Prevalence of Skin Changes and Their Management After Bariatric Surgery: A Prospective Study at International Metabolic and Bariatric Center
Skin Changes and Their Management After Bariatric Surgery
DOI:
https://doi.org/10.54393/pjhs.v6i2.2715Keywords:
Alopecia, Bariatric Surgery, Psoriasis, SkinAbstract
Numerous skin disorders, including ulcerated necrobiosis lipoidica diabeticorum, hidradenitis suppurativa, intertrigo, and psoriasis, have shown improvement post-bariatric surgery. On the other hand, there have been reports of the occurrence of unfavourable skin disorders, most of which are related to nutritional deficiencies, such as those of iron, folic acid, vitamins, and trace elements. Objectives: To determine the prevalence of skin changes and diseases following bariatric surgery at our centre and their management strategies. Methods: This longitudinal study was carried out from April 2021 to March 2023. Patients were eligible for inclusion if they were aged 18 years or older, and had undergone one of the following bariatric procedures: sleeve gastrectomy, Roux-en-Y gastric bypass, or mini gastric bypass. Baseline clinical and demographic information was documented, At frequent follow-up intervals postoperative data were collected to record any new onset or changes in skin problems. Results: A total of 1656 patients who had undergone bariatric surgery were included. During the 12-month follow-up period, 1292 (78%) of patients experienced skin changes. Excess skin was the most prevalent type of skin alteration, affecting 1026 (62%) of patients, especially in the arms 745 (45%) and abdomen 1159 (70%). Conclusions: It was concluded that significant dermatological challenges are faced by patients post bariatric surgery and a holistic and multidisciplinary approach should be incorporated in managing these issues. By addressing both aesthetic and functional concerns, healthcare providers can enhance patients’ overall satisfaction and quality of life.
References
Arterburn DE, Telem DA, Kushner RF, Courcoulas AP. Benefits and Risks of Bariatric Surgery in Adults: A Review. Journal of American and Medical Association. 2020 Sep; 324(9): 879-87. doi: 10.1001/jama.2020.12567. DOI: https://doi.org/10.1001/jama.2020.12567
Gulinac M, Miteva DG, Peshevska-Sekulovska M, Novakov IP, Antovic S, Peruhova M et al. Long-Term Effectiveness, Outcomes and Complications of Bariatric Surgery. World Journal of Clinical Cases. 2023 Jul; 11(19): 4504. doi: 10.12998/wjcc.v11.i19.4504. DOI: https://doi.org/10.12998/wjcc.v11.i19.4504
Hany M, Zidan A, Ghozlan NA, Ghozlan MN, Abouelnasr AA, Sheta E et al. Comparison of Histological Skin Changes After Massive Weight Loss in Post-Bariatric and Non-Bariatric Patients. Obesity Surgery. 2024 Mar; 34(3): 855-65. doi: 10.1007/s11695-024-07066-y. DOI: https://doi.org/10.1007/s11695-024-07066-y
Bundela M, Bhatia K, Bhandari K, Namdeo C, Gupta S. Cutaneous Changes in Obese Patients Before and After Bariatric Surgery. International Journal of Research in Dermatology. 2023; 9(4): 182–188. doi: 10.18203/issn.2455-4529.IntJResDermatol20231825. DOI: https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20231825
Rosen J, Darwin E, Tuchayi SM, Garibyan L, Yosipovitch G. Skin Changes and Manifestations Associated with the Treatment of Obesity. Journal of the American Academy of Dermatology. 2019 Nov; 81(5): 1059-69. doi: 10.1016/j.jaad.2018.10.081. DOI: https://doi.org/10.1016/j.jaad.2018.10.081
Itthipanichpong Y, Damkerngsuntorn W, Tangkijngamvong N, Udomsawaengsup S, Boonchayaanant P, Kumtornrut C et al. Skin Manifestations After Bariatric Surgery. BioMed Central Dermatology. 2020 Dec; 20: 1-8. doi: 10.1186/s12895-020-00120-z. DOI: https://doi.org/10.1186/s12895-020-00120-z
Derderian SC, Dewberry LC, Patten L, Sitzman TJ, Kaizer AM, Jenkins TM et al. Excess Skin Problems Among Adolescents After Bariatric Surgery. Surgery for Obesity and Related Diseases. 2020 Aug; 16(8): 993-8. doi: 10.1016/j.soard.2020.04.020. DOI: https://doi.org/10.1016/j.soard.2020.04.020
Butt M, Khesroh E, Simmers J, Rogers AM, Helm MF, Rigby A. Evaluating the Need for Dermatological Care in A Postsurgical Bariatric Sample. Surgery for Obesity and Related Diseases. 2021 Jul; 17(7): 1302-9. doi: 10.1016/j.soard.2021.03.021. DOI: https://doi.org/10.1016/j.soard.2021.03.021
Toninello P, Montanari A, Bassetto F, Vindigni V, Paoli A. Nutritional Support for Bariatric Surgery Patients: The Skin Beyond the Fat. Nutrients. 2021 May; 13(5): 1565. doi: 10.3390/nu13051565. DOI: https://doi.org/10.3390/nu13051565
Richarz NA, Bielsa I, Morillas V, Enguita V, Fumagalli C. Bowel‐Associated Dermatosis–Arthritis Syndrome (BADAS). Australasian Journal of Dermatology. 2021 May; 62(2). doi: 10.1111/ajd.13516. DOI: https://doi.org/10.1111/ajd.13516
Bramante C, Wise E, Chaudhry Z. Care of the patient After Metabolic and Bariatric Surgery. Annals of Internal Medicine. 2022 May; 175(5): ITC65-80. doi: 10.7326/AITC202205170. DOI: https://doi.org/10.7326/AITC202205170
Vieira de Sousa JP, Santos-Sousa H, Vieira S, Nunes R, Nogueiro J, Pereira A, Resende F, Costa-Pinho A, Preto J, Sousa-Pinto B, Carneiro S. Assessing Nutritional Deficiencies in Bariatric Surgery Patients: A Comparative Study of Roux-En-Y Gastric Bypass Versus Sleeve Gastrectomy. Journal of Personalized Medicine. 2024 Jun; 14(6): 650. doi: 10.3390/jpm14060650. DOI: https://doi.org/10.3390/jpm14060650
Gasmi A, Bjørklund G, Mujawdiya PK, Semenova Y, Peana M, Dosa A et al. Micronutrient Deficiencies in Patients After Bariatric Surgery. European Journal of Nutrition. 2022 Feb; 61(1): 55-67. doi: 10.1007/s00394-021-02619-8. DOI: https://doi.org/10.1007/s00394-021-02619-8
Silva AC, Kazmarek LM, Souza EM, Cintra ML, Teixeira F. Dermatological Manifestations Relating to Nutritional Deficiencies After Bariatric Surgery: Case Report and Integrative Literature Review. Sao Paulo Medical Journal. 2022 Aug; 140(5): 723-33. doi: 10.1590/1516-3180.2021.0616.r1.17022022. DOI: https://doi.org/10.1590/1516-3180.2021.0616.r1.17022022
Triwatcharikorn J, Itthipanichpong Y, Washrawirul C, Chuenboonngarm N, Chongpison Y, Udomsawaengsup S et al. Skin Manifestations and Biophysical Changes Following Weight Reduction Induced by Bariatric Surgery: A 2‐Year Prospective Study. The Journal of Dermatology. 2023 Dec; 50(12): 1635-9. doi: 10.1111/1346-8138.16951. DOI: https://doi.org/10.1111/1346-8138.16951
Lie C, Liew CF, Oon HH. Alopecia and the Metabolic Syndrome. Clinics in Dermatology. 2018 Jan; 36(1): 54-61. doi: 10.1016/j.clindermatol.2017.09.009. DOI: https://doi.org/10.1016/j.clindermatol.2017.09.009
Darlenski R, Mihaylova V, Handjieva-Darlenska T. The Link Between Obesity and the Skin. Frontiers in Nutrition. 2022 Mar; 9: 855573. doi: 10.3389/fnut.2022.855573. DOI: https://doi.org/10.3389/fnut.2022.855573
Golbari NM, Porter ML, Kimball AB. Response to: Remission of Hidradenitis Suppurativa After Bariatric Surgery. Journal of the American Academy of Dermatology Case Reports. 2018 Apr; 4(3): 278-9. doi: 10.1016/j.jdcr.2017.11.024. DOI: https://doi.org/10.1016/j.jdcr.2017.11.024
Hossler EW, Wood GC, Still CD, Mowad CM, Maroon MS. The Effect of Weight Loss Surgery On the Severity of Psoriasis. British Journal of Dermatology. 2013 Mar; 168(3): 660-1. doi: 10.1111/j.1365-2133.2012.11211.x. DOI: https://doi.org/10.1111/j.1365-2133.2012.11211.x
Schlosshauer T, Kiehlmann M, Jung D, Sader R, Rieger UM. Post-Bariatric Abdominoplasty: Analysis of 406 Cases with Focus On Risk Factors and Complications. Aesthetic Surgery Journal. 2021 Jan; 41(1): 59-71. doi: 10.1093/asj/sjaa067. DOI: https://doi.org/10.1093/asj/sjaa067
Herman CK, Hoschander AS, Wong A. Post-Bariatric Body Contouring. Aesthetic Surgery Journal. 2015 Aug; 35(6): 672-87. doi: 10.1093/asj/sjv008. DOI: https://doi.org/10.1093/asj/sjv008
Elander A, Biörserud C, Staalesen T, Ockell J, Olsén MF. Aspects of Excess Skin in Obesity, After Weight Loss, After Body Contouring Surgery and in A Reference Population. Surgery for Obesity and Related Diseases. 2019 Feb; 15(2): 305-11. doi: 10.1016/j.soard.2018.10.032. DOI: https://doi.org/10.1016/j.soard.2018.10.032
Sadeghi P, Duarte-Bateman D, Ma W, Khalaf R, Fodor RA, Pieretti G et al. Post-Bariatric Plastic Surgery: Abdominoplasty, The State of the Art in Body Contouring. Journal of Clinical Medicine. 2022 Jul; 11(15): 4315. doi: 10.3390/jcm11154315. DOI: https://doi.org/10.3390/jcm11154315
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Pakistan Journal of Health Sciences

This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments