Cohort study links GLP-1RAs therapy to elevated risk of nonscarring hair loss

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly linked to an unexpected side effect: hair loss. A large, real-world cohort study reported a significant association between GLP-1RA use and increased risk of nonscarring hair loss, particularly telogen effluvium and androgenetic alopecia (AGA).

The retrospective cohort study, presented by Mr Yagiz Akiska (George Washington University, Washington D.C., USA), analysed data from the TriNetX US Collaborative Network (2014–2024), encompassing 67 healthcare organisations [1]. Adults aged 18–89 years with ≥2 GLP-1RA prescriptions (liraglutide, semaglutide, dulaglutide, exenatide, lixisenatide, or tirzepatide) were compared with propensity-matched controls without GLP-1RA exposure. Exclusion criteria included prior hair loss, thyroid disease, malnutrition, chemotherapy, and other confounding factors.

At 12 months, GLP-1RA use was significantly associated with telogen effluvium (adjusted odds ratio (aOR) 1.76; 95% CI 1.34–2.32; P <0.001) and AGA (aOR 1.64; 95% CI 1.35–1.99; P<0.001), while no significant increase in alopecia areata was detected. Overall, nonscarring hair loss was also more likely (aOR 1.40; 95% CI 1.31–1.49; P<0.001). These associations were already apparent by 6 months for AGA and overall nonscarring hair loss, with statistical significance achieved at P <0.001 in both cases.

Longitudinal data from 2014 to 2024 demonstrated a marked rise in the incidence of nonscarring hair loss among GLP-1RA users, particularly telogen effluvium and AGA. This trend highlights the need for clinical vigilance, especially in patients experiencing rapid weight loss, a known precipitant of telogen effluvium.

The authors recommend proactive counselling for patients initiating GLP-1RA therapy about potential hair loss risks. Nutritional monitoring and multidisciplinary management may help mitigate this adverse effect and support treatment adherence.

Recognising and addressing the dermatological impact of GLP-1RAs is essential for maintaining quality-of-life and treatment continuation.

1. Akiska Y, et al. Increased incidence and risk of hair loss with GLP-1 agonists: A real-world multicenter cohort study. EPS04.04, EADV Congress 2025, 17–20 September, Paris, France.

Medical writing support was provided by Dr Susanne Kammerer and Karin Drooff

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Posted on 24 September 2025