BACKGROUND Perimenopause and menopause may alter skin quality, repair capacity, sleep, mood, self-perception, and aesthetic motivation, yet midlife aesthetic aging is often framed primarily around estrogen and collagen loss. OBJECTIVE To propose a midlife skin–mood axis that integrates cutaneous biology, neuroendocrine signaling, immune activity, and psychosocial experience in perimenopausal and menopausal aesthetic dermatology. MATERIALS AND METHODS This narrative review synthesizes evidence regarding menopausal hormonal change, barrier and extracellular matrix remodeling, stress and sleep physiology, oxytocin-related signaling, body image, observer perception, and aesthetic motivation. RESULTS Midlife skin concerns may reflect interactions among reduced barrier resilience, altered repair capacity, neuroendocrine stress pathways, and changes in self-perception rather than isolated tissue aging. These relationships may influence tissue readiness, consultation goals, recovery counseling, patient-reported outcomes, and treatment satisfaction. CONCLUSION Recognizing the skin–mood axis may help aesthetic dermatologists individualize consultation, sequence treatments around tissue quality and recovery capacity, and align procedural choices with patient motivation and realistic patient-centered outcomes.
BACKGROUND Conventional clinical study results may not always translate to meaningful real-world outcomes due to strict patient selection and rigorous study design. OBJECTIVE To evaluate real-world clinical experience with use of a crosslinked hyaluronic acid filler containing 0.3% lidocaine. METHODS A survey was developed containing multiple choice and open-answer questions regarding experience with the crosslinked hyaluronic acid filler (OSM) including syringe characteristics, injection procedures, treatment appearance outcomes, patient satisfaction, and practitioner adoption. RESULTS Overall, 394 unique respondents from 317 different aesthetic practices responded to the survey 611 times. A total of 1,517 injections were administered with the most common injection areas being the nasolabial folds, midface, and the labiomental and prejowl sulci. In total, 81.3% (497/611) reported the extrusion force was "Good" or "Very Good" while 85.6% (523/611) reported the syringe was "Easy" or "Very Easy" to use during the injection procedure. A total of 92.6% (566/611) felt the areas of injection looked "Natural" or "Very Natural" after administration. In total, 92.0% (562/611) believe OSM complements current aesthetic treatment options. CONCLUSION In real-world clinical practice, OSM demonstrated high levels of clinician satisfaction. Overall, this study showcases the importance of real-world evidence generation when making aesthetic product adoption decisions.
BACKGROUND Glucagon-like peptide-1-based therapies have transformed obesity management. Their growing use among perimenopausal and menopausal women introduces new dermatologic considerations, particularly when weight loss occurs alongside menopause-associated changes in skin, adipose tissue, muscle, bone, and hair. OBJECTIVE To provide a practical framework for dermatologic management of perimenopausal and menopausal women receiving glucagon-like peptide-1-based therapies. METHODS PubMed was searched from inception through September 2026 for literature on Glucagon-like peptide-1-based therapies, menopause, skin aging, lean mass, alopecia, and aesthetic procedures. Reference lists of relevant reviews and consensus statements were also hand-searched. The senior author, a dermatologist and obesity medicine specialist, provides a practice-based perspective. RESULTS Key considerations include weight-loss trajectory, lean mass and bone preservation, nutrition, hair changes, procedural timing, and multidisciplinary comanagement. A staged aesthetic approach prioritizes skin quality during active weight loss, with structural correction as weight stabilizes. CONCLUSION Dermatologic care should anticipate the overlapping effects of menopause and substantial weight loss. A longitudinal, tissue-preservation approach may shift care from reactive correction toward proactive management.
