GLP-1 receptor agonists are an increasingly popular treatment for type 2 diabetes and obesity. Additionally, some dermatologists are finding success with treating psoriasis and hidradenitis suppurativa with GLP-1s independent of an impact on weight loss. As GLP-1 use becomes even more common in medicine, it’s important to understand side effects, including skin effects that could lead GLP-1 patients to seek a dermatologist’s care.
An article in the January Journal of Drugs in Dermatology looked at reported cutaneous adverse events from popular GLP-1s. I interviewed one of the article’s authors, Aaron S. Farberg, MD, FAAD, chief medical officer of Bare Dermatology.
What led you to want to investigate the cutaneous adverse effects of GLP-1s?
GLP-1 receptor agonists have rapidly become some of the most widely prescribed medications in the world for both diabetes and weight loss. As dermatologists, we are increasingly seeing patients on these medications (or prescribing them), yet the dermatologic literature on their cutaneous adverse effects was sparse and largely limited to case reports. Most safety data focuses on gastrointestinal and endocrine effects, leaving a gap in understanding how these drugs may affect the skin. Given their widespread use and the frequency with which dermatology clinicians encounter patients taking GLP-1s, we felt it was important to characterize reported cutaneous adverse events at a population level.
How did you conduct your study, and what did you find?
We conducted a retrospective analysis of the FDA Adverse Event Reporting System (FAERS) database from 2018 through 2024. We queried reports associated with commonly prescribed GLP-1s and identified those coded with dermatologic adverse events. We then categorized these reactions and analyzed reporting patterns across different therapies.
We found a wide spectrum of reported cutaneous events, ranging from relatively benign reactions, such as pruritus, rash, and injection-site reactions, to more concerning reports, including alopecia, urticaria, and rare severe hypersensitivity reactions. Certain patterns emerged suggesting that cutaneous events, while not the most common adverse effects overall, were consistently reported across therapies and may be underrecognized in clinical practice.
Were any of the results surprising?
One of the more surprising findings was the frequency of alopecia reports. Hair loss is not widely discussed as a potential effect of GLP-1 therapy, yet it appeared repeatedly in the database. Additionally, hypersensitivity-type reactions such as urticaria were more frequently reported than expected, suggesting that immune-mediated mechanisms may play a larger role than previously appreciated. Overall, the breadth of cutaneous manifestations was also notable, reinforcing that these medications can affect more than just metabolic pathways.
What were some of the limitations of your study?
FAERS is a passive surveillance database and is subject to underreporting, reporting bias, and incomplete clinical detail. We cannot establish causation, only associations. Important patient-level data such as comorbidities, concurrent medications, and timing of symptom onset are often missing. Therefore, our findings should be interpreted as signals that warrant awareness and further study rather than definitive incidence rates.
What does this study tell us about the safety of GLP-1 agonists?
Overall, GLP-1s remain safe and effective medications. Our study does not suggest that cutaneous adverse events are common enough to limit their use, but rather that dermatologic reactions are part of the broader safety profile and may be underrecognized. Awareness of these potential reactions allows clinicians to better counsel patients and identify medication-related skin findings when they arise.
What were the most common adverse effects, and which patients were most susceptible? Which GLP-1 was most likely and least likely to have cutaneous side effects?
The most frequently reported events included pruritus, nonspecific rash, injection-site reactions, urticaria, and alopecia. Reports were more common in patients using GLP-1s for weight loss indications, which may reflect higher dosing, more rapid weight changes, or simply higher reporting rates in this population.
Some variability was seen among agents, with certain GLP-1s having higher relative reporting of cutaneous events than others. However, because FAERS does not account for total prescription volume, these differences should be interpreted cautiously and not as definitive risk comparisons.
What should dermatology clinicians take away from this study?
Dermatology clinicians are increasingly caring for patients on GLP-1s or prescribing the therapy in their own practice. When evaluating our dermatology patients, it is worth considering GLP-1 therapy as a potential contributing factor in patients utilizing these therapies. Most importantly, this study highlights the need for continued dermatologic awareness as systemic medications evolve and are used at scale.
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