Do Glucagon-like peptide-1 (GLP-1) receptor agonists cause hair loss?

GLP-1 Receptor Agonists and Hair Loss

GLP-1 receptor agonists can cause hair loss as a reported adverse effect, though it is not among the most common side effects of this medication class. Recent pharmacovigilance data indicates that GLP-1 receptor agonists are associated with higher reporting of hair loss compared to several other antidiabetic medications, with semaglutide, liraglutide, and dulaglutide being the three leading medications in this category 1.

Evidence on GLP-1 RAs and Hair Loss

A 2024 real-world pharmacovigilance study examining adverse events associated with GLP-1 receptor agonists found:

• GLP-1 RAs were the most reported class of diabetes medications associated with hair loss [ROR = 0.61 (0.60-0.64)] 1
• While this did not meet the formal criteria for a positive safety signal (defined as PRR > 2 and χ2 > 4), the reporting rate was higher than for other diabetes medications 1

Another 2025 study specifically analyzing cutaneous adverse reactions found:

• Alopecia (hair loss) was among the 5 most common cutaneous reactions associated with GLP-1 agonists 2
• Interestingly, GLP-1 agonist use for type 2 diabetes exhibited significantly higher rates of alopecia compared to use for weight management (P=0.000) 2

Clinical Context and Management

The American Diabetes Association and European Association for the Study of Diabetes consensus report (2018) does not list hair loss among the commonly discussed side effects of GLP-1 receptor agonists 3. Instead, they focus on:

• Gastrointestinal side effects (nausea, vomiting, diarrhea)
• Minimal risk for hypoglycemia when used as monotherapy
• Potential for weight loss
• Cardiovascular effects

For patients experiencing hair loss while on GLP-1 receptor agonists:

1. Document and report the adverse event to appropriate pharmacovigilance systems
2. Consider whether the benefit of continued therapy outweighs the cosmetic concern
3. If hair loss is significant and distressing to the patient, discuss alternative diabetes or weight management options with similar efficacy profiles

Clinical Considerations

When prescribing GLP-1 receptor agonists, be aware that:

• Hair loss appears to be more common when these medications are used for diabetes treatment rather than weight management 2
• The mechanism behind GLP-1 RA-associated hair loss is not well understood
• Hair loss is not listed as a common side effect in major guidelines, suggesting it may be less frequent than gastrointestinal effects 3

Important Caveats

• The evidence for hair loss with GLP-1 RAs comes primarily from adverse event reporting systems, which have inherent limitations including reporting bias
• No causality has been definitively established
• Individual susceptibility to this side effect likely varies
• The benefit-risk profile of GLP-1 RAs remains favorable for most patients with diabetes or obesity

While hair loss is a reported adverse effect of GLP-1 receptor agonists, it should be weighed against the significant benefits these medications provide for glycemic control, weight management, and potential cardio-renal protection.