GLP-1 RAs and Skin Health: Exploring Dermatologic Side Effects and Therapeutic Interventions

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely used for managing type 2 diabetes and obesity due to their profound systemic metabolic effects. These effects include enhanced insulin secretion, slowed gastric emptying, appetite suppression, and significant weight loss. However, along with these benefits, concerns have arisen regarding negative dermatological effects. Rapid weight reduction from GLP-1 RAs has been linked to loss of facial fat (“Ozempic face”), skin laxity, and an aging appearance. Evidence from human studies, including case reports and cohort analyses, suggests a connection between GLP-1 RA–induced rapid weight loss and decreased collagen and elastin, reduced hydration, and even hair loss (telogen effluvium) in a subset of patients. Cell-based studies provide additional insight into potential mechanisms, including nutrition deficiency, elevated oxidative stress, and impaired mitochondrial function associated with an altered catabolic state. This review examines the known and proposed mechanisms by which GLP-1 RAs might negatively affect skin integrity, collagen synthesis, skin hydration, and hair follicle cycling. We also discuss treatment hypotheses to counteract these dermatologic effects, such as supporting skin barrier with ceramides and including mitochondrial-targeted antioxidants such as methylene blue, which also promotes collagen renewal. Understanding and addressing these cutaneous side effects is crucial for the holistic management of patients on GLP-1 RAs, ensuring that metabolic benefits are achieved without undue compromise to skin health and appearance.