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Tightening and Firming Loose Saggy Skin

When we loose weight, age, or spend too much time in the sun, we get stretched, saggy skin. What is the best skin tightening cream or serum to tighten skin? Do collagen supplements or foods help tighten skin? This article will discuss skin tightening treatments, “facelift creams”, skin firming creams, facial exercises, and other treatments to firm skin.


 The most common causes of loose sagging skin are:

  • Aging

  • Genetics

  • Pregnancy

  • Rapid weight loss

  • Sun damage

These issues cause loss of the skin component known as elastin.  Elastin gives skin it's elasticity and ability to bounce back after stretching.  Loss of elastin causes loose, saggy skin.


Can you replace lost elastin in skin and help skin regain it's firmness?  Keep reading to learn about serums, creams, supplements, and other ways to tighten skin.


Tightening and firming saggy skin

Laser Skin Tightening

How laser skin tightening works

Elastin gives our skin the remarkable ability to bounce back, but sadly, there's no current treatment to increase its levels. Thus, we turn our attention to collagen when trying to tighten saggy skin.

Imagine collagen as a tightly woven rope, structured in a triple helix pattern. This design is held together by connections called crosslinks, acting like tiny bridges between the strands. To understand how collagen reacts to heat, think about placing a steak on a grill and what happens- it shrinks! That is the collagen shortening from the high heat.

Diving into the science, when collagen fibrils – the small fibers of collagen – are heated, they undergo specific changes. The initial shrinking starts at around 149 degrees Fahrenheit (65°C), marking the beginning of denaturation. The main change occurs at 149 degrees Fahrenheit (65°C). This is when the internal crosslinks break, making the collagen contract even more, resulting in a shorter and thicker form. This immediate contraction of collagen means tissue contraction, which reduces the skin's looseness and gives it a lifted look.

Moreover, the heat and mechanical force of the device triggers a wound-healing process, leading to the formation of new collagen by active fibroblasts. Interestingly, the time needed for collagen to denature and contract depends on the temperature: the hotter, the faster.

So, how do we use this knowledge for skin tightening? It's all about accuracy. Devices like skin-tightening lasers, ultrasound, and radiofrequency aim to deliver the right amount of heat to the correct skin layer. When done right, this technique doesn't just heat the skin, but rejuvenates it, resulting in a tighter and more lifted appearance. Skin tightening laser, radiofrequency, and ultrasound treatments do not work unless they can heat the skin to 149 degrees Fahrenheit (65°C). This means that if it does not hurt- it does not work!  So not waste your money on painless skin tightening treatments- they are not effective.

Devices used to tighten saggy skin

Types of Devices Used to Firm and Tighten Loose Skin

List of popular skin-tightening treatments and the modalities used to tighten skin:

  1. ClearLift (laser)
  2. Cold atmospheric plasma (CAP) - Specific brand names might emerge as the technology gains traction.
  3. Doublo (High-intensity ultrasound (HIFU))
  4. Er:YAG lasers (laser)
  5. Exilis (radiofrequency)
  6. Fraxel (laser)
  7. Pelleve (radiofrequency)
  8. Thermage (radiofrequency)
  9. Thermomechanical fractional injury (TMFI) - Await more commercial names as this method gains popularity.
  10. Ulthera (Ultherapy) (High-intensity ultrasound (HIFU))
  11. Venus Viva (radiofrequency)
  12. VShape Ultra (ultrasound and radiofrequency)

For the most up-to-date devices and brand names for skin tightening, particularly for emerging methods like CAP and TMFI, consult with a dermatologist or aesthetic provider.

Remember- these only work if they can increase the collagen temperature to 149 degrees Fahrenheit (65°C). Not all of these can! (1,3)

Skin Tightening and Firming Creams

Many products claim to be a facelift cream or a facelift in a bottle, but do these really work to tighten and firm excess loose skin? Yes in some cases, but the results are temporary. Face, neck and body skin firming creams and serums work much better to prevent sagging skin than to get rid of loose skin.  So if you plan to get pregnant, use Ozempic or a weight loss drug, or are getting older, use a skin firming cream to prevent saggy loose skin before it happens.


There are a few ways that these skin tightening creams work:

  1. Hydrate and plump the skin
  2. Form a firm coating on the skin's surface
  3. Prevent loss of elastin
  4. Increase collagen in skin

Lets look at each of these, and how they work, but first, lets see which skin firming creams are best before we learn why.

Will Any Face Tightening Product Work for My Skin?

Every skin care product will function differently depending on your skin care routine and your Baumann Skin Type. 


Skin tightening products work best with a full regimen built for your skin's unique needs. 


Take the quiz and we will help you shop by your Baumann Skin Type.



Glycolic acid

Which Skin Firming Products Are Best?

It is always best to prevent skin sagging. Applying daily SPF is one of the best ways to prevent wrinkles or sagging skin by protecting your kin from loosing elastin.


If have sagging loose skin, the best products with long term results are hydroxyacids, exosomes, growth factors, and retinoids. These help the body produce collagen, which helps tighten the skin by thickening the size of the dermal layer of the skin by increasing the amount of collagen.


Retinol is the best way to tighten face skin with a cream or a serum because it also helps prevent the loss of elastin so that skin retains its elasticity.

 Look for face tightening products with at least 0.25% retinol to see your desired results. Many of these creams or serums may take time to produce a noticeable amount of collagen, so be patient and give it 4- 6 months for a noticeable effect. Start with a low strength and work your way up to stronger strengths if you want to tighten the face, neck, or chest.




If you want to tighten the skin on the arms, thighs, or stomach or other parts of the body, use a high strength retinol or a prescription retinoid.



To tighten the skin on your eyelids, try the Plated Skin Science Intense Serum that has exosomes.  This can also be used on the entire face and neck.  It works best when it is used in your skin care routine along with a retinoid.  The Plated is twice a day and at night should be followed by the retinoid at night for most aging skin types.



retinol

Skin Firming Ingredients

The best skin care for your body comes down to the ingredients. Though everyone will have different needs depending on their Baumann Skin Type, there are a few key ingredients to look for.


Our dermatologist-recommended skin firming ingredients include:

  • Exosomes: increase production of collagen
  • Retinol: Retinol encourages the natural production of collagen to tighten skin and smooth wrinkles. Retinol also prevents the loss of collagen and elastin.
  • Saccharides: Saccharides are sugars that are placed in skincare products to give the skin a temporary feeling of firmness(1). They coat the skin like fondant on a cake. There are many types of saccharides. Examples include algae, CM glucan, carrageen, alginic acid, hyaluronic acid, heparan sulfate and other glycosaminoglycans.
  • Glycerin: Glycerin is a common humectant moisturizing ingredient that draws water to the skin’s surface making it feel instantly firmer
  • Vitamin C: Increases collagen synthesis making skin firmer, thicker and stronger
Glycerin

How Face Lift Creams Work

There are several way that skin tightening “facelift in a bottle” creams and serums can make your stretched skin appear tighter.  However, these results are temporary.

Products That Plump the Skin

Humectants are remarkable agents that have the ability to attract and retain moisture. Among these, hyaluronic acid, glycerin, and heparan sulfate stand out for their exceptional hydrating properties. When applied to the skin, these molecules bind to its surface, effectively drawing water into themselves like tiny sponges. This action fills the skin with moisture, leading to a visibly firmer and plumper appearance. Hyaluronic acid and heparan sulfate, in particular, belong to a class of molecules known as glycosaminoglycans. Their structure allows them to hold onto a vast amount of water relative to their size. However, it's worth noting that the hydrating effects of these humectants are temporary, often requiring reapplication to maintain the skin's plumpness. Furthermore, their efficacy is accentuated in humid climates, where there's ample moisture in the air for these humectants to harness and deliver to the skin.

Products That Coat the Skin

Saccharides, specifically mannitose and sorbitol, have an interesting behavior when applied to the skin. Much like the fondant on a cake creates a smooth, firm surface, these saccharides lay down a protective coating on the skin. From a physics perspective, this coating acts as a barrier that resists deformation. When pressure is applied to the skin, the saccharide layer distributes this force, preventing localized strain and helping the skin maintain its shape. In essence, it adds an element of rigidity to the skin's surface, similar to how a protective shell might bolster the structural integrity of an object. Chemically speaking, saccharides have an affinity for water due to their hydroxyl groups. These groups can form hydrogen bonds with water molecules, allowing saccharides to bind and retain moisture. This water-binding property not only hydrates the skin but also creates a cohesive, gel-like layer that adheres to the skin's surface, giving it that firm feel. However, these effects are temporary. Like makeup or other surface treatments, this saccharide "shield" is washed away when cleansed, returning the skin to its natural state.

Creams and other products

Products That Prevent Sagging

If you are starting a weight loss drug like Ozempic or a diet and plan to lose weight, using these serums and crams can help prevent skin sagging that occurs with weight loss.

Retinoids and antioxidants can help prevent the elastin loss that leads to loose skin.


Retinoids and Elastin:
Retinoids, derivatives of Vitamin A, play a pivotal role in the maintenance of skin health, particularly when it comes to safeguarding elastin. Elastin is a protein in our skin that gives it the ability to spring back after being stretched, akin to a rubber band. Elastase, on the other hand, is a type of matrix metalloproteinase (MMP), an enzyme responsible for breaking down and remodeling the extracellular matrix. While MMPs have natural, necessary functions in the body, excessive elastase activity is detrimental because it breaks down elastin, leading to loss of elasticity and, ultimately, sagging skin. Retinoids act as guardians, inhibiting the activity of harmful MMPs like elastase, thereby preserving the elastin network in our skin and preventing sagging.

Antioxidants and Elastin:
Antioxidants are the skin's natural defenders against oxidative stress caused by free radicals. Free radicals are unstable molecules that can wreak havoc on skin components, including elastin. Apart from directly damaging elastin, free radicals can also influence the expression of MMPs, pushing the scales towards more elastin breakdown. By neutralizing these damaging free radicals, antioxidants play a dual role. First, they directly protect elastin from free radical damage, and secondly, they help mitigate the adverse effects free radicals have on MMP expression. This two-pronged action ensures that the skin retains its elasticity, warding off premature sagging and maintaining a youthful appearance.

16 Bauman Skin Types

Products That Increase Collagen

Collagen is the very foundation that provides skin its density and sturdiness. It is the scaffolding of the skin and gives structure, thickness, and resilience. Think of collagen as a dense mesh that lends the skin its strength and thickness. 

From a physics perspective, a thicker material necessitates more force to be deformed or disturbed. Therefore, skin rich in collagen with a thicker dermis requires more pressure to show movement, reducing the jiggly or loose appearance often associated with stretched or excess skin. An abundant collagen supply makes the skin appear firmer, smoother, tighter, and more youthful.

Retinoids

Vitamin C

Vitamin C

In the supplement section below I discuss why Vitamin C is good for skin tightening.  However, it is very difficult to consume enough Vitamin C by mouth to raise levels of ascorbic acid in the skin. For this reason, topical Vitamin C serums are good to use to try and tighten the skin.

Apply them 2 times a day, preferably after using a low pH cleanser or body wash.


Exosomes

There are many types of exosomes, but they are not all effective. 

These are our favorite exosome products to tighten skin.  


Plated Skin Science Intense Serum

Plated Skin Science Daily Serum


You can learn more about these in my interview of the cardiologist who created these.

How Long Will the Effects of Skin Firming Products last?

Some products like saccharides, hyaluronic acid and glycerin have immediate but temporary effects and last only while the products are on the face. Other products such as retinol and vitamin C have more long-term effects but must be used for months before results are seen. All products work best to firm the skin as part of a complete and consistent skincare routine designed for your Baumann Skin Type.

Proline to hydroxyproline

Supplements For Loose Skin

Will taking Vitamin C or collagen supplements or capsules tighten the face or body skin? Vitamin C supplement can help thicken skin but collagen supplements are not worth taking to try to tighten the skin unless you are vegan or a vegetarian and are not getting a lot of collagen in your diet.

Collagen Supplements To Tighten Skin

Collagen is a protein found in various parts of our body including bones, tendons, skin, and muscles. Collagen supplements contain certain amino acids, notably hydroxyproline, glycine, and proline. When we ingest these supplements, our body breaks them down into smaller pieces which are then absorbed into our bloodstream. Some studies suggest that these pieces can reach our skin but that is not known for sure.

But here's the catch: collagen supplements are derived from various sources like fish, cattle, or other animals, so it is not  choice for vegans and vegetarians.

Vitamin C supplements

Vitamin C Supplements

Collagen contains an amino acid called proline. For our body to produce collagen, proline needs to be converted into another compound called hydroxyproline and Vitamin C is required for this proline to hydroxyproline conversion to occur. Without Vitamin C, collagen is not produced and a condition known as scurvy occurs.

Consuming vitamin C helps increase our body's own production of collagen.

So instead of taking collagen supplements, consider taking Vitamin C (500mg twice daily) to increase skin collagen content.

Diet to Firm Skin

The best foods to firm skin have high amounts of collagen or Vitamin C.

Foods With Collagen

  • Beef: Particularly tougher cuts that are slow-cooked.
  • Bone Broth: Made from simmering bones and cartilage, homemade versions are especially rich.
  • Chicken: Especially the skin and tougher, slow-cooked parts.
  • Eggs: The whites contain amino acids that can support collagen production.
  • Fish: Especially the skin and any connective tissues.
  • Gelatin: This is essentially cooked collagen and can be found in foods like jellies and certain desserts.
  • Pork: Like with beef, the tougher cuts that are usually slow-cooked.
  • Shellfish: The connective tissues are the parts that contain collagen.
  • Turkey: As with chicken, the tougher parts and the skin are rich in collagen.
  • Wild Game: Animals like deer can also be good sources, especially their tougher cuts.

Foods high in Vitamin C:

  • Acerola Cherries: Often used in supplements due to their extremely high vitamin C content.
  • Bell Peppers: Especially the red variety.
  • Blackcurrants.
  • Broccoli.
  • Brussels Sprouts.
  • Cantaloupe.
  • Cauliflower.
  • Citrus Fruits: Including oranges, grapefruits, lemons, and limes.
  • Guavas: One of the richest sources of vitamin C.
  • Kiwi Fruit.
  • Kale.
  • Mango.
  • Papayas.
  • Parsley.
  • Pineapple.
  • Potatoes: Especially the skin.
  • Raspberries.
  • Spinach.
  • Strawberries.
  • Tomatoes: Especially when they are ripe.
  • Watermelon
Does loose skin go away?

Does Loose Skin Go Away?

Whether or not the skin tightens on its own largely depends on its elasticity, which is the skin's ability to return to its original form after being stretched. This elasticity is significantly influenced by the presence of elastin, a protein that endows the skin with its spring-back quality.

Younger skin generally has a higher concentration of elastin compared to older skin. This means that younger individuals are more likely to see their skin bounce back more quickly and efficiently after it has been stretched, say, post-pregnancy or after shedding a considerable amount of weight. Additionally, skin that has been protected from sun damage retains its elastin better than sun-exposed skin. (Sun damage accelerates the breakdown of elastin, causing the skin to lose its elasticity faster.)

However, while the skin's natural elasticity can help it recover to some degree, there are limits. If the skin has been excessively stretched for prolonged periods or if someone has experienced significant and rapid weight loss, the skin may not fully return to its original state. Other factors like genetics, nutrition, and overall health also play roles in the skin's ability to tighten after being stretched.

While loose skin can improve and regain some of its tightness due to the elastin present, it may not always revert entirely to its former tautness, especially in older individuals or those with prolonged skin stretching. Protecting the skin from sun damage and maintaining its health can improve its resilience and ability to bounce back.

Facial exercises to tighten skin

Facial Exercises to Tighten Skin

Many believe that exercises for facial muscles might slow down the signs of aging and give more volume to the face. However, as we age, our muscles naturally become more tense, so this idea might not hold up scientifically. Studies over 8 to 12 weeks where participants did facial exercises or used devices that moved the face muscles found that the muscles of middle-aged women might appear bigger. But it's not clear if the muscles actually grew or if they just relaxed and lengthened. (18)

Moreover, it's not certain if the bigger appearance of facial muscles after these exercises is because the muscles grew, they relaxed, they became more toned, or the ligaments attached to them changed. While some studies did find that the facial muscles looked bigger, they didn't necessarily show that the overall appearance of the face improved.

One specific study worked with 18 people. Half of them did facial exercises targeting five facial areas for 7 weeks, while the other half didn't. This study found no major difference between the two groups. 919) Another review of nine different studies found that, as of 2014, there wasn't enough evidence to say facial exercises help make the face look younger. (20) At this point, the consensus is that facial exercises might not help the aging face look better. In fact, doing these exercises might even make wrinkles appear more pronounced. This is supported by the fact that treatments like Botox work by reducing facial movements to lessen wrinkles.

Facial Massage To Treat Saggy Skin

Facial massage tools are all the rage now. Studies have shown that massage and pulling of the skin can prompt fibroblasts to make more collagen. However, the results are minimal. These facial firming tools work best in conjunction with Vitamin C and retinol that boost collagen production.

Build a Skin Care Regimen That Tightens Your Skin

There is a lot to know when shopping for firming creams and serums. Let us help!


Take the skin care routine quiz and we will help you build a skin care routine that is right for your Baumann Skin Type.





Level up your skin care knowledge with medical advice from dermatologists

Best References and Scientific Publications on Skin Tightening:

  1. Baumann L. Skin Tightening in Ch. 30 of Baumann's Cosmetic Dermatology Ed 3. (McGraw Hill 2022)
  2. Baumann L. Facial Anatomy and Aging in Ch. 7 of Baumann's Cosmetic Dermatology Ed 3. (McGraw Hill 2022)
  3. Baumann, L. Cosmeceuticals and Cosmetic Ingredients (McGraw Hill 2015)
  4. Stylianopoulos, T., Aksan, A., & Barocas, V. H. (2008). A structural, kinetic model of soft tissue thermomechanics. Biophysical journal94(3), 717-725.
  5. Alexiades-Armenakas M, Rosenberg D, Renton B, Dover J, Arndt K. Blinded, randomized, quantitative grading comparison of minimally invasive, fractional radiofrequency and surgical face-lift to treat skin laxity. Arch Dermatol 2010;146(4):396-405.

  6. Ortiz AE, Goldman MP, Fitzpatrick RE. Ablative CO2 lasers for skin tightening: Traditional versus fractional. Dermatol Surg 2014;40 Suppl 12:S147-S151.
  7. Carruthers J, Fabi S, Weiss R. Monopolar radiofrequency for skin tightening: our experience and a review of the literature. Dermatol Surg 2014;40 Suppl 12:S168-S173.
  8. MacGregor JL, Tanzi EL. Microfocused ultrasound for skin tightening. Semin Cutan Med Surg 2013;32(1):18-25.
  9. Alam M, White LE, Martin N, Witherspoon J, Yoo S, West DP. Ultrasound tightening of facial and neck skin: A rater-blinded prospective cohort study. J Am Acad Dermatol 2010;62(2):262-269.
  10. Juhász M, Korta D, Mesinkovska NA. A review of the use of ultrasound for skin tightening, body contouring, and cellulite reduction in dermatology. Dermatol Surg 2018;44(7):949-963.
  11. Rohrich, R. J., Schultz, K. P., Chamata, E. S., Bellamy, J. L., & Alleyne, B. (2022). Minimally Invasive Approach to Skin Tightening of the Face and Body: Systematic Review of Monopolar and Bipolar Radiofrequency Devices. Plastic and Reconstructive Surgery150(4), 771-780.
  12. Rohrich, R. J., Schultz, K. P., Chamata, E. S., Bellamy, J. L., & Alleyne, B. (2022). Minimally Invasive Approach to Skin Tightening of the Face and Body: Systematic Review of Monopolar and Bipolar Radiofrequency Devices. Plastic and Reconstructive Surgery150(4), 771-780.
  13. Albornoz, C. A., Nichols, S. E., Wang, J. V., Saedi, N., & Munavalli, G. S. (2022). Optimizing skin tightening in aesthetics in men. Clinics in Dermatology40(3), 244-248.
  14. Araújo, A. R. D., Soares, V. P. C., Silva, F. S. D., & Moreira, T. D. S. (2015). Radiofrequency for the treatment of skin laxity: mith or truth. Anais brasileiros de dermatologia90, 707-721.
  15. Oni, G., Hoxworth, R., Teotia, S., Brown, S., & Kenkel, J. M. (2014). Evaluation of a microfocused ultrasound system for improving skin laxity and tightening in the lower face. Aesthetic Surgery Journal34(7), 1099-1110.
  16. Xhauflaire‐Uhoda, E., Fontaine, K., & Piérard, G. E. (2008). Kinetics of moisturizing and firming effects of cosmetic formulations. International journal of cosmetic science30(2), 131-138.
  17. CAMPOS, P., Melo, M. O., & Camargo Junior, F. B. (2014). Effects of polysaccharide-based formulations on human skin. Journal: Polysaccharides, 1-18.
  18. Moy, M., Diaz, I., Lesniak, E., & Giancola, G. (2023). Peptide‐pro complex serum: Investigating effects on aged skin. Journal of Cosmetic Dermatology22(1), 267-274.
  19. Abe T, Loenneke JP. The influence of facial muscle training on the facial soft tissue profile: A brief review. Cosmetics. 2019;6(3):50.
  20. De Vos MC, Van den Brande H, Boone B, Van Borsel J. Facial exercises for facial rejuvenation: a control group study. Folia Phoniatr Logop. 2013;65(3):117-22.
  21. Van Borsel J, De Vos MC, Bastiaansen K, Welvaert J, Lambert J. The effectiveness of facial exercises for facial rejuvenation: a systematic review. Aesthet Surg J. 2014;34(1):22-7.Aito-Inoue M, Lackeyram D, Fan MZ, Sato K, Mine Y. Transport of a tripeptide, Gly-Pro-Hyp, across the porcine intestinal brush-border membrane. J Pept Sci. 2007;13(7):468-74.
  22. Shigemura Y, Kubomura D, Sato Y, Sato K. Dose-dependent changes in the levels of free and peptide forms of hydroxyproline in human plasma after collagen hydrolysate ingestion. Food Chem. 2014;159:328-32.

  23. Spiro A, Lockyer S. Nutraceuticals and skin appearance: Is there any evidence to support this growing trend? Nutrition Bulletin. 2018;43(1):10-45.

  24. León-López A, Morales-Peñaloza A, Martínez-Juárez VM, Vargas-Torres A, Zeugolis DI, Aguirre-Álvarez G. Hydrolyzed Collagen-Sources and Applications. Molecules. 2019;24(22):4031.

  25.  Choi FD, Sung CT, Juhasz ML, Mesinkovsk NA. Oral Collagen Supplementation: A Systematic Review of Dermatological Applications. J Drugs Dermatol. 2019;18(1):9-16.

  26. Ohara H, Ichikawa S, Matsumoto H, Akiyama M, Fujimoto N, Kobayashi T, et al. Collagen-derived dipeptide, proline-hydroxyproline, stimulates cell proliferation and hyaluronic acid synthesis in cultured human dermal fibroblasts. J Dermatol. 2010;37(4):330-8.

  27. Kawaguchi T, Nanbu PN, Kurokawa M. Distribution of prolylhydroxyproline and its metabolites after oral administration in rats. Biol Pharm Bull. 2012;35(3):422-7.

  28. Watanabe-Kamiyama M, Shimizu M, Kamiyama S, Taguchi Y, Sone H, Morimatsu F, et al. Absorption and effectiveness of orally administered low molecular weight collagen hydrolysate in rats. J Agric Food Chem. 2010;58(2):835-41.

  29. Xu D, Li D, Zhao Z, Wu J, Zhao M. Regulation by walnut protein hydrolysate on the components and structural degradation of photoaged skin in SD rats. Food Funct. 2019;10(10):6792-6802.

  30. Jhawar N, Wang JV, Saedi N. Oral collagen supplementation for skin aging: A fad or the future? J Cosmet Dermatol. 2020;19(4):910-912.

  31. Alcock RD. Dietary collagen intake and sources for support of dense connective tissues in athletes. Doctoral dissertation, ACU Research Bank, 2019.


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