Derm Appeal Blog

Ozempic was approved by the U.S. Food and Drug Administration (FDA) in 2017 to help adults with type 2 diabetes manage their blood sugar. Later, in 2021, semaglutide, the active ingredient in Ozempic, was approved by the FDA under the name Wegovy for adults with obesity who also have weight-related medical problems.

Unlike Wegovy however, Ozempic was not officially labeled for use in weight loss. Their website, in fact, specifically states, “Ozempic is not for weight loss”. But, because it was more easily obtainable, many people started to use it off-label for weight loss purposes. This ensuing higher demand for the drug has given rise to global supply constraints and in 2022, both Ozempic and Wegovy experienced shortages. At the time of writing (February 2023) both are still listed on the FDA website as “currently in shortage”. These events have led to much controversy as those living with type 2 diabetes are unable to get the medication they need for their health condition.

Hollywood Trend

With many Hollywood stars being linked to Ozempic to achieve rapid weight loss, some blame these massive drug shortages on this latest ‘Hollywood trend’. Celebrity comedian Chelsea Handler, who was unknowingly taking Ozempic after being prescribed the drug, has since spoken out, stating, “Everyone is on Ozempic. It’s gonna backfire, something bad is gonna happen.”

Speaking recently to PEOPLE, Caroline Apovian, MD, co-director of the Center for Weight Management and Wellness at the Brigham and Women’s Hospital in Boston, stated,

"The Hollywood trend is concerning. We're not talking about stars who need to lose 10 pounds. We're talking about people who are dying of obesity, are going to die of obesity. We have lifesaving drugs… and the United States public that really needs these drugs can't get them."

Side Effects

Ozempic (as well as other drugs in the same class) come with many side effects. The most common involve gastrointestinal symptoms such as nausea, vomiting, diarrhea, constipation, and abdominal pain. Some patients may also experience kidney damage and pancreatitis.

“Ozempic Face”, a term originally coined by cosmetic dermatologist, Paul Jarrod Frank, MD, is yet another of the medication’s side effects, and one which is making its way around the internet and dermatology space. But unlike the other side effects, “Ozempic Face” does not result from the drug itself, but rather from the weight loss associated with it.

What is Ozempic Face?

While any form of weight loss can cause a corresponding loss of volume in the face, the rate at which this is seen with Ozempic (semaglutide) is accelerated. Significant weight loss over a short period of time depletes the skin of essential nutrients, therefore thinning the skin and making it lose its elasticity. This results in more prominent hanging skin and accentuating hollowed-out cheekbones.

Plastic surgeon, Oren Tepper, MD, explains this phenomenon perfectly in his statement to the New York Times. 

“When it comes to facial aging, fat is typically more friend than foe. Weight loss may turn back your biological age, but it tends to turn your facial clock forward.”

Ava T. Shamban, MD, a cosmetic dermatologist based in California and SBS: West Coast Derm faculty member, further explains that the rapid weight loss seen with Ozempic has effects not just for the face, but the entire body as well. 

“When volume losses are extensive in short time periods, the structural skin fibers and dermal network do not have the right amount of time to process the adipose tissue loss with any ‘snap back’ and tighten up as it might with a slower weight loss.”

With “Ozempic Face” being one of the latest complaints being seen by dermatologists, there is a subsequent need to find the best approaches and treatments to help patients improve their appearance.

“Ozempic Face”: Dermatologists’ Latest Concern

Losing too much fat on the face causes the skin to sag, wrinkle and generally give an aged appearance. Dermatologists are now faced with the task of treating patients experiencing “Ozempic Face” and helping them to regain some of the facial volume.

Many experts recommend using dermal fillers as a way to boost volume in the face. According to New York plastic surgeon, David Shafer, MD, dermal fillers are, “one of the most effective and instant fixes for loss of volume as a result of facial weight loss”. He goes on to state that of these, hyaluronic acid fillers are among the most popular.

According to Dr. Paul Jarrod Frank, the risks of treating “Ozempic Face” are the same as with any filler treatment. Patients can experience swelling, bruising, and infection. He goes on to speak about the additional aesthetic risk, that being, the more filler you insert around the face, the less natural it can appear.

SBS West Coast Derm faculty member and Los Angeles-based cosmetic dermatologist, Jason J. Emer, MD, mentions that micro-needling to facilitate nonsurgical skin tightening may also be necessary. 

“Combine this treatment with proper skin care protocols, and patients should see a beautiful, and much-improved result.”

For some patients, especially those that are older, surgery, such as face-lifts, may be required to tighten the skin.

Key Takeaway

This statement by South Beach Symposium Planning Committee Member, Doris J. Day, MD, sums things up nicely. 

"Any type of rapid weight loss can make our face look saggy, heavier and older than our years. This drug is a great option for many people for both diabetes management and for weight loss, but it needs to be under proper supervision, proper guidance, and not just as something to get you to that weight loss quickly."


Sign up to receive updates on educational opportunities, complimentary content, exclusive discounts, and more.