GLP-1s linked to hair loss

For the study, researchers from the University of Pennsylvania Health System analyzed data from patients with type 2 diabetes who were on GLP-1 receptor agonists or other types of diabetes drugs known as SGLT-2 inhibitors, or DPP-4 inhibitors.

In total, 12,004 patients using GLP-1s were compared to 15,221 patients using SGLT-2 inhibitors while 11,964 patients using GLP-1s were compared to 11,233 patients using DPP-4 inhibitors.

After adjusting for factors that could affect the results, including age and weight, the researchers found that using GLP-1s was associated with a 37% increased risk of alopecia hair loss than use of SGLT-2 inhibitors. Similarly, GLP-1s were associated with a 68% increased risk of hair loss than the use of DPP-4 inhibitors.

The researchers noted that FDA has been informed of the link between GLP-1s and hair loss, especially semaglutide (Wegovy and Ozempic) and tirzepatide (Mounjaro). "In response, the FDA has indicated that it is evaluating this potential safety signal," the researchers wrote.

Other research has also found a link between GLP-1s and hair loss. For example, a recent study published in the Journal of the American Academy of Dermatology with over 1 million participants found significantly higher risks of various subtypes of alopecia with GLP-1s than with the commonly used diabetes drug metformin.

Another preprint study submitted for peer review had similar findings. In the study, researchers at analytics firm nference compared 11,046 patients taking tirzepatide with the same number of patients taking semaglutide. The rate of new-onset alopecia was 4.24% with tirzepatide and 3.33% with semaglutide.

"Such changes could influence hair growth through endocrine mechanisms, particularly in individuals with underlying hormonal conditions," they added.

While the researchers noted that the "absolute risk" of hair loss while taking GLP-1s is low, "the observed association may still influence patients' satisfaction, adherence, and decisions to start or continue therapy."

"Hair loss is a patient-valued outcome, and even cases captured in routine clinical care may be important for shared decision-making," the researchers wrote. "Although hair loss does not typically result in physical harm, it may have significant psychosocial consequences, affecting self-esteem, quality of life, and adherence to treatment."

As a result, proactive communication with patients about the potential risk is essential, the researchers wrote. "Clinicians may consider discussing the possibility of hair loss when initiating GLP-1 receptor agonist therapy and monitoring for symptoms during follow-up, particularly in the first year," they wrote. "Supportive measures such as ensuring adequate nutrition, reviewing concurrent factors that may contribute to hair loss, and referral to dermatology when appropriate may be needed."