The secret side of GLP-1 weight loss drugs and the skin

Glucagon like peptide-1 receptor agonists (GLP-1) are a group of drugs which have recently changed weight loss for many patients, particularly those with diabetes. In an earlier blog I discussed a negative aspect – Ozempic® feet (click here) but there is another dermatological dimension to this class of drugs. Following their introduction, clinical observations and reports emerged about the positive benefits namely improvement in inflammatory skin conditions such as psoriasis in patients receiving the medication. In this piece, I will look at some of the reports and how these drugs maybe beneficial in the dermatology clinic.

Weight Loss drugs (GLP-1RAs) have hidden dermatological effects too

What are GLP-1 receptor Agonists?

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are a group of drugs used in the management of diabetes and obesity. They work by duplicating the action of an endogenous hormone (GLP-1). Normally this is released after eating and its effects are widespread including increasing insulin secretion, suppressing glucagon release along with delayed gastric emptying so giving rise to satiety which ultimately improves blood sugar control and facilitates weight loss [1].

How do they appear to help skin disease?

In addition to there effects on weight loss, there have been several studies highlighting that the GLP-1 receptors exist on several immune cells such as macrophages and T cells. This work has demonstrated how receptor blockade on these cells can inhibit the production of pro-inflammatory cytokines such as TNF-α, IL-17 and IL-23 – having an immunomodulatory effect. The relevance of this is that these cytokines are the central inflammatory axis of psoriasis.

The drugs appear to supress another immune pathway the nuclear factor kappa-B  (NF-κB) pathway. GLP-1s can also reduce inflammation by suppressing NF-κB which is crucial in order to recruit inflammatory cells to sites of inflammation [2].

Suppression of these leads to a reduction in psoriasis. Liraglutide (Saxenda®) was compared in a 12 week randomised controlled trial in 25 patients with diabetes  and showed significant reduction in lesion size and in improvements in the patients reported quality of life [3]. This effect has been shown in other studies – Nicolau and colleagues demonstrated that in a cohort of obese patient with diabetes, semaglutide (Wegovy® & Ozempic®) similar outcomes of significantly improved psoriasis and systemic health [4, 5].

In addition, a recent review collated case reports demonstrating benefits in patients with other dermatological diseases including hidradenitis suppurativa, hyperandrogenism, insulin resistance, Hailey-Hailey disease, acne keloidalis nuchae, folliculitis decalvans, androgenic alopecia, and localized linear scleroderma [6]. Research has also shown that Liraglutide can accelerate wound healing by increasing the migration of keratinocytes in wounds [7]. Although this work was conducted in mice [7], early reports on surgery outcomes from one centre suggests fewer wounds healing complications such as wound dehiscence (click here). The impact of semaglutide (2013-2023) on diabetic foot ulcers has also been investigated with better outcomes reported for patients taking the drug [8].

Is it all good news?

With every drug there is always a balance to be struck. The early evidence certainly shows positive benefits for patients but equally there have been calls for consideration around the adverse dermatological effects of these drugs [9]. Persson et al., [10] undertook a review (2014-2025) to examine the effects of these drugs. Whilst reporting benefits amongst 51 reviewed papers, there were 34 cases of adverse drug reactions affecting the skin including:

·         Hypersensitivity

·         Injection-site reactions

·         Pruritus

·         Urticaria

·         Angioedema

·         Bullous pemphigoid

·         Panniculitis

·         Vasculitis

Whilst these effects are known, it is difficult to predict or understand why they may arise in specific patients but not in others. Consequently, as the drugs are used more widely, more research should uncover the reasons for these negative effects.

Conclusion

From the available data, the effects of GLP-1 drugs are promising on many fronts with improvements in several skin disease and the apparent positive benefits on wound healing. As these drugs are used for longer, we can expect further research to investigate new indications and best applications for these drugs.

 References

1.            Lyseng-Williamson, K.A., Glucagon-Like Peptide-1 Receptor Agonists in Type 2 Diabetes: Their Use and Differential Features. Clinical Drug Investigation, 2019. 39(8): p. 805–819.

2.            Zheng, Z., et al., Glucagon-like peptide-1 receptor: mechanisms and advances in therapy. Signal Transduction and Targeted Therapy, 2024. 9(1): p. 234.

3.            Lin, L., et al., Glucagon-like peptide-1 receptor agonist liraglutide therapy for psoriasis patients with type 2 diabetes: a randomized-controlled trial. Journal of Dermatological Treatment, 2022. 33(3): p. 1428–1434.

4.            Nicolau, J., et al., Dermatological and metabolic benefits of semaglutide in psoriasis with obesity: a 6-month prospective cohort study. Clinical and Experimental Dermatology, 2025. 51(3): p. 442–450.

5.            Petković-Dabić, J., et al., Effects of Semaglutide Treatment on Psoriatic Lesions in Obese Patients with Type 2 Diabetes Mellitus: An Open-Label, Randomized Clinical Trial. Biomolecules, 2025. 15(1): p. 46.

6.            Tassavor, B. and S. Al Salem, Use of Glucagon-Like Peptide-1 (GLP-1) Agonists in Modulating Preexisting Dermatologic Disease: A Systematic Review. Cureus, 2025. 17(9): p. e93282.

7.            Nagae, K., et al., Glucagon-like peptide-1 analogue liraglutide facilitates wound healing by activating PI3K/Akt pathway in keratinocytes. Diabetes Res Clin Pract, 2018. 146: p. 155–161.

8.            Lewis, J.E., et al., The impact of semaglutide on wound healing in diabetes related foot ulcer patients: A TriNetX database study. Diab Vasc Dis Res, 2025. 22(2): p. 14791641251322909.

9.            Awadalla, R. and D. Davies, The GLP-1 Receptor Agonist Paradox in Dermatology: Why We Cannot Afford the Knowledge Gap. International Journal of Dermatology, 2026. n/a(n/a).

10.         Persson, C., A. Eaton, and H.N. Mayrovitz, A Closer Look at the Dermatological Profile of GLP-1 Agonists. Diseases, 2025. 13(5): p. 127.