Losing weight to manage overweight or obesity can significantly reduce disease risk. However, major weight loss can sometimes result in loose skin, which may lead to feelings of self-consciousness and discomfort that may interfere with quality of life. The majority of people who lose 50 or more pounds will experience loose skin somewhere on their body. This article explores the causes of loose skin after weight loss and offers natural and medical solutions to help tighten and address it.
What Causes Loose Skin After Weight Loss?
The skin, the largest organ in your body, forms a protective barrier against the environment. The innermost layer of your skin consists of proteins, including collagen and elastin. Collagen, which makes up 80% of your skin’s structure, provides firmness and strength. Elastin provides elasticity and helps your skin stay tight.
Weight gain is normally a gradual process, and as an individual gains weight, their skin stretches out to adapt to the extra layer(s) of fat. Stretch marks may form as a result of the skin being stretched beyond its limits of elasticity. During weight gain, skin expands to make room for increased growth. Pregnancy is one example of this expansion. Skin expansion during pregnancy occurs over a few months. The expanded skin typically retracts within several months of delivery.
When an individual loses weight rapidly, the fat that is typically lost is the layer right below the surface of the skin. Where an individual stores fat is often determined by genetics and is not within their control. By contrast, when skin has been significantly stretched and remains that way for a long period of time, collagen and elastin fibers become damaged. As a result, they lose some of their ability to retract. Consequently, when you lose a lot of weight, excess skin may hang from the body. In general, the greater the weight loss, the more pronounced the effect of loose skin. What’s more, 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 Affecting Skin Elasticity
Several factors contribute to loose skin following weight loss:
Read also: Bizarre Murder Cover-Up in Florida
- Length of time: In general, 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 a greater amount of loose skin than more moderate weight loss. Mild weight loss (think: 20 pounds or less) typically doesn’t lead to excess skin. When it comes to problems with loose skin, a weight loss of 40 to 50 pounds can seem as big as a weight loss of 100+ pounds.
- Age: Older skin has less collagen than younger skin and tends to be looser following weight loss. As we age, our older skin naturally loses elasticity due to a decrease in existing collagen and elastin production. Collagen and elastin are proteins that give the skin its firmness and ability to stretch and bounce back.
- Genetics: Genes may affect how your skin responds to weight gain and loss. Some individuals may be genetically predisposed to have more resilient skin that retains its elasticity even after substantial weight loss.
- Sun exposure: Chronic sun exposure reduces skin’s collagen and elastin production, which may contribute to loose skin. Prolonged and repeated exposure to environmental factors like UV rays from the sun can alter the structure and function of the skin. Aged skin can appear dry and wrinkled and is more likely to sag.
- Smoking: Smoking leads to a reduction in collagen production and damage to existing collagen, resulting in loose, sagging skin.
The amount of loose skin experienced after undergoing a substantial loss of weight and where that loose skin will be located will vary by individual as no two individuals have the exact same DNA (except in rare cases of identical twins). Some individuals who lose weight may not experience any loose skin at all.
Potential Problems Caused by Excess Loose Skin
For some people, loose skin from a lot of weight loss may cause physical and emotional challenges:
- Physical discomfort: Excess skin may be uncomfortable and possibly interfere with normal activity.
- Emotional discomfort: An older longitudinal 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: While a 2022 study found that weight loss encouraged more people to exercise, excess skin was found to interfere with exercise in some people after bariatric surgery. Excess skin hanging on the thighs, upper arms, and belly can make it hard to move. So even after you’ve slimmed down your body fat, you may still face hurdles moving about your daily life.
- Skin irritation and breakdown: An older 2014 study found that of 124 people who requested plastic surgery to tighten skin after weight loss surgery, 44% had reported skin pain, ulcers, or infections due to the loose skin. Loose skin can form folds that trap moisture, sweat, and bacteria. Loose skin rash can occur if moisture continues to collect within folds of skin, the skin can rub together and cause a condition called intertrigo. This red or brownish-red rash is more common in warm, humid climates and during the summer months and can cause itching and stinging. Yeast infection, or candidiasis, are another reason for giving loose skin folds some extra love. This fungus overgrowth can cause discomfort, including redness, itchiness, and burning. Another of the challenges with loose skin and mobility is chafing. Similar to a skin rash, chafing happens when skin rubs against skin or clothing, causing redness, bumps, itching, burning, or increased skin warmth.
- 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.
Resistance Training
Engaging in regular strength training is one of the most effective ways to build muscle mass in both young and older adults. The Physical Activity Guidelines for Americans recommends doing strength training twice a week. Incorporate physical activity focused on resistance training exercises like weightlifting and resistance band workouts into your routine to build muscle mass. Stronger muscles provide support to the skin and can improve its appearance by filling out loose areas and preventing weight gain. While research isn’t currently available, it’s possible that an increase in muscle mass may help improve the appearance of loose skin. Building new muscles can help fill out some minimal sagging skin caused by fat loss. Replacing fat mass with lean muscles can improve your health and make you look and feel better.
Collagen Supplementation
Collagen hydrolysate is very similar to gelatin. It’s a processed form of the collagen found in the connective tissue of animals. 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. In a controlled 2019 study, 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. Another popular source of collagen is bone broth, which can also provide other health benefits.
Read also: Women's Well-being and Nutrition
Nutritional Considerations
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. Plant or animal protein is essential for the maintenance and repair of skin tissue and helps build muscle. 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. Incorporate an antioxidant-rich diet with lots of Vitamins C, E, and A to combat free radicals. Fruits and veggies rich in vitamins C and E help prevent cell damage.
- 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. Omega-3 in fish oil also has various proven benefits, including improving skin elasticity.
- Water: Staying well-hydrated may improve the skin’s appearance. An older 2015 study found that women who increased their daily water intake had significant improvements in skin hydration and function. Drinking enough water keeps the skin hydrated, while foods like fruits, vegetables, lean proteins, and healthy fats promote skin regeneration and collagen production. Experts advise drinking 2 or more liters of water daily for skin health. Getting enough water is vital for keeping your skin elastic and hydrated. A study found that increased water consumption positively impacted normal skin physiology, especially in those who didn't drink much water before.
Gradual Weight Loss
Aim for a sustainable approach with moderate weight loss of about 1-2 pounds per week. This gradual weight loss helps minimize the risk of developing loose skin or excess skin folds. Slow your weight loss and give your body some time to adjust to the reduction in fat mass. Slow weight loss is also more sustainable over the long term. 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.
Topical Treatments
Use topical firming creams and lotions with collagen-boosting ingredients like retinol, hyaluronic acid, and vitamin C. Apply these products regularly to areas prone to loose skin to support skin elasticity and create the appearance of tighter, younger skin. 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.
Lifestyle Adjustments
- Avoid smoking: Research shows that tobacco smoke and the intake of nicotine have a toxic effect on skin and increase the chances of premature aging. The effects are caused both by the smoke and the breathing in of toxins. In a study comparing smokers with nonsmokers, hydration and firmness were lower in the smokers’ skin.
- Limit alcohol consumption: Like nicotine, alcohol is a toxin that can damage the skin on a cellular level. Alcohol is a diuretic, which means it makes you pee more. So drinking it can lead to dehydration. 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.
- Sun Protection: 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.
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. 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. 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.
Read also: Pregnancy and Low-Carb
Specific body contouring surgeries include:
- Abdominoplasty (tummy tuck): Removal of skin from the abdomen. A tummy tuck will not only address loose skin on the stomach but also repair torn or stretched muscles that provide core strength and influence posture. This surgery addresses the loose pouch of skin that may reside below the naval. During a tummy tuck, an incision is made along the lower abdomen, excess tissue is removed, and the abdominal muscles are tightened and sutured into place.
- 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. Depending on the amount of weight lost, individuals can be left with loose, flabby skin on their inner thighs or above their knees that cannot be addressed through diet or exercise. The back of the thigh, extending to the upper buttock area, can begin to sag after a substantial weight loss.
- Brachioplasty (arm lift): Removal of skin from the upper arms. An arm lift, or brachioplasty, is a surgical procedure that removes excess skin and fat from the upper arms, resulting in a more toned and contoured appearance. During the procedure, incisions are made along the inner arm, and excess tissue is excised before the skin is tightened and reshaped.
Multiple surgeries are usually performed on different body parts over time after major weight loss.
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 (RF) therapy: 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. 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. BodyTite is a minimally invasive procedure that uses radiofrequency-assisted lipolysis to break up fat deposits and tighten the skin at the same time. A two-part tool is inserted by the cosmetic surgeon during the BodyTite operation. The upper attachment carries the radiofrequency and is directly connected to the cannula. As the instrument is moved along under the skin, the upper paddle travels over the top of the skin’s layers and works in tandem with this cannula to deliver the desired results.
- Microneedling: Microneedling is a minimally invasive procedure that involves creating tiny punctures in the skin with a device containing fine needles. These micro-injuries stimulate the body’s natural healing response, leading to increased collagen production and skin lifting. When microneedles are combined with Radiofrequency energy, the term is called Radiofrequency Microneedling.
- Ultrasound: A 2019 research review of ultrasound treatment for skin tightening found it to be efficacious, effective, and safe with minimal adverse effects. Ultrasound therapy utilizes focused ultrasound energy to target the skin’s deeper layers, promoting collagen remodeling and lifting loose skin.
- Laser treatment: Laser treatment may be recommended for individuals seeking to address loose skin. They involve using laser energy to heat the skin’s deeper layers, stimulating collagen production and improving skin elasticity. Different types of lasers may be used, depending on the specific concerns being addressed and the patient’s skin type.
It appears that although there are fewer risks with these alternative procedures, the results may not be as dramatic as with body contouring surgery.
Evolve Treatments
Evolve is a collection of body-contouring procedures that perform together to reduce extra body fat, tighten areas of loose skin, and tone various body areas. Evolve Tite, Evolve Trim, and Evolve Tone are a group of three non-surgical therapies that can repair and considerably improve a wide range of common problems that are experienced by many people. All skin types can benefit from these quick, painless procedures. Evolve Tite treats the skin’s subdermal layer to produce smoother, tighter skin that presents a more toned appearance. Evolve Trim is used to target small areas of stubborn fat and can reduce the look of visible cellulite. Evolve Tone uses electronic muscle stimulation to help tone the muscles in the treatment area. The PHYSIQ treatments also use EMS (electronic muscle stimulation) and heat to tighten loose skin, define muscles, and eliminate concentrated pockets of fat.
Considerations for GLP-1 Medications
GLP-1 medications have changed how people lose weight. Gradual, significant weight loss from medication can lead to loose or sagging skin, prompting may to choose body contouring surgery to feel more comfortable and confident in their bodies. If you’re on weight-loss medications and exploring surgery for loose skin, consult both your physician and a board-certified plastic surgeon. You will need to stop your medication for a short time before surgery. Your surgical team will tell you how long to stop the medication before the procedure and when it is safe to start taking it again. Your surgeon will want to make sure your weight has been stable for at least six months before the surgery.