Some GLP-1 drugs may be causing more hair loss than others.Adobe StockSave this storySave this story
Hair loss can be sparked by everything from your genetics to your stress levels, making it hard at times to pinpoint what’s fueling the shedding. But new research suggests that, if you’re suddenly losing hair, you might want to take a closer look at your GLP-1.
The study, which hasn’t been published in a medical journal yet, found that the risk of developing hair loss was "significantly greater” when people started using tirzepatide (Zepbound, Mounjaro) over fellow GLP-1 medication semaglutide (Wegovy, Ozempic).
If you’re taking tirzepatide, don’t panic just yet. Doctors say there could be a few reasons for the link—and it doesn’t mean you’ll lose your hair if you’re on this GLP-1.
The study followed GLP-1 users for a year.
For the study, researchers analyzed data over 12 months from 12,863 people who took semaglutide and 12,863 people who took tirzepatide. None of the participants had a documented history of alopecia (the medical term for hair loss).
The researchers discovered that people who took tirzepatide were more likely to develop hair loss during the study period compared to those who took semaglutide. While the numbers were small overall—4.2% vs. 2.88%—there was a clear difference.
Because people tend to lose more weight on tirzepatide, the researchers also matched tirzepatide and semaglutide users based on how much weight they lost. The data still showed that people on tirzepatide were more likely to develop hair loss than those who took semaglutide—4.24% vs. 3.33%—when they lost the same amount of weight.
The difference was noticeable by six months, when 1.55% of tirzepatide users developed hair loss compared to 1.24% of semaglutide users. But the gap really widened after a year.
Women were especially vulnerable to hair loss on these medications: Nearly 5.5% of tirzepatide users and 3.6% of semaglutide users dealt with alopecia during the study.
“Both tirzepatide and semaglutide have been associated with alopecia during weight reduction, but it remained unknown whether this was simply a consequence of losing weight or whether the risk might differ between the two therapies,” says Venky Soundararajan, PhD, study co-author and chief scientific officer at Nference. “In our study, hair loss was uncommon overall, but it was a real signal and should not be brushed aside.”
It’s important to point this out: The study was observational, so it can’t prove that taking tirzepatide or semaglutide caused the hair loss. (It's also worth noting that, by some estimates, roughly 50% of women will deal with hair loss in their lifetimes anyways). Instead, it just found a link.
This isn’t the only recent study to link GLP-1s with hair loss.
Research published in late July in The BMJ stacked data from people who used GLP-1s to manage type 2 diabetes against patients who took other popular medications for the condition. The researchers found that GLP-1 users had a 37% higher risk of being diagnosed with alopecia compared to those who took type 2 diabetes medications SGLT-2 inhibitors (like Jardiance and Farxiga) and a 68% higher risk of hair loss than people on DPP-4 medications (such as Januvia and Tradjenta).
A different study published in June analyzed data from nearly 2.4 million GLP-1 users and found that people on semaglutide had a higher risk compared to those on diabetes medication metformin of developing androgenetic alopecia—a common type of hormone-driven hair loss—while those who took tirzepatide had a “borderline association” with developing telogen effluvium, a type of temporary hair loss that’s usually caused by a physical or emotional shock.
This part isn't shocking to dermatologists. “We know that rapid weight loss, whether it is from diet and exercise or from medication, may be associated with hair loss,” says Joshua Zeichner, MD, director of Cosmetic and Clinical Research in the Department of Dermatology at The Mount Sinai Hospital.
There are probably a few things going on here.
Again, weight loss is linked to hair loss, especially when it’s fast or dramatic, says Susan Massick, MD, a board-certified dermatologist at The Ohio State University Wexner Medical Center. GLP-1s are known for helping people to lose weight quickly, which can explain why some patients on tirzepatide and semaglutide were faced with hair loss.
But tirzepatide and semaglutide work a little differently in the body, which could explain the gap in how many patients ended up with hair loss on the medications. Semaglutide acts on one receptor in the body, called glucagon-like peptide-1 (or GLP-1), while tirzepatide works on GLP-1 and another receptor called glucose-dependent insulinotropic polypeptide (GIP), Dr. Zeichner points out.
“Since the tirzepatide affects more than one receptor, it may have a greater impact on the body than just weight loss,” he says. “GIP receptors have been identified in the hair follicles and, as the drug binds to these receptors, it may have an effect on the microenvironment surrounding the hair follicles, impacting their activity.” Cue the hair loss—in some people.
Women on tirzepatide who experienced hair loss were also more likely to have irregular periods, hypothyroidism (an under-active thyroid), and polycystic ovary syndrome (PCOS) than those who didn’t have hair loss. “These are associations, not proof that any of these conditions cause medication-associated hair loss, but they suggest that underlying hormonal or autoimmune susceptibility may matter alongside weight loss for women using tirzepatide,” Soundararajan says.
Dr. Massick also stresses that the data doesn’t tell the whole story. “This [new] study does not truly capture other confounding factors such as lifestyle, dietary intake, and other underlying medical conditions,” she says. Meaning, there could be something going on with people who are more likely to use tirzepatide that raises the risk of hair loss—and it may have nothing to do with the medication itself.
What’s the takeaway?
More research is needed to figure out what could be fueling more hair loss in people who take tirzepatide, Soundararajan says. But that’s not helpful if you’re dealing with hair loss right now.
Hair loss is complicated, making it important to rope in a dermatologist, Dr. Zeichner says. If you haven’t started a GLP-1 yet but are planning to, he suggests touching base with your dermatologist to be proactive and talk about how to maintain your skin and hair health during your weight loss journey.
If you happen to deal with hair loss, your dermatologist will likely recommend treatments like minoxidil, finasteride, vitamin supplements, red light therapy, or platelet-rich plasma (PRP), Dr. Zeichner says.
But Dr. Massick says you may need to have a little patience with your hair while you're on a GLP-1. “If your hair loss is related to telogen effluvium, you will not go bald or lose all your hair, and your hair will likely grow back once your weight stabilizes,” she says.
While you ride things out, Dr. Massick also recommends doing what you can to make sure you’re getting in enough calories, along with eating a varied diet. But if you’re dealing with hair shedding and it doesn’t seem to be improving, she suggests checking in with your doctor to make sure something else isn’t going on, like a vitamin deficiency or thyroid disease.
It's easy to feel alone in a hair loss journey, but dermatologists stress that you’re not the only one dealing with this. GLP-1 use has caused side effects that have impacted dermatology and plastic surgery. As Dr. Zeichner says: “Hair thinning has become an expected side effect in patients, especially women, on GLP-1 drugs.”
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