We see many patients, “gym warriors,” who have fought the good fight trying by exercise to defeat wrinkles in the tummy, slack skin in the upper arms, jowl laxities in the face, crevices in the back, jiggly skin in the thighs. What gives? Quite simply, for skin toning the gym usually is the wrong battlefield. Health and fitness magazines fail to emphasize the limitations of exercise: fat-burning, cardiovascular conditioning, muscle strengthening and bulking, and stress relief, which is quite an impressive list of benefits. However, primary skin toning is dependent on altering the chemical content of the skin, i.e. a tissue component called extracellular matrix which contains elastic fibers, collagen bundles, hyaluronic acid, and water. The enemies: sun’s rays (tanning beds included), age, stress, nicotine, major weight changes, aging, heredity, disease or medication effects. Effective treatments, therefore are medical in nature, meaning pharmaceutical agents to redirect, replenish, or repair injured or spent skin elements (e.g. moisturizers, hyaluronic acid supplements, retinoic acid, healthy diets, anti-oxidants), safe heat-delivery devices (e.g. laser/radio-frequency/ intense pulsed light), and surgical skin tightening. The only way that exercise may help skin tone is by increasing the muscle volume to “fill up” the inside of a slack sack of skin (e.g. upper arm). May the exercise gods smile on these truths.