Diabetic GLP-1 use linked to increased hair loss risk

Patients with type 2 diabetes treated with GLP-1 medications are more likely to lose their hair than when they’re treated with other diabetes medications, new analysis shows. In one comparison, the GLP-1 users were almost 70 percent more likely to have hair loss.

The study was published in the BMJ.

“This is the first study to look at hair loss among patients taking GLP-1s at a wide, population level,” said senior author Yong Chen, PhD, a professor of Biostatistics. “Hair loss has been reported anecdotally, butclinical trials to this point were not designed to evaluate this outcome. Given the widening use of these medications, we felt it was important to systematically examine this potential side effect in real-world patients.”

Head to head

GLP-1 medications have been used to improve blood sugar levels through diet control in people with type 2 diabetes since 2005. In recent years, however, they have become increasingly popular because of their effectiveness in promoting weight loss, with approximately one in ten Americans now receiving these medications.

Chen and his colleagues examined electronic health record data from adults with type 2 diabetes seen at the University of Pennsylvania Health System between January 2019 and September 2024. They focused on patients who were starting new medications to treat their diabetes.

The team examined GLP-1RAs (like Ozempic, which curb appetite through mimicking the hormone that signals fullness and slows digestion), SGLT2i medications (like Jardiance, which lower blood sugar by removing extra sugar in the body through urination), and DPP4i medications (like Januvia, which improve blood sugar regulation by controlling the actions of certain hormones). These three medications are typically prescribed at similar stages in a patient’s journey with diabetes.

For up to five years, patients were followed for any report of head hair loss.

In the group measuring GLP-1s compared to SGLT2i use, data from more than 27,000 patients was evaluated. In the GLP-1 versus DPP4i group, there were data from more than 23,000 patients.

Users of GLP-1s were 37 percent more likely to report hair loss than patients using SGLT2i. Compared to users of DPP4i, patients taking GLP-1s were 68 percent more likely to have hair loss.

The findings were consistent across age and sex.

Reason behind hair loss remains a head scratcher

“Weight loss is a known cause of hair shedding so GLP-1 therapy likely causes hair loss because patients on the drugs lose weight. However, there is a chance that the drug causes hair loss through a different mechanism, and that needs to be explored,” said co-author George Cotsarelis, MD, chair of Penn’s Department of Dermatology.

The researchers hope their work provides a clearer picture of potential side effects and who exactly might be affected.

“We’re hoping that it may also be possible to determine specific risk factors that may increase certain people’s susceptibility to hair loss,” said Chen.

This work was supported in part by grants from the National Institutes of Health (RF1AG077820, R01AG073435).