Dermatologica Sinica · Apr 2026

The expanding role of dermatologists in the era of glucagon-like peptide-1 receptor agonist therapies

By Hsiao Y

DERMATOLOGISTS PLAY A CRUCIAL ROLE IN THE CARE OF HUMAN HEALTH The skin maintains systemic homeostasis and serves as a visible indicator of overall health status. Numerous systemic disorders, including hepatic, renal, thyroid, autoimmune, and metabolic diseases, present with characteristic cutaneous manifestations.[1-5] In addition, dermatologic status may reflect physiological and psychological stressors, including nutritional imbalance, sleep deprivation, and emotional distress.[6,7] Amid the global expansion of glucagon-like peptide-1 receptor agonists (GLP-1RAs) therapies for weight management,[8,9] dermatologists assume an increasingly vital role extending beyond conventional esthetic practice. As frontline clinicians with expertise in facial anatomy and cutaneous aging, dermatologists are uniquely positioned to recognize the characteristic phenotypic features of “Ozempic face.”[10] Beyond esthetic considerations, dermatologists also take on an increasingly important role in identifying treatment-associated adverse effects, including cutaneous adverse effects, hair loss, and sarcopenia-related changes, while emerging evidence suggests potential therapeutic applications of GLP-1RAs in chronic inflammatory skin diseases.[11-14] THERAPEUTIC MECHANISMS AND ADVERSE EFFECTS OF GLUCAGON-LIKE PEPTIDE-1 RECEPTOR AGONISTS GLP-1RAs promote weight loss independent of diabetes status through integrated central and peripheral mechanisms, including enhanced satiety, delayed gastric emptying, suppression of glucagon secretion, augmentation of glucose-dependent insulin secretion, modulation of the intestinal microbiome, and reduction of adipose inflammation and ectopic fat deposition.[15,16] The rapid and substantial weight loss associated with GLP-1RAs may induce body composition changes, including loss of muscle and bone mass,[11,15] potentially contributing to appearance-related changes such as the gaunt, fatigued, and prematurely aged face.[17] Reported dermatologic adverse effects include injection site reaction and immune-mediated reactions such as bullous pemphigoid, lupus, vasculitis, alopecia, eosinophilic fasciitis, panniculitis, and appearance-related changes such as volume depletion and skin laxity.[12,18-21] Dermatologic manifestations arising after GLP-1RA therapy may resemble preexisting inflammatory dermatoses, necessitating dermatologists for differentiation diagnosis from drug-induced adverse effects.[11,12] THERAPEUTIC APPLICATIONS OF GLUCAGON-LIKE PEPTIDE-1 RECEPTOR AGONISTS IN INFLAMMATORY SKIN DISEASES GLP-1RAs have demonstrated potential anti-inflammatory and immunomodulatory effects, with clinical reports of benefit in inflammatory dermatoses such as psoriasis, hidradenitis suppurativa, acanthosis nigricans, and Hailey–Hailey disease.[11,20-24] Current evidence supports GLP-1RAs as potential adjunctive therapies, particularly in patients with psoriasis accompanied by obesity, metabolic syndrome, or type 2 diabetes, rather than as primary monotherapy for psoriasis. However, robust large-scale randomized controlled trials remain limited, and the optimal treatment dosing, duration, and patient selection criteria remain undefined.[20,22,25,26] FUTURE DIRECTIONS Emerging dual-and triple-agonist therapies have reshaped metabolic pharmacotherapy by concurrently targeting GLP-1, glucose-dependent insulinotropic polypeptide, and glucagon receptor pathways.[27] However, important challenges remain, including optimization of therapeutic efficacy while minimizing adverse effects, clarification of long-term cardiovascular and systemic safety, and the mitigation of excessive lean mass loss during profound weight reduction despite resistance training and adequate protein intake.[28,29] Dermatologists play an increasingly interdisciplinary role in GLP-1RA therapies, encompassing recognition of cutaneous adverse reactions, evaluation of emerging applications in inflammatory dermatoses, and management of esthetic changes such as facial deflation and soft-tissue laxity.[12] Early dermatologic consultation is recommended for persistent or severe manifestations to facilitate accurate diagnosis and guide treatment modification.[11,20] Further studies are needed to optimize the safe and effective use of multi-receptor agonist therapies while minimizing dermatologic complications.[11,18,21] Data availability statement Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

doi.org/10.4103/ds.ds_v44-2_editorialOpen accessInterventions