, we asked the experts to share what this means in practice for the faces (and bodies) of the millions taking GLP-1s.

Decoding the science

First things first, don’t panic because it’s worth digging a little deeper to understand what the research does and doesn’t prove. The study in question is a literature review of existing laboratory and mechanistic research, rather than a clinical trial that measures collagen levels in actual patients.

“While the biology is fascinating and there is enough evidence to justify further investigation, we do not yet have robust long-term human trials demonstrating that GLP-1 medication independently causes clinically meaningful collagen depletion,” says Dr Ahmed El Muntasar, Aesthetics Doctor and Founder, The Aesthetics Doctor.

Interestingly, the science also shows that, “GLP-1 medications may also reduce inflammation and glycation, both of which can damage collagen. So, the relationship may be more complicated than simply saying GLP-1s age your skin,” shares Teresa Tan, Advanced Clinical Practitioner and Clinical Director, Tan&Co.

This could mean that the two ‘cancel each other’ out so to speak, meaning there’s no noticeable change in your skin’s collagen levels.

Ozempic face

Almost every visible skin change associated with GLP-1 use sits at the intersection of two things happening simultaneously: the potential cellular effects of the medication, and the physical consequences of (often) rapid, significant fat loss.

When it comes to the face, the areas most affected are those most dependent on the relationship between skin quality, fat compartments and structural support, such as the temples, mid-cheek, under-eye area, jawline, neck.

Tan experienced this first-hand, having lost around 24kg on a GLP-1 medication herself. “Initially my face looked noticeably more gaunt, with more laxity and more defined nasolabial folds. It’s difficult to know whether it’s the GLP-1 at play, or simply the effects of significant weight loss itself, because when you lose a lot of weight, you’re also losing the fat that supports the skin,” she explains.

What skincare can and can’t do

No topical product can replace lost facial fat, muscle or bone (which recedes as we age). Nor can it reverse a biological process happening deeper within the skin. What skincare can do is optimise the environment in which collagen is produced, and reduce the rate it’s broken down.

“UV radiation is one of the biggest drivers of collagen degradation, so if you are concerned about maintaining collagen, preventing unnecessary breakdown is fundamental,” says El Muntasar.

Aside from sunscreen to protect collagen stores, Tan reveals, “the best-established topical ingredient for stimulating collagen is a retinoid. Prescription tretinoin has the strongest evidence, although well formulated retinal and retinol products can also be useful. Vitamin C is another ingredient I like because it acts as an antioxidant (which reduces collagen breakdown), and is also required for normal collagen production.”

In-clinic treatments worth considering

Where skin quality is genuinely declining, collagen-stimulating treatments are a more direct intervention, although El Muntasar flags that your treatments should suit the problem. “If somebody has poor skin quality, simply adding lots of filler is not necessarily the answer,” he says. “Equally, if someone has significant volume loss, a collagen stimulating treatment alone may not recreate the lost structural support.”

What’s worked for Tan has been a combination of microneedling, laser (Aerolase Neo 1064nm laser), radio frequency treatments and collagen biostimulators like PLLA injectable Julaine, and polynucleotides to encourage collagen remodelling. “I’m particularly interested in treatments that stimulate the skin, rather than simply replacing every bit of volume that has been lost,” she says.

Nutrition is non-negotiable

One of the most under appreciated aspects of this conversation is what GLP-1 medications do to appetite, and how that impacts the nutritional value of your daily food intake. Collagen is a protein, and the body needs amino acids, vitamin C, zinc, copper and iron to produce it.

“I became much more conscious of protein intake and resistance training during my own journey,” says Tan. “We want people to lose excess fat while preserving as much muscle and nutritional health as possible, rather than simply chasing the lowest number on the scales.”

To do this, you need to “prioritise protein at every meal, rather than simply focusing on eating fewer calories. Foods such as eggs, fish, meat, dairy, beans, nuts and seeds can help provide protein and essential micronutrients, while fruit and vegetables provide the body with vitamin C and antioxidants,” shares El Muntasar.

The reality 

GLP-1s have yet to be proven to empty your collagen stores. What the evidence suggests is that rapid weight loss, potential nutritional changes and possibly some direct cellular effects, may combine to influence how the skin ages during and after treatment.

There’s no need to stop treatment or not start at all, you just need to be prepared. Focus on getting enough protein, vitamins and minerals in your diet, and protect and encourage collagen production by way of a collagen-focused skincare regime, and collagen boosting treatment plan.