Losing weight to manage overweight or obesity can significantly reduce disease risk. However, major weight loss can sometimes result in loose skin, leading to feelings of self-consciousness and discomfort that may interfere with quality of life. The popularity of GLP-1 drugs have revolutionized weight loss and have also increased the demand for surgery to remove excess skin.
This article explores the causes of loose skin after weight loss and provides information on natural and medical solutions to help tighten and get rid of it.
Understanding Loose Skin After Weight Loss
The skin, the largest organ in your body, forms a protective barrier against the environment. Its innermost layer consists of proteins, including collagen and elastin. Collagen, making up 80% of your skin’s structure, provides firmness and strength. Elastin provides elasticity, helping your skin stay tight.
Skin Elasticity
Skin elasticity allows for organs to expand beneath the skin when you gain weight, build muscle, or during pregnancy. Elastin and collagen in the dermis give skin this quality. Like rubber bands, elastic fibers, made of elastin in the skin, enable it to flex, stretch, and expand. Collagen, a protein, provides structure, support, and strength to skin and other organs. As you age, your body produces less collagen, which can cause skin to sag.
The Impact of Weight Gain and Loss
During weight gain, skin expands to accommodate increased growth. Pregnancy exemplifies this expansion, occurring over a few months, with the skin typically retracting within several months of delivery. However, when skin has been significantly stretched for a long time, collagen and elastin fibers become damaged, losing some of their ability to retract. Consequently, significant weight loss may result in excess skin hanging from the body. In general, the greater the weight loss, the more pronounced the effect of loose skin.
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Researchers report that people who have weight loss surgery form less new collagen, and its composition is not as strong as the collagen in young, healthy skin.
Factors Influencing Skin Elasticity Loss
Several factors contribute to loose skin following weight loss:
- Length of Time: Generally, the longer someone has had overweight or obesity, the looser their skin will be after weight loss due to elastin and collagen loss.
- Amount of Weight Lost: Rapid loss of substantial body weight typically results in more loose skin than moderate weight loss. A substantial weight loss of 100 or more pounds can cause your skin to be loose. But even a person who appears thin or athletic can have loose skin due to weight loss.
- Age: Older skin has less collagen than younger skin and tends to be looser following weight loss. As you age, your body produces less collagen, which can also cause skin to sag.
- Genetics: Genes may affect how your skin responds to weight gain and loss.
- Sun Exposure: Chronic sun exposure reduces skin’s collagen and elastin production, contributing to loose skin. Sun damage impacts the skin’s elasticity and can cause skin to sag over time.
- Smoking: Smoking reduces collagen production and damages existing collagen, resulting in loose, sagging skin. Research shows that tobacco smoke and nicotine intake have a toxic effect on skin and increase the chances of premature aging. In a study comparing smokers with nonsmokers, hydration and firmness were lower in the smokers’ skin.
Problems Related to Excess Loose Skin
Excess loose skin from significant weight loss may cause physical and emotional challenges:
- Physical Discomfort: Excess skin may be uncomfortable and possibly interfere with normal activity. Excess skin hanging on the thighs, upper arms, and belly can make it hard to move.
- Emotional Discomfort: A study found a possible increase in self-consciousness after weight loss. Loose skin may be a reminder of when you had overweight or obesity. You may feel so self-conscious that you withdraw from social activities or feel anxious or depressed.
- Decreased Physical Activity: Excess skin can interfere with exercise after bariatric surgery. For some, loose skin may actually get in the way of taking part in activities and exercise.
- Skin Irritation and Breakdown: A study found that 44% of people who requested plastic surgery to tighten skin after weight loss surgery reported skin pain, ulcers, or infections due to loose skin. Loose skin can form folds that trap moisture, sweat, and bacteria. Hygiene issues can arise, with moisture collecting within folds of skin, leading to intertrigo, a red or brownish-red rash causing itching and stinging.
- Body Dissatisfaction: Loose skin from weight loss may negatively affect body image and mood.
Natural Remedies to Tighten Loose Skin
The following natural remedies may improve skin strength and elasticity to some degree in people who have lost small to moderate amounts of weight.
Exercise
Exercise is typically a key part of any ongoing weight loss plan and helps burn calories and builds muscle.
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- Perform Resistance Training: Engaging in regular strength training is one of the most effective ways to build muscle mass in both young and older adults. Building muscle beneath that skin can help fill the gap. That’s why strength training, which focuses on muscle growth, has been shown to improve skin elasticity and thickness. The Physical Activity Guidelines for Americans recommends doing strength training twice a week. Increasing circulation, which delivers oxygen and nutrients to the skin to support collagen production, elasticity, and overall skin health. Promoting skin hydration, which may give skin a plumper, firmer look. For better skin tightening, prioritize exercises that build muscle and boost circulation. Building lean muscle can help fill out loose skin and also boosts your metabolism, helping you burn more calories even at rest.
Diet and Hydration
Cutting calories should not mean cutting down on the nutritious foods that your body, especially your skin, needs.
Take Collagen: Although it hasn’t been tested in people with loose skin related to major weight loss, an older study suggests that collagen hydrolysate may have a protective effect on skin’s collagen. A controlled study found that skin elasticity, along with texture and hydration, increased significantly after 12 weeks of taking a liquid collagen supplement. It comes in powdered form and can be purchased at natural food stores or online.
Consume Certain Nutrients and Stay Hydrated: Certain nutrients are important for the production of collagen and other components of healthy skin:
- Protein: Adequate protein is vital for healthy skin. The amino acids proline, hydroxyproline, and glycine play a direct role in collagen production. Your body turns protein into building blocks called amino acids and reuses them to make other proteins, including the collagen that is essential for the elasticity of skin.
- Vitamin C: Vitamin C is needed for collagen synthesis and also helps protect skin from sun damage. Fruits and veggies rich in vitamins C and E help prevent cell damage. These and other foods high in vitamin C can play a role in increasing collagen protein synthesis such as Citrus fruit, peppers, strawberries, broccoli.
- Omega-3 Fatty Acids: The omega-3 fatty acids found in fatty fish and plant sources, including walnuts, chia, and flax, may help increase skin elasticity and have anti-aging effects. Foods rich in omega-3 fatty acids, such as salmon, tuna, walnuts, almonds, and edamame, help restore collagen in your skin and help improve firmness.
- Water: Staying well-hydrated may improve the skin’s appearance. Since skin cells are 64% water, it’s essential for healthy skin. Drinking 2 or more liters of water per day may significantly improve skin health.
Some sources of protein and Omega-3s include walnuts, flaxseeds, soybeans, fish, eggs, dairy products, and vegetables like spinach and Brussel sprouts. Plant or animal protein is essential for the maintenance and repair of skin tissue and helps build muscle. Plant proteins can also provide essential amino acids needed for muscle building and skin repair such as Beans, tofu, and nuts.
Skin Care
Skin health can also be approached from the outside through a variety of products that help nourish, moisturize, and protect it.
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- Sun Protection: Sun damage impacts the skin’s elasticity and can cause skin to sag over time. The best example of this is sunscreen. Sun damage impacts the skin’s elasticity and can cause skin to sag over time. Applying plenty of lotion with sun protection factor (SPF) 30 or higher can help keep this damage from happening.
- Moisturizers: Although there is no magic elixir that will fully hydrate and tighten your skin overnight, moisturizers may help plump the skin and relieve dryness right away. Likewise, hydrating the skin from the outside in can help improve the appearance of skin and prevent dry, flaky skin.
- Firming Creams and Lotions: Lotions, serums, and creams that contain retinoids may have some positive effects on saggy skin, as retinol promotes the skin’s ability to make collagen. But creams containing collagen don’t seem to have much benefit for the skin’s natural collagen production. Lotions that contain vitamin C or hyaluronic acid may help reduce sun damage to skin and skin discoloration, but they won’t improve the tightness or elasticity of skin over the long run.
Lifestyle Adjustments
- Gradual Weight Loss: Experts agree that slow and steady weight loss is the best strategy, especially if your goal is to trim down by 100 pounds or more. Slow, gradual weight loss gives that all-important collagen and elastin in the epidermis time to retract. Gradual weight loss is also considered better for your general health. Losing weight slowly-about 1 to 2 pounds per week-helps prevent loose skin because it gives your skin time to shrink as your body gets smaller. The CDC recommends trimming down at a rate of 1-2 pounds per week.
- Avoid Smoking and Excessive Alcohol: Research shows that tobacco smoke and the intake of nicotine have a toxic effect on skin and increase the chances of premature aging. Like nicotine, alcohol is a toxin that can damage the skin on a cellular level. Since the skin is 64% water, dehydration can have a visible impact and can affect skin health beneath the surface. Drinking too much alcohol can also deplete the body of beneficial vitamins, like A, B, and C, that are essential for skin health.
Medical Treatments to Tighten Loose Skin
Medical or surgical treatments are more invasive options to tighten loose skin after major weight loss.
Body Contouring Surgery
People who have lost a significant amount of weight via bariatric surgery or other weight-loss methods often request surgery to remove excess skin. Body contouring surgery removes excess skin and fat while reshaping the remaining tissue for a smoother appearance. The popularity of GLP-1 drugs have revolutionized weight loss and have also increased the demand for surgery to remove excess skin.
In body contouring surgery, a surgeon makes a large incision and removes excess skin and fat. They then suture the incision with fine stitches to help minimize scarring. Specific body contouring surgeries include:
- Abdominoplasty (tummy tuck): Removal of skin from the abdomen.
- Lower-body lift: Removal of skin from the belly, buttocks, hips, and thighs.
- Upper-body lift: Removal of skin from the breasts and back.
- Medial thigh lift: Removal of skin from the inner and outer thighs.
- Brachioplasty (arm lift): Removal of skin from the upper arms.
Multiple surgeries are usually performed on different body parts over time after major weight loss. Multiple procedures can be done in one surgery. Belly and upper arm surgeries are often done together, for example. “When multiple areas need to be addressed it’s best to start with the abdomen, as this serves as the core around which to contour the remainder of the body,” says Dr. Khouri. “For the most part, it’s best to avoid areas in which the lift or contouring goes in opposite directions.
Body contouring surgeries may require a brief hospital stay, followed by a period of recovery time at home. There may be also some complications from the surgery, such as bleeding and infections. Several studies have found that body contouring surgery may improve quality of life after significant weight loss.
Dr. Khouri says the only way to get rid of excess skin is plastic surgery. Abdominoplasty, Fleur-de-Lis panniculectomy. A more extensive procedure for patients with massive weight loss. “I look for patients to be at their ideal weight for six months to a year, preferably a year,” says Dr. Khouri.
“Patients lose all this weight, they go off insulin, their hearts are much healthier, but they can feel disappointed by a new problem they didn’t have before,” Dr. Khouri says.
Considerations for Body Contouring Surgery
- Timing: It’s important to wait until you’ve reached a stable weight and maintained it for a while before considering skin removal surgery. "I look for patients to be at their ideal weight for six months to a year, preferably a year,” says Dr. Khouri.
- Insurance Coverage: In many cases, insurance doesn’t cover surgery. For insurance approval, excess skin must be causing rashes and sores that interfere with daily activities and don’t respond to non-surgical treatments such as antibiotics, Dr. Some insurers require waiting at least 18 months after bariatric surgery or weight loss. “We try to help patients get portions of the procedures covered, but some procedures insurance companies consider cosmetic,” says Dr.
- Scarring: Dr. Khouri says it’s important to manage expectations. “I stress to patients that you are trading scar for skin, in order to achieve the functional and aesthetic benefits of removing the excess skin,” he says. “We try to place scars in hidden locations and to minimize them as much as possible.” He emphasizes the importance of properly caring for scars for at least one year.
- Recovery: Recovery generally takes about two weeks. “Plan to return to exercise around 4 weeks. Between 4 and 6 weeks, gradually ramp up your activities so that at 6 weeks you’re doing what you were doing before surgery. Obviously, it’s different for different parts of the body.
Alternative Medical Procedures
Although body-contouring surgery is by far the most common procedure to remove loose skin, less invasive options with a lower risk of complications include:
- Radiofrequency Treatment: This treatment uses low-frequency electromagnetic waves to create heat that penetrates the skin and encourages collagen and elastin production as well as production of new skin cells. It can take as long as 6 months for skin to show improvement in tone, texture, and firmness. The good news is there is no downtime afterward, and side effects tend to be minor. With one treatment, you can see an improvement that can last up to 3 years. Such treatments may use a combination of infrared light, radiofrequency, and massage to reduce loose skin. While this treatment doesn’t induce weight loss, it may help reduce small areas of fat cells.
- Ultrasound: This procedure stimulates collagen growth by targeting skin tissue deep within the dermis. The result is that over time, the body begins to make collagen again, which makes sagging skin firmer and more elastic. A research review of ultrasound treatment for skin tightening found it to be efficacious, effective, and safe with minimal adverse effects. You can expect to feel warmth at the site along with temporary swelling, redness, or tenderness.
- Laser Skin Tightening: This method uses a light to send heat deep into the skin to tighten loose skin all over the body. Unlike the other nonsurgical procedures, laser skin tightening requires three to five treatments to show results, which will appear gradually about 6 months after the final treatment.
It appears that although there are fewer risks with these alternative procedures, the results may not be as dramatic as with body contouring surgery.
Additional Tips
- Compression Clothing: Wearing compression clothing can help prevent some of the side effects of loose skin. Compression stockings and other garments that firmly hold loose skin together minimize friction from skin-to-skin contact. This can help reduce pain, irritation, itching, and the risk of infection.