The Impact of GLP-1 Receptor Agonist–Induced Nutritional Deficiencies on Skin Health: A Narrative Review With a Proposed Framework for the Aesthetic Practitioner

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2026
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Abstract
Abstract Semaglutide and tirzepatide have reshaped obesity care, and aesthetic practitioners increasingly encounter patients with rapid weight-loss–associated facial volume loss and skin changes. Nutritional deficiency may be an underrecognized contributor to impaired dermal repair during GLP-1 receptor agonist (GLP-1RA) therapy. We reviewed and synthesized evidence across metabolic pharmacology, facial anatomy and aesthetics, dermatologic histology, and clinical nutrition. PubMed, Embase, and the Cochrane Library were searched from January 2019 through March 2026, supplemented by foundational studies in collagen biology and post–weight-loss skin histology. GLP-1RA–mediated caloric restriction can reduce intake of micronutrient cofactors required for collagen biosynthesis and wound repair. Vitamin D deficiency reaches 13.6% at 12 months, and approximately 22.4% of patients have at least one documented deficiency within one year. Deficiencies in vitamin D, iron, vitamin B12, folate, zinc, copper, and protein may plausibly compound rapid fat-compartment depletion and collagen remodeling. Direct GLP-1RA effects on dermal cells remain preclinical and should be interpreted cautiously. In summary, GLP-1RA–associated facial aging changes are multifactorial. We propose a risk-stratified framework for aesthetic practitioners emphasizing dietary optimization, selective supplementation, targeted laboratory assessment in at-risk patients, coordination with prescribing clinicians, and procedural timing when nutritional status is optimized. Prospective studies are needed to determine whether correcting deficiencies improves aesthetic or surgical outcomes.
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Authors Justin N. Karlin, Zhaoping Li, Kami Parsa
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Journal Aesthetic Surgery Journal Open Forum
Year 2026
DOI
10.1093/asjof/ojag169
URL
https://academic.oup.com/asjopenforum/advance-article-pdf/doi/10.1093/asjof/ojag169/71025575/ojag169.pdf
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