Ozempic face: what causes it and how can it be treated?

Key points to remember.

The “Ozempic face” corresponds to a loss of facial volume associated with rapid weight loss.
The most affected areas are the cheeks, temples, and the eye contour, which take on a more hollowed and lax appearance.
This phenomenon can be explained by a reduction in adipose (fat) tissue and sometimes muscle tissue, combined with an alteration in skin quality (collagen, elastin, lipids).
Preventing “Ozempic face” relies primarily on regular medical monitoring, gradual weight loss, and an appropriate diet.
Cosmetic treatments (injections, radiofrequency, PRP, etc.) can help improve “Ozempic face,” but they must be performed by professionals.
Cosmetic products, for their part, cannot restore lost volume, but they can support the overall quality of the skin.

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Focus on the Ozempic treatment.

Ozempic is the brand name of a medication whose active ingredient is semaglutide, a molecule originally developed for the treatment of type 2 diabetes.

It belongs to the class of GLP-1 (glucagon-like peptide-1) receptor agonists, a hormone naturally produced by the body and involved in regulating blood glucose. Since its approval, semaglutide has been used to help control blood sugar levels in patients with diabetes, in the form of weekly injections or tablets. However, its effects on body weight have contributed to its popularity beyond the context of diabetes, against the advice of health authorities.

The way semaglutide works is based on several complementary mechanisms. By binding to GLP-1 receptors located in particular in the pancreas, the digestive system, and the brain, it stimulates insulin secretion when blood glucose is elevated and reduces glucagon release, thereby helping to lower blood sugar levels. This mechanism makes it possible to regulate blood glucose in a more physiologic way, with a limited risk of hypoglycemia. At the same time, semaglutide also acts on the central nervous system, especially in the hypothalamus, a region involved in appetite regulation. It is precisely this action that explains its effects on body weight. Semaglutide helps reduce the feeling of hunger and prolong the feeling of fullness. This leads to a reduction in calorie intake, which can result in sometimes rapid weight loss.

15 to 25%

Average weight loss after one year of semaglutide treatment.

300%

Increase in prescriptions for GLP-1 receptor agonists between the beginning of 2020 and the end of 2022.

While Ozempic can be beneficial for people with diabetes when used in a supervised medical setting, its off-label use for weight loss in non-diabetic individuals raises serious public health concerns (supply shortages for diabetic patients who genuinely need it, health risks for non-diabetic individuals who use it, etc.).

Note : Ozempic is not the only medication containing semaglutide. This active ingredient is also found in Rybelsus and Wegovy.

"Ozempic Face": how can this side effect be explained?

The term “Ozempic face” refers to a set of facial changes observed in some people after rapid weight loss, often associated with taking semaglutide. In practical terms, the face appears more hollow, less full, with a drawn or tired look. The most affected areas are the cheeks, temples, eye contour, and neck, where one can observe a loss of volume, skin sagging, and an increase in the visibility of wrinkles, especially the nasolabial folds and marionette lines. This phenomenon is not specific to Ozempic itself, but it has been widely publicized under this name because of the drug’s popularity.

Avant (gauche)/après (droite) la prise d'Ozempic, avec des manifestations de l'"Ozempic face". — Before (left) / after (right) taking Ozempic, showing manifestations of “Ozempic face.”
Source: GOLDBERG D. J. & al. Semaglutide “Ozempic” face and Implications in cosmetic dermatology. Dermatological Reviews (2024).

From a biological standpoint, this transformation is explained primarily by a reduction in subcutaneous adipose tissue, which plays a major role in supporting and structuring the face. A young-looking face is generally associated with a harmonious distribution of volume, particularly in the cheekbone area. When significant weight loss occurs, this lipid reserve decreases, making the bony contours more visible and giving the face a “hollowed” appearance. In addition, a partial loss of muscle mass may occur if daily protein requirements are not met, which also contributes to altering the structural support of the facial tissues.

Moreover, the skin’s intrinsic quality can also be affected. Rapid weight loss is sometimes accompanied by a reduction in nutritional intake or an imbalance in micronutrients, which can impact the synthesis of collagen and elastin, two proteins that are essential for skin firmness and elasticity. At the same time, the skin barrier may be weakened, particularly due to a decrease in epidermal lipids (ceramides, fatty acids, cholesterol), promoting dryness and a duller complexion.

All of these mechanisms together give the face an appearance suggestive of accelerated skin aging, even though it is in fact a phenomenon related to volume loss.

How can we prevent “Ozempic face”?

Preventing “Ozempic face” is based on a comprehensive approach that combines medical support, healthy lifestyle habits, and appropriate skin and facial care. First and foremost, it is essential to recall that semaglutide is a medication intended for the treatment of type 2 diabetes, and its use must be based on a prescription and accompanied by medical monitoring. Rapid weight loss, especially when pursued for purely aesthetic reasons, can lead to adverse effects, including impacts on the face. Medical supervision makes it possible in particular to adjust the pace of weight loss and limit these effects.

Upstream or at the very beginning of treatment, certain aesthetic medicine techniques can help preserve skin quality. Techniques that aim to stimulate collagen production and maintain skin elasticity, such as radiofrequency, photobiomodulation, or certain biorevitalization approaches, can help better manage changes in volume. Do not hesitate to ask your dermatologist for advice before starting a semaglutide-based treatment, so they can guide you toward the technique best suited to your skin and your situation.

The goal is not to offset fat loss, but rather to support the cutaneous tissues in order to limit skin laxity and loss of firmness.

In parallel, diet can help. An adequate protein intake is essential to maintain muscle mass, including the muscles that help support the face. As a general guideline, recommendations are usually around 0.8 to 1 g of protein per kilogram of body weight per day, or even higher (up to 1.2–1.5 g/kg/day) during periods of weight loss or in physically active individuals, in order to limit muscle wasting. Beyond protein, it is important to avoid overly strict dietary restriction, which can accelerate weight loss and increase tissue loss. The goal is to prioritize a balanced diet, including in particular unsaturated fats (avocado, fatty fish, nuts, seeds, etc.), which support proper cellular function, as well as of course fruits, vegetables, legumes, whole grains, etc.

Can “Ozempic face” be treated?

When facial changes are already established, several options can be considered to reduce their appearance. The first consists, in theory, of stopping semaglutide, which may halt further volume loss, but this is not always possible for people with diabetes. Fortunately, there are other, more targeted approaches with varying levels of invasiveness, ranging from minimally invasive dermatologic techniques to surgical solutions. Current aesthetic interventions are mainly based on two strategies: restoring volume, for example with hyaluronic acid injections or fat grafting, and stimulating the activity of the extracellular matrix to improve skin firmness and elasticity, using microneedling, radiofrequency, or PRP (platelet-rich plasma). Below is an overview of the main options currently used, along with their advantages and limitations:

Technique	Advantages	Limitations
Discontinuation of semaglutide	Stops volume loss. No additional cost.	Is not necessarily possible for people with diabetes. Does not fully correct the aesthetic changes.
Surgery (lifting, lipofilling)	Significant, long-lasting results. Ability to treat multiple areas.	Invasive procedures, prolonged recovery, high costs.
Injections (fillers)	Rapid results, minimally invasive. Adaptable to hollowed or sunken areas.	Temporary results. Technique with risks (bruising, migration, reactions) and costly.
Microneedling	Improves skin texture and firmness.	Several costly sessions are required. Does not always correct volume loss satisfactorily because it targets only the dermis.
PRP (platelet-rich plasma)	Uses the patient’s own cells. Stimulates skin regeneration.	Blood sample required. Results provided progressively.
Energy-based devices (radiofrequency, ultrasound)	Non-invasive. Improves skin firmness and texture.	Gradual results. Multiple sessions are often required.

The advantages and disadvantages of potential treatments for “Ozempic face.”

Source: GOLDBERG D. J. et al. Semaglutide “Ozempic” face and implications in cosmetic dermatology. Dermatological Reviews (2024).

It is important to emphasize that these approaches fall within the medical and aesthetic domains and require a personalized evaluation by a qualified professional.

Are cosmetic treatments effective against “Ozempic face”?

With the growing popularity of Ozempic treatment, some cosmetic brands have quickly noticed the emergence of a new concern—and a marketing opportunity. As a result, products are now appearing that are promoted as being able to target the so‑called “Ozempic face.”

However, it is important to be clear: cosmetics cannot correct a loss of facial volume.

In fact, “Ozempic face” is linked to a decrease in adipose tissue and, to a lesser extent, in muscle mass—two structures located in the deeper layers of the skin, particularly the hypodermis. However, cosmetic products, by definition, act mainly at the level of the epidermis and the superficial layers of the dermis. They do not penetrate deeply enough to stimulate the production of adipocytes or restore lost volume. Therefore, even the most sophisticated formulas cannot compensate for this type of structural change.

Note : This does not mean, however, that cosmetics are useless in this context. Well-formulated skincare products can help improve the overall appearance of the skin by supporting hydration, barrier function, and radiance. These effects, however, remain complementary and should not be mistaken for an effect on facial volume.