Weight loss interventions can cause new skin issues to crop up for your patients

While bariatric surgery can alleviate some skin problems, rapid weight loss can also trigger other skin conditions, researchers warn in advocating for improved dermatological monitoring after surgery.Obesity is associated with a variety of skin disorders, including psoriasis, hidradenitis suppurativa, hirsutism and acanthosis nigricans. Significant weight loss, particularly through surgery, generally slows the progression of these conditions.Paradoxically, bariatric surgery is sometimes responsible for the development of new pathologies. A literature review conducted by Polish researchers identified these postoperative dermatological manifestations.Hair loss is a frequent and well-known complication of bariatric surgery. Rapid weight loss combined with zinc and iron deficiencies could be the cause of this phenomenon. In patients who have developed post-surgical alopecia, taking multivitamins can help with hair regrowth, but zinc sulfate supplements show better results in stopping hair loss and promoting gradual regrowth.Post-surgical complicationsSeveral case reports have described prurigo pigmentosa following bariatric surgery. Metabolic disturbances caused by the procedure and a decrease in insulin levels are suggested as possible explanations for this condition.Cases of acquired acrodermatitis enteropathica, also caused by zinc malabsorption, have been reported in the literature. Niacin deficiency has been associated with cases of pellagra, while vitamin A deficiency has led to cases of xeroderma and phrynoderma. Their incidence remains relatively rare and resolves with appropriate supplementation.These cases highlight the importance of monitoring nutritional status after bariatric surgery, as patients are at higher risk of developing deficiencies, according to the authors of this literature review.Disease improvementsNearly 20% of obese patients experience symptoms of hidradenitis suppurativa. When weight loss following surgery reaches at least 15%, a reduction in the affected areas is observed, and in some cases, the disease even disappears. Improvements are seen even in patients resistant to conventional therapies such as chlorhexidine and oral antibiotics.Regarding psoriasis, an increase in GLP-1 levels after bariatric surgery contributes to rapid improvement even before significant weight loss occurs. Some studies show that, as early as three months post-surgery, more than half of patients can successfully discontinue their systemic psoriasis medications. For treating obesity-related acanthosis nigricans, sleeve gastrectomy shows promising results. A 2023 study involving 319 obese patients reported a remission rate of over 85% for acanthosis nigricans.What about GLP-1 agonists? Taking GLP-1 receptor agonists may produce dermatological results similar to those achieved with bariatric surgery. GLP-1 agonists also show therapeutic potential in improving wound healing and treating lichen planopilaris. However, alopecia is also a frequently reported side effect of GLP-1 agonists. Hair loss is more common in semaglutide users compared to tirzepatide users. Redness, hives or itching are also possible, but these symptoms are generally localized to the injection site.This article has been translated from its original French and first appeared on our sister site Profession Santé.

Weight loss interventions can cause new skin issues to crop up for your patients

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