The Role of Glucagon-Like Peptide-1 Receptor Agonists in Hair Loss: Clinical Evidence and Proposed Mechanisms.

BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are an increasingly prescribed class of antidiabetic medications with expanded use in chronic weight management. Emerging literature has raised concerns regarding dermatologic adverse effects of GLP-1RAs, including various forms of alopecia. OBJECTIVE: To evaluate the prevalence of GLP-1RA-associated alopecia, differences among agents, and proposed underlying mechanisms. MATERIALS AND METHODS: A scoping review of GLP-1RAs and alopecia was conducted using PubMed, including articles published up to April 2026. RESULTS: Current literature presents conflicting evidence regarding the effects of GLP-1RAs on hair loss. Available data suggest an association between GLP-1RAs and telogen effluvium and androgenic alopecia, with risk potentially increasing with longer duration of use, greater weight loss, and higher doses, particularly with tirzepatide and semaglutide. Proposed mechanisms include weight loss-related changes, alterations in dermal white adipose tissue, and hormonal influences, although their relative contributions remain unclear. Conversely, a smaller body of literature suggests improvement in inflammatory alopecia with GLP-1RA use, particularly among patients with metabolic dysfunction. CONCLUSION: Given the increasing use of GLP-1RAs, dermatology practitioners should be aware of their association with alopecia and consider patient counseling, monitoring, and proactive treatment in patients receiving GLP-1RA therapy.