The top 10 things to understand about peptides

It's the newest buzzword in skincare and plastic surgery. Open your TikTok feed or the pages of a glossy fashion magazine, and you'll probably be inundated with videos and articles about the "magic" of peptides. But what are they, and do they work?  There is a lot of mystery and misinformation circulating about these amino acids and how they can be leveraged to give your skin a youthful boost.

With the help of ASPS Member Surgeons Roy Kim, MD, and Sara Dickie, MD, it's time to unravel the top ten things you need to understand about peptides and how you can incorporate them into your aesthetic and wellness routine.

What are peptides?

Let's start with the basics. Peptides are signaling molecules and building blocks of proteins. These molecules help regulate metabolism, growth and the body's inflammation response.

"Peptides are short chains of amino acids that act as signaling molecules in your body," said Dr. Kim. "They tell cells what to do. The basic science is legitimate, which is why they sound so appealing. The problem is the gap between lab science and what's actually proven safe in humans."

How do peptides work in the body?

We aren't done with our science lesson just yet. Peptides work by instructing the body's systems to perform specific tasks, for instance, stimulating collagen production or releasing certain growth hormones.

"They work by mimicking your body's own signaling pathways," said Dr. Kim. "Different peptides target different things – growth hormone release, collagen production, tissue repair and appetite regulation. The mechanisms are real. The question is always whether a specific peptide has been tested enough in people to know the full risk picture."

Are peptides approved by the U.S. Food and Drug Administration?

Unfortunately, this is a tricky question to answer because there isn't one single type of peptide.

"The FDA has already approved over 100 peptide drugs," said Dr. Kim. "This is the part people miss. Insulin is a peptide. Semaglutide (Ozempic/Wegovy) is a peptide. Trofinetide (Daybue) was approved for Rett syndrome. Leuprolide for prostate cancer, octreotide for acromegaly. The FDA is not anti-peptide. When the data supports approval, it happens."

So, yes, some peptides are FDA-approved, and some are not. That makes untangling what's what more challenging, since everyone wants to jump on the peptide-wagon and call their product the next "big" thing, whether it's skincare or plastic surgery.

"The U.S. FDA remains the most highly regarded patient safety organization in the world," said Dr. Dickie. "If a peptide is promising, ‘Big Pharma' will get the research done and get it to market.  If it hasn't passed FDA muster yet, it is not worth the hype."

New products are being tested all the time

Peptides may be all the rage, but it takes time to test and bring new products to market. At the end of the day, it's the FDA's job to ensure products and medical devices are safe for the American public. That said, a few peptides show clinical promise but are not yet FDA-approved.  

"Thymosin alpha-1, for example, was an orphan drug with prior FDA approval that's no longer commercially manufactured but is available through compounding pharmacies," said Dr. Kim. "That's the best-case scenario among non-approved peptides, not the norm."

Are there risks to using peptides?

Like anything else in the world, there are potential risks and side effects, even when taking or using FDA-approved drugs and peptides.

"Even the approved ones have real complications," said Dr. Kim. "Ozempic can cause severe GI slowdown (gastroparesis), nausea, pancreatitis and there are concerns about thyroid tumors from animal studies. Leuprolide causes bone density loss. The difference is that these risks are known and documented through clinical trials, so doctors know what to watch for. With non-approved peptides, you don't have that information."

What to know about non-approved peptides being prescribed to patients

"Plenty of doctors prescribe non-approved peptides," said Dr. Kim.  "Anti-aging docs, sports medicine and integrative health. Some do it carefully with informed consent. Others do it because it's profitable and patients are asking for it."

Wade into the peptide pool with caution.

"From the dawn of time, people have strived to make money, and using the fear of illness and the promise of the fountain of youth is a way to do it," said Dr. Dickie. "2026 is no different."

When buzzy products hit social media and create a stir, everyone wants to get in on the action. It's FOMO to the extreme. Unfortunately, some want to profit from trends and have little concern about whether a product will deliver the promised results, and even less concern about whether it ends up doing people more harm than good.

Never purchase peptides online or from non-approved sources

Read the label, and you may be shocked by what you find. Dr. Kim shared that many online peptide products carry warnings such as "not for human consumption" or "research purposes only."

"That means it was not made under pharmaceutical-grade conditions," said Dr. Kim. "Independent testing has found contamination with heavy metals like arsenic and lead, sometimes at 10 times the acceptable limits for injectables. Bacterial contamination capable of causing sepsis has also been found."

"Unregulated injectable peptide products are beyond sketchy and have no evidence of effectiveness," added Dr. Dickie. "And no one who cares about an individual's health and well-being is dispensing them."

What are compounding pharmacies, and are they safe?

Another option that has emerged amid the peptide craze, offering people greater access to specific medications, is compounding pharmacies. Compounding has been around for a long time, but is gaining more recognition now in the era of Ozempic and other expensive weight loss medications.

These are pharmacies that specialize in creating custom-made medications. Compounded drugs can be essential for patients who may be allergic to a particular dye and need a medication made without it, or for patients who cannot swallow tablets and need a capsule medication converted to a liquid dose.

However, compounded drugs are not FDA-approved, meaning the FDA has not verified their safety or effectiveness.

"Compounding pharmacies are better than online suppliers, but 'better' is relative," said Dr. Kim. "You get a cleaner, more accurately dosed product. You do not get the clinical trial data that tells you whether the peptide is safe long-term, what the right dose is or what the drug interactions are. It's a better-manufactured version of something that's still inadequately studied."

Are peptides good or bad?

Peptides aren't just the talk of social media. They are having a moment in medical circles, as doctors and clinicians carefully weigh the pros and cons.

"Pro-peptide doctors point to the biology and their clinical observations," said Dr. Kim. "Skeptical doctors point to the lack of human safety data. Here's something consumers should know – if you have a complication from a non-approved peptide, your doctor's malpractice insurance may not cover it. The insurer can deny the claim because the treatment was not FDA-approved."

"The real issue is not whether peptides are good or bad," continued Dr. Kim. "It's that we don't have enough human data for most of the ones being marketed for anti-aging, athletic performance, etc. The FDA approved 100-plus peptides when the evidence was there. The ones being pushed in wellness clinics and online haven't met that bar. I'm not comfortable recommending treatments where my patients are essentially the clinical trial, but I know and respect many other plastic surgeons and doctors who routinely recommend non-FDA-approved peptides."

Do I need a peptide treatment?

That really depends on the aesthetic you are looking for. Do you want to shed some stubborn weight? A GLP-1 medication, dosed and used under the supervision of a doctor, may be the type of peptide you need to help you achieve your goals.

Injectable peptides offered for half price in the basement of your best friend's house or the corner convenience store? That's something you probably want to skip. The long-term safety and effectiveness of many peptide products have not been thoroughly evaluated. Being the first to try a hot new fad doesn't necessarily guarantee a fabulous outcome.

"Don't try to outsmart the system," said Dr. Dickie. "You won't look or feel better, and you are very likely to end up injured, dead, out of money or all the above."

Your health and safety come first. If you are interested in a peptide treatment or product, talk to an ASPS Member Surgeon first and let them help you find the treatments, procedures, and products that are going to give you the results you are looking for, without wasting your time and money, or more importantly, jeopardizing your health.

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.