By Bridget Sullivan, PA-C Coastal Skin Surgery and Dermatology PCB
Glucagon- like peptide-1 (GLP-1), also known as the weight loss shot, is commonly prescribed and used for patients to help with weight loss, diabetes and other medical conditions. Examples include Semaglutide, Tirzepatide, and Liraglutide. They have become very popular and widely prescribed within the last two to three years. Studies have shown that these medications have proven to have a myriad of medical benefits and have improved the health and longevity of many of their users. Some of the medical benefits include: weight loss, cardiovascular risk reduction, improved blood sugar control, reduced kidney disease progression, blood pressure and cholesterol improvements, sleep apnea improvement, and reduced inflammation and improved metabolic health. Additional potential benefits are currently being studied in the fields of addiction/ craving reduction, fertility/ metabolic reproductive health, heart failure, Alzheimer’s disease, and neuroprotection. With all of these benefits, it is no wonder that these medications have become so popular and widely prescribed.
There are side effects to consider when taking these medications. The potential side effects and precautions should be thoroughly discussed with the medical provider prescribing these medications to you. Some of the side effects seen in the dermatology office setting include: reduction in inflammation, hair thinning, facial volume loss, and body skin laxity.
A positive side effect and benefit of these medications is their anti-inflammatory effects.
A recent trial (The TOGETHER- PsO trial) found that adding tirzepatide to a psoriasis medication, ixekizumab (Taltz), significantly outperformed Taltz therapy alone. This trial highlights the anti-inflammatory effects of GLP-1’s and how the anti-inflammatory effects can secondarily improve inflammatory skin conditions. These skin conditions include, but are not limited to, psoriasis, eczema, hidradenitis supprativa, and polycystic ovary syndrome.
A side effect of these medications that is becoming more commonly seen in the clinic is hair loss and increased hair shedding. According to the Dermatology Times, “Hair loss affects approximately 70% of GLP-1 users per cross-sectional survey data- far higher than reported in clinical trials. It is multifactorial: telogen effluvium, nutritional deficiencies, and possible precipitation of androgenetic alopecia in susceptible individuals.” It is therefore important to monitor for nutritional deficiencies with labs, eat the proper amount of protein, and take a multivitamin to help combat excessive hair loss and shedding.
Another common side effect seen in the dermatology office is facial volume loss, commonly called “Ozempic face.” Our face has multiple fat pads. When we lose a significant amount of weight, we lose facial volume, including fat, collagen fibers, and bone resorption. This can cause skin laxity, hollowing, and jowls. This can be treated with collagen-stimulating procedures (for example, Sculptra or microneedling facials) and fillers.
Lastly, a common side effect that has been seen in the office is skin laxity and excess skin of the body. Weight loss reduces thick collagen fibers and increases elastic fiber density, resulting in lax, structureless skin and sagging. This can be reduced by building muscle and lifting weights. Also, surgical intervention from a plastic surgeon might be recommended.
GLP-1s, also known as the weight loss injections, have had many significant medical breakthroughs and have improved many lives. However, there are many side effects that are not readily discussed and observed. With the confidence of weight loss sometimes comes the unintended effects of the conditions listed above. The good news is that there are remedies and solutions to these conditions. As always, if you have any questions or concerns regarding your skin health and wellness, always reach out to your dermatology medical provider.
