25 pound weight loss, crepey forearms - how can I fix significant wrinkling and skin laxity? (Photo)

Question

I was on a Glp For about 16 monyths and lost about 25 lbs slowly. Its been over a year now and i have noticed some muscle loss as well as significant wrinkling and sin laxity to my forearms. I am also fair skinned and have years of sun damage from growin up in SO CA. I cant seem to find any info on treating the forearms. Ive had 6 treatments of Potenza microneedling over last yr with little to no improvement. Also curious if Sculptra might help.

Nelson Lee Novick, MD · Answer

Crepey skin on the arms and legs can be a difficult issue to treat. However, I have found that combining a series of in-office superficial peels, particularly using a high concentration of a beta hydroxyacid, coupled with the regular, at-home use of a  Rx alpha hydroxyacid for morning application and a topical retinoid for bedtime use, to yield gratifying results after about six to eight months of the combined regimen. Particularly resistant areas of skin can be addressed with the additional use of a series of treatments using injectable hyaluronic acid skin boosters, if necessary.  Naturally, the regular, daily use of a high SPF sunscreen should go without saying from here on in to prevent further damage to the "fabric" of the skin, and, if medically feasible, beginning a regular program of strength strength training would be helpful for building muscle mass.
Exercise a good deal of "buyer beware" caution when considering the use of expensive, energy-based device treatments, as the hard science to support their use lags woefully behind the heavy marketing hype and social media buzz to promote them.  You would be wise to make sure to consult with an experienced, board certified cosmetic dermatologist. Hope this helps and best of luck.

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your concerns and the photo. What you’re describing—crepey, wrinkled forearms with some muscle loss after significant weight loss—is very common, especially in fair-skinned individuals with a history of sun exposure. It can be frustrating because the forearms are one of the more challenging areas to rejuvenate.

Here’s a breakdown of what’s happening and options to consider:

1. Why this occurs

Skin laxity and wrinkling: After weight loss, the skin may not fully “bounce back,” particularly in areas with thinner dermis like the forearms.

Sun damage: Years of sun exposure accelerate collagen and elastin breakdown, worsening crepiness.

Muscle loss: Reduced muscle mass under the skin further contributes to sagging and wrinkling.

2. Treatments you’ve tried

Potenza microneedling: This is great for stimulating collagen, but forearms are often resistant, especially if there is significant sun damage or laxity. Limited improvement is common in this area.

3. Potential next steps

Sculptra:

Sculptra can help by stimulating collagen over time, improving skin thickness and texture. Multiple sessions may be needed, spaced a few months apart.

It can improve some volume loss, but it may not fully tighten severely lax skin.

Energy-based treatments:

Radiofrequency or fractional RF (like Profound RF or Morpheus8): Can stimulate deeper collagen remodeling and improve firmness.

Ultrasound-based treatments (Ultherapy): May help lift and tighten some skin, though results vary on forearms.

Combination approach:

Often, the best results come from combining treatments:

Collagen-stimulating injectables (Sculptra)

Energy-based skin tightening (RF or ultrasound)

Microneedling with PRP or radiofrequency (to maximize texture improvement)

Lifestyle and supportive measures:

Daily broad-spectrum sunscreen to prevent further sun damage

Strength training for forearms can help improve the underlying muscle tone

Moisturizers with retinoids or peptides can modestly improve skin thickness and texture over time

Bottom line:
Forearm skin is stubborn, especially after weight loss and chronic sun exposure. While no single treatment is likely to fully restore smoothness, a multi-modal approach with Sculptra and energy-based skin tightening usually provides meaningful improvement. Patience is key, as results can take several months to become visible.

You’ve already made a great start with microneedling, and building on that with collagen stimulation and tightening strategies can make a noticeable difference.

25 pound weight loss, crepey forearms - how can I fix significant wrinkling and skin laxity? (Photo)

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