What can I do to fix the loose skin above my knees? (Photos)

Question

I’m pretty athletic, 39, have gone through some ups and down with my weight. I’m pretty self conscience about the loose skin above my knees and thighs. Is there anything I can do about it or help to further prevent it from getting worse?

Kally Papantoniou, MD, FAAD · Answer

Loose skin above the knees can be frustrating because exercise can improve muscle tone, but it usually will not fully tighten stretched skin. For mild to moderate laxity, non-surgical tightening treatments such as Ultherapy, radiofrequency-based treatments, or certain collagen-stimulating devices may help improve firmness over time, though results are typically gradual and modest.

If there is a larger amount of loose skin, surgical options may give the most dramatic improvement. I would start with an in-person consultation so your skin quality, degree of laxity, and overall thigh/knee anatomy can be assessed. To help prevent worsening, maintaining a stable weight, strength training, daily sunscreen when exposed, and good body skincare can all support the skin as much as possible.

Erik Peterson, MD · Answer

Hi, I’m Dr. Erik Peterson, a cosmetic dermatologist.
Loose skin above the knees and on the thighs is a really common concern, especially in people who’ve had weight fluctuations. That area tends to be stubborn because the skin is relatively thin and doesn’t “snap back” as well once it’s been stretched.
If the issue is early or mild laxity, you can often get some improvement with skin tightening treatments that stimulate collagen, such as radiofrequency microneedling or other energy-based tightening devices. These can help firm the skin gradually over a series of treatments, but the results are typically subtle to moderate, not a full correction.
If there is a stronger component of actual excess skin (as opposed to just mild laxity), non-surgical treatments have limits. They can improve texture and a bit of firmness, but they won’t fully remove loose skin once it’s mechanically stretched.
From a prevention standpoint, the biggest factors are:
* Keeping weight stable going forward (this matters more than any device)* Building muscle in the thighs through resistance training, which helps support and “fill out” the skin* Sun protection, since UV exposure accelerates collagen breakdown over time
If it’s more noticeable when standing or after weight loss, a surgical thigh lift is the only truly definitive option, but most athletic patients in your situation start with non-surgical tightening first and reassess based on response.

Anna Chacon, MD, FAAD · Answer

Loose skin above the knees is very common in active patients who have had weight fluctuations, and it’s usually a combination of mild skin laxity, changes in collagen, and sometimes a small amount of residual fat. The key is matching the treatment to how significant the laxity is.

For mild to moderate looseness, start conservatively. The most impactful non-surgical options are skin-tightening devices like radiofrequency microneedling or ultrasound-based treatments. These work by stimulating collagen and can gradually firm the area over a few months. Results are subtle but meaningful, especially in someone already fit. Pairing this with consistent strength training (especially quads and hamstrings) helps “fill out” the area and improve overall contour.

If there’s a small pocket of fat contributing, combining tightening with fat-reduction treatments can improve the result. Topical skincare (retinoids, body firming creams) plays a supporting role but won’t significantly tighten on its own.

For more noticeable or crepey laxity, energy-based devices can still help, but expectations should be realistic—multiple sessions are usually needed, and improvement is partial, not dramatic.

The only definitive option for significant excess skin is a surgical thigh lift (thighplasty), which physically removes the extra skin and tightens the area. This gives the most dramatic improvement but comes with scars and downtime, so it’s typically reserved for more advanced cases.

To prevent progression, focus on weight stability, resistance training, and good skin care. The earlier you intervene with collagen-stimulating treatments, the better the long-term outcome tends to be.

What can I do to fix the loose skin above my knees? (Photos)

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