‘A devastating cocktail for the face’: Is Ozempic aging us prematurely?

The face is the window to the soul, they say. Also, that by the time people are in their 40s, they have the face that they deserve. But a better way of putting it might be, they have the one they can afford. The truth is, looks often have more to do with a person’s pocketbook than their spirit. In addition to being able to access high-cost aesthetic services, it can be hard to parse other pseudo-scientific claims regarding our facial musculature. For example, can running really make us look older?

Putting aside those rumors for the moment, another group of people who experience rapid, up-and-down movement are those who lose weight rapidly. Along with the pounds, such individuals can lose fat compartments that lend balance and volume to the face. Ever seen someone after a long period of time who has lost weight and thought, are they ill? It may be that they’re doing just fine — but that their face isn’t reflecting that fact.

In the lead-up to bikini season, such changed faces may begin to appear, accompanied by muscular, lean bodies that can seem a decade younger than the mug that sits above them. Two phrases, one more accurate than the other, have emerged to label this phenomenon: “Ozempic face” and “runner face.”

The former refers to the impacts of a rapid weight loss that doesn’t discriminate between fat and muscle mass, causing decreases in both. This is just one of the issues that have been linked to the so-called “drug of the century.” The term “Ozempic face” was coined by dermatologist Paul Jarrod Frank, an authority in his profession who sees it as a side effect of the Ozempic treatment, whose principal active component is semaglutide.

After attending various individuals who were taking the medication and presented the symptom, he wrote a scientific article that states that the drug has “a more pronounced effect” on the face, producing dermatological impacts and some sagging from the displacement or elimination of fats that lend the face volume. “Additionally, facial skin loses its ability to retract and return to its rightful place after rapid weight loss, and there is a drop in the levels of elastin and collagen, two key components of facial structure,” Frank wrote.

The doctor describes the Ozempic face phenomenon using four key points: an increase in signs of aging associated with worry lines and wrinkles, loss of fat compartments that loosen the skin and cause it to sag, a hollowed-out appearance and lipodystrophy (a condition that causes abnormal changes in the distribution of body fat).

Last May, Doctor Dennis Gross, a New York-based dermatologist, told EL PAÍS that he had several patients who were trying to reverse the effects of Ozempic on their facial volume. “The problem is that even if you gain the weight back, facial fat may not return to its original formation, that is one of the biggest challenges in derma cosmetics.”

In contrast, debate surrounds the very use of the term “runner face.” There is little evidence to suggest that running is a primary factor behind emaciated and gaunt faces, and doctors point out that the poor hydration and insufficient solar protection that can accompany the sport are more likely the causes of such changes in appearance.

Dr. Kiya Movassaghi, plastic surgeon and avid marathon runner, points to a combination of factors that may lead to such a phenomenon in a social media post: “Being naturally thin, exposure to the sun for long periods of time without protection and not hydrating adequately can lead to a haggard appearance, which is often seen among skiers, gardeners, sailors and cyclists.” Movassaghi believes that causation and correlation are being confused by those who use the term, as such facial appearances are typically related to the collagen loss that can typically occur with age.

Dr. Carmen Lorente of The Beauty Concept says that extreme sports can cause oxidative stress that produces free radicals, shortens telomeres and accelerates aging. “This, added to sun exposure, pollution, cold and the impact of exercise itself is a devastating cocktail for the face. The solution can start with protecting yourself more when you go running, or not practicing sports in extreme weather conditions.”

Another professional who is familiar with such faces is Dr. Adriana Ribé. She explains: “After rapid weight-loss, tissues don’t put themselves back together in the same way.” In her opinion, the critical areas of the face whose alteration can give it an aged appearance are the fatty layers of the nose and cheekbones. “If fat compartments disappear from the middle of the face, volume is lost and tissue is displaced. Even if they are refilled with other substances, it is difficult to avoid skin distension.” She adds: “When you slim down too quickly, the face can act like a balloon that is deflating. Skin can thin out and become wrinkled and sag.”

Starting at 25 years old, men and women begin to lose collagen, the substance that lends the skin elasticity and allow facial skin to return to its original position after rapid weight loss. “When you lose weight beginning in your 40s due to sports or a medication, it can have a direct impact on the superficial fatty layers of the face, which can in turn affect skin quality,” says Dr. Victoria Páez, whose clinic is located in Marbella, Spain. Páez says that she sees more and more male patients who are worried about their “new faces.” “If weight loss is continuous, the elastic recuperation of tissue becomes slower and the moment will arrive in which there is no turning back.”

The solution that experts propose is to avoid abrupt weight loss, and not to wait until one has slimmed down to care for one’s face. “It’s better to undergo controlled weight loss, and along the way, boost collagen and insert anchors to prevent sagging,” suggests Ribé, who adds that it’s realistic to assume that one’s face will be impacted by weight loss. Páez proposes a similar strategy: “Among men, it’s better to prevent the loss of facial fat compartments before they arrive at their final weight-loss goal.”

Facial fail? It depends

At any rate, a face with an aged appearance is not always a sign of poor health. Expectations related to beauty and health have changed over time. “When I see someone who is overly tan and thin, my reading is, too much sports and sun. Someone can like their own appearance, but to me, their face has been damaged. That doesn’t mean that their body isn’t functioning as it should, just that they are oxidizing rapidly and their skin is bearing the brunt,” says Lorente.

You can be in phenomenal shape and still have an aged face. You can lose 60 pounds and people will still ask if you’re feeling alright. You can run three marathons a year and still look 10 years older than you should. Another popular refrain holds that, at some point, you have to make the decision between your face or your derrière. Thousands of individuals, from the celebrities to average folk, have opted for the latter.

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