"GLP-1 Diabetes and Obesity Drugs Linked to 37%-68% Higher Risk of Hair Loss... Absolute Risk Low"

Researchers have found that type 2 diabetes patients taking glucagon-like peptide-1 (GLP-1) receptor agonists, which are also widely used as obesity treatments, face a 37% to 68% higher risk of hair loss compared to patients taking other classes of medications.

The research team at the University of Pennsylvania Perelman School of Medicine announced the findings on the 23rd in the medical journal British Medical Journal (BMJ), based on an analysis of electronic health records from approximately 39,000 type 2 diabetes patients, showing that GLP-1 treatments carry a higher risk of hair loss than other therapies.

However, the researchers noted that the absolute risk of hair loss was low and that most cases were analyzed as non-scarring alopecia, where hair follicles are not damaged and hair can regrow. They emphasized the importance of being aware of this risk and comprehensively evaluating it alongside treatment benefits when choosing a therapeutic approach.

GLP-1 receptor agonists lower blood sugar while suppressing appetite and promoting weight loss, making them widely used not only for treating type 2 diabetes but also for obesity management.

Representative drugs include semaglutide and tirzepatide.

The research team pointed out that while recent reports of hair loss following the use of these drugs have raised the possibility that hair loss is a side effect of GLP-1 medications, studies directly comparing the risk of hair loss with other diabetes drugs have been lacking until now.

They compared the risk of hair loss among type 2 diabetes patients newly prescribed GLP-1 receptor agonists, sodium-glucose cotransporter-2 (SGLT-2) inhibitors, or dipeptidyl peptidase-4 (DPP-4) inhibitors from the University of Pennsylvania Health System electronic health records between January 2019 and September 2024.

The analysis included 12,004 users of GLP-1 receptor agonists and 15,221 users of SGLT-2 inhibitors, as well as 11,964 users of another GLP-1 cohort and 11,238 users of DPP-4 inhibitors.

The results showed that even after adjusting for age, sex, race, preexisting conditions, use of other medications, and body mass index (BMI), GLP-1 users had a 37% higher risk of hair loss compared to SGLT-2 inhibitor users, and a 68% higher risk compared to DPP-4 inhibitor users.

However, the absolute risk was low.

In the cohort compared with SGLT-2 inhibitors, the incidence of hair loss for GLP-1 treatments was 6.91 per 1,000 person-years (compared to 5.04 in the control group), and in the cohort compared with DPP-4 inhibitors, it was 6.53 (compared to 3.89 in the control group).

The research team explained that this translates to about 6 to 7 cases of hair loss per 1,000 patients followed for one year among those using GLP-1 treatments, meaning that while relative risk increases, absolute risk remains low.

Additional analysis revealed that the increased risk was largely driven by non-scarring alopecia, where hair follicles are not destroyed and hair is likely to regrow once treated or when the underlying cause is resolved.

The research team stated that rapid weight loss can induce physiological stress and lead to deficiencies in nutrients such as iron, zinc, and biotin, which can disrupt the hair growth cycle. They suggested that metabolic changes resulting from rapid weight loss, rather than direct damage to hair follicles by GLP-1 treatments, are the most likely cause of the increased hair loss risk.

(Photo: AP, Yonhap News)
※ Please note: This article was translated by AI and may contain errors.