r/aestheticnursing

This review looks at what we keep seeing (Ozempic face) and investigates whether it's a result of rapid fat loss or could GLP-1 rector agonists directly accelerate aging. The authors actually conclude that both may be true. And ironically, they also have research showing they have anti-aging effects on other parts of the body by reducing inflammation and oxidative stress. They examine whether mechanisms beyond fat loss may contribute to skin aging during GLP-1 therapy. Skin aging is characterized by reduced mitotic activity, impaired skin barrier function, decreased collagen and elastin product, diminished cellular proliferation, increased apoptosis, and elevated oxidative stress. Increased production of reactive oxygen stress damages DNA and cellular membranes, activates signaling pathways that reduce pro collagen synthesis, and stimulates inflammatory pathways involved in collagen metabolism.

GLP-1s have proven research on type 2 diabetes, obesity, and weight loss, but they also have demonstrated anti-inflammatory effects have been investigated for skin diseases. As their use has increased, so has facial aging associated with significant weight loss been noticed. The change is usually connected to the loss of facial fat because it alters facial contours and results in excess skin, more visible wrinkles, and changes in facial proportions. The authors note that this phenomenon is not unique to GLP-1s though, and has also been described following bariatric surgery. Histological studies of patients with major weight loss have demonstrated alterations in dermal structure, including changes in collagen and elastic fiber density.

The authors describe evidence suggesting that GLP-1s may influence dermal white adipose tissue (DWAT) and adipose-derived stem cells (ADSCs). These both express GLP-1 receptors. DWAT contribute to skin maintenance and regeneration and reduced DWAT has been associated with aging skin, decreased collagen production, and increased activity of an enzyme involved in collagen degradation (matrix metalloproteinase-1.) Studies show that GLP-1 receptors on ASDCs may decrease the production of protective cytokines and growth factors, impair fibroblast migration and collagen synthesis, and increase oxidative stress within the cells. There's also a lot more interesting in the weeds findings, but don't want this to get crazy long. They touch on estrogen receptors, muscle loss, etc.

The authors ALSO found evidence suggesting that GLP-1RAs may have effects that support skin health too. It reduces chronic inflammation and lower concentrations of AGEs. They also associate this with reduction of blood glucose levels. There are various studies touching on this as well. The authors also found from other studies that GLP-1s improve endothelial function and increase microvascular perfusion within the skin and subcutaneous tissue. But they note that no published study has directly linked these effects to delay skin aging yet and state additional research is needed.

The point of this review is that it argues Ozempic face is way more complex than simply losing facial fat, but there is currently still not enough evidence that GLP-1s directly age the skin. Please do not take this as discouragement from using them or as fear mongering. I want people to know the science of what could be going on. Keep in mind that this is a mini review, not a clinical trial. A lot of the mechanisms come from biology research and inferences. But what I would offer from this is. If these mechanisms are happening and you are using them, what would theoretically protect against them? If you're worried about reduced collagen signaling, you would want things that support collagen production. If you're concerned on oxidative stress, you would want to reduce oxidative damage. If it's about the reduced stem cell activity, you want to support tissue repair and regeneration. If you're worried about the loss of dermal estrogen signaling, that is currently being studied in peri and postmenopausal research. This paper to me actually is something that can be used on future research on how to combat these things.

Paschou IA, Sali E, Paschou SA, Tsamis KI, Peppa M, Psaltopoulou T, Nicolaidou E, Stratigos AJ. GLP-1RA and the possible skin aging. Endocrine. 2025 Sep;89(3):680-685. doi: 10.1007/s12020-025-04293-w. Epub 2025 Jun 11. PMID: 40498168; PMCID: PMC12370548.

https://www.dropbox.com/scl/fi/xldxphuzqw86m7xqx5s20/GLP-1RA-and-the-possible-skin-aging.pdf?rlkey=iiqiobjnckzwu3zt4yqxm1djl&st=pato0lja&dl=0 (dropbox link is actually from Thriving Through Menopause by Chiza Westcarr)

This is the first study to investigate the efficacy and safety of using laser-induced microjet injectors to administer PDLLA, tailored for the treatment of patients with rosacea.

Yes this study is not using microneedling, BUT... the paper emphasizes how Mirajet creates repeated micro-tearing, creates dermal mechanical stimulation, has rapid pressure, and no needle tracts. Those are essentially the same biological ideas with microneedling. PLUS Juvelook already has medical research with microneedling (and more in clinical trials currently.) Who knows how much of Mirage's effect is actually unique or if it deliver more uniformly. Maybe microneedling creates a different inflammatory pattern and maybe neither matters. That comparison in research paper doesn't exist here or yet, but something that should be investigated.

Also including this information as I've been doing a lot of research into rosacea because my friend has it. And I've found that tox helps.

>"In the quest for novel treatments for rosacea, botulinum toxin has emerged as a potential solution. It has demonstrated efficacy in addressing persistent erythema and flushing associated with rosacea by inhibiting mast cell degranulation and acetylcholine release, while also modulating substance P, calcitonin gene-related peptide, and vasoactive intestinal peptide. According to various studies, botulinum toxin can alleviate symptoms of
rosacea, such as flushing and erythema, for a duration of at least 8 weeks, with its effects typically lasting between 3 and 4 months. In the case report by Yu et al., botulinum toxin was
administered to a female patient with rosacea, resulting in temporary improvement. However, 1 month after the injection, the erythema returned, following a 1-month absence of symptoms.
Subsequently, the patient received poly-L-lactic acid (PLLA) via injection with a mesogun. Notably, 1 week after the injection, the patient experienced a recurrence of flushing and redness, which gradually subsided after 4 weeks without further treatment."

I also wanted to add when it comes to the safety profile of ingredients and molecules. It cites a study from 2022 where PLLA actually aggravated rosacea. So we have preliminary research on the difference between PDLLA and PLLA and rosacea now. The authors also use that study as an example on why PDLLA might behave differently. Their reasoning is essentially that PLLA is crystalline, has slower degradation, is irregular particles, and has longer inflammatory response. Versus PDLLA is amorphous, has faster degradation, is spherical porous particles, and potentially has a different tissue response. What I'd like to see in future research is comparative histology. Looking at macrophage recruitment, foreign body giant cells, IL-6, TNF-α, and mast-cell activation because how it affects wound healing and inflammation is relevant for rosacea.

Something also interesting I'd point out is that the authors propose that PDLLA induced collagen plus VEGF improves vascular stability, reinforcing the basement membrane and making superficial vessels less reactive. Most treatments for rosacea suppress inflammation, vasodilation, and neuromuscular signaling. They're suggesting that maybe chronic erythema is partly a structural dermal problem, not only an inflammatory one. That is very different at how experts look at it, now if that's true or not I dunno, but it's worth exploring.

And after seeing this, I actually am wondering if regenerative biostimulators be used not just to build collagen or stimulate regenerative aesthetics in the sense of anti-aging purposes, but to remodel inflammatory skin disease.

Seo SB, Wan J, Thulesen J, Jalali A, Vitale M, Kim SB, Yi KH. Poly-d,l-Lactic Acid Via Transdermal Microjet Drug Delivery for Treating Rosacea in Asian Patients. J Cosmet Dermatol. 2024 Dec;23(12):3993-3998. doi: 10.1111/jocd.16556. Epub 2024 Sep 9. PMID: 39248245; PMCID: PMC11626325. https://onlinelibrary.wiley.com/doi/10.1111/jocd.16556

I put together a free MedSpa market-data report and wanted to share it here in case it’s useful to owners/operators.

No email required, no gated download -- it's free, no catch

there's plenty of vendor reports, trend pieces, and isolated benchmarks available online, but not much that pulls together market size, state-level expansion signals, treatment demand, Botox pricing corridors, PE/M&A activity (which is actually booming rn), and actual operator questions in one place.

The report covers:

• where expansion looks attractive by state
• treatment demand signals
• pricing/profit considerations, including Botox pricing corridors
• medspa M&A / PE buyer activity --> this one was the most interesting for me
• a conversion checklist for clinics

I’m planning to keep improving this quarterly, so I’d genuinely appreciate feedback from people actually running, managing, or working in medspas.

The intent is free value to the community, so help me help you.

Full report here:
https://aiclearpath.com/mirror/medspa-atlas-v2