Does GLP-1 Use Result in Significant Hair Loss?

About 20 million people across the US, UK, and EU are taking GLP-1 receptor agonists like tirzepatide and semaglutide (Ozempic or Mounjaro are common brands) for weight loss and type 2 diabetes. As their use has surged, we’re learning more about their side-effects. One that’s been getting a lot of attention from researchers lately: hair loss.

In one survey of people who take these medications, 20% of respondents experienced hair shedding, although the lack of high-quality data from a randomized, controlled trial to assess this side-effect makes it difficult to know exactly how common it is.

While GLP-1-related hair loss is often temporary and reversible, it’s significant enough that some patients hesitate to take drugs they would otherwise benefit from using. Here’s what you need to know.

What Kind Of Hair Loss Are People Seeing On Glp-1S?

Most people who take GLP-1 drugs don’t have hair loss. However, those who do often notice it within the first year, usually peaking a little before the 12th month.

They’re usually experiencing one of two types of hair loss, says Lynn Petukhova, a geneticist at New York University who studies hair loss disorders. The most common type is a stress-related condition that dermatologists call telogen effluvium, where a stressor pushes an unusually large share of hair follicles into their resting phase. During this stage, the affected hair ceases to grow – and after two to three months, it falls out. This kind of hair loss is temporary; the growth interruption and shedding stops once the stressor does, and hair typically goes back to growing normally.

A much smaller proportion of people taking GLP-1s experience new or increased pattern baldness, says Petukhova. That’s the genetically influenced, usually permanent hair loss that causes a receding hairline or thinning at the crown in men, and widening of the center part in women.

In a recent study Petukhova led, men taking GLP-1 drugs were 7% more likely to experience this type of hair loss than men not taking the drugs. (The study was unable to assess the risk in women because their genes for the condition aren’t as well understood.)

Hair loss may also manifest differently depending on hair type. In one study, white patients were more likely to report hair shedding and thinning, while Black patients more commonly reported hair dryness and breakage.

What Causes Hair Loss On Glp-1 Drugs?

Telogen effluvium has two possible causes in the setting of rapid weight loss: the shock of sudden and severe calorie restriction, and micronutrient deficiencies that result from dramatically reduced food intake.

The type of drug and dosage is also relevant; people taking tirzepatide and semaglutide, especially at higher doses, had the highest rates of temporary hair loss.

Women make up nearly 90% of people who report telogen effluvium when taking GLP-1 drugs. Women also commonly experience it after giving birth, as a result of abrupt hormonal changes. It frequently follows weight loss surgery too; as many as 60% of patients have hair loss after the procedure.

Pattern baldness on GLP-1s is less well understood but likely occurs because of some biological connection between the genes that make someone respond to GLP-1 drugs and those that cause this type of hair loss, says Petukhova. “Some people have a higher genetic risk” for pattern baldness, she says, “and the drug will unmask it.”

Can You Prevent Or Reverse Hair Loss On A Glp-1 Drug?

If you’re considering starting a GLP-1 drug, it’s worth discussing the possibility of hair loss with your doctor.

Because hair follicles are extremely sensitive to certain nutritional deficiencies, eating enough protein and ensuring you’re consuming sufficient iron, zinc and biotin are sound strategies. However, these precautions are not guaranteed to prevent hair loss, especially if you’re losing weight rapidly. A lower dose and slower weight loss may also reduce your risk.

If you are experiencing hair loss, consult your regular doctor or a dermatologist who can help you determine whether it is temporary or permanent, and thus how to treat it. As mentioned above, temporary hair loss is reversible with nutrition, time and patience. For pattern hair loss, medications like minoxidil and finasteride may be useful.

If you have been prescribed a GLP-1 drug for health reasons and are concerned about side effects like hair loss, it’s important to talk to your doctor. The prospect of cosmetic changes alone shouldn’t discourage people from doing what’s best for the rest of their body, says Petukhova. “It’s more important for most people to get your metabolic health under control than to ensure that you have all the hairs on your head,” she says.