Popular GLP-1 medications used for weight loss and type 2 diabetes (such as Ozempic, Wegovy, Mounjaro, Zepbound, Victoza, and Trulicity) have been linked to an unexpected problem involving nails. A multinational study found that people taking these medications were four times more likely to report nail separation, a condition in which the nail separates from the skin underneath.
Researchers found that 39% of GLP-1 users experienced nail peeling, compared to only 9% of people who had never taken the drug. Nail discoloration was also significantly more common, and two-thirds (66%) of users reported at least one nail disorder.
The findings, presented at the 2026 European Academy of Dermatology and Venereology (EADV) Congress, come from the first controlled study to investigate the possible relationship between GLP-1 drugs and nail health.
Unexpected Nail Problems Among GLP-1 Users
GLP-1 receptor agonists have become increasingly popular for managing obesity and type 2 diabetes. These medications act on a hormonal signaling system that helps regulate blood sugar and appetite, making them effective tools for improving metabolic health and promoting weight loss.
However, scientists are still studying their potential effects on other parts of the body. Until recently, information on nail changes during GLP-1 treatment came mainly from individual reports of possible adverse effects, rather than controlled comparisons.
To study this link, researchers looked at 575 people using GLP-1 medications and compared them to 1,329 people who had type 2 diabetes and/or obesity but had never used the medications. Participants were recruited in France, the United States, Brazil and Mexico.
The results revealed a consistent trend. Overall, 66% of GLP-1 users reported at least one nail disorder, compared to 53% of the control group. Nail discoloration showed a particularly significant difference, affecting 46% of users compared to 17% of non-users.
Nail peeling was even more striking, with reports more than four times more common among people taking GLP-1 drugs.
Weight loss alone cannot explain changes in nails
An important question was whether the nail problems could simply be linked to weight loss rather than the medications themselves. Rapid changes in body weight can affect nutrition and other physiological processes, potentially influencing nail and hair health.
However, the researchers found that weight loss did not fully explain the differences. Even when limiting their analysis to participants who lost weight, GLP-1 users continued to report significantly more nail problems than those who did not use these medications.
“Until now, nail changes associated with GLP-1 therapies have been mostly anecdotal,” said study author Dr. Charles Taïeb. “Our results show a clear association, but they also highlight an important point: not everything that happens during GLP-1 treatment is necessarily caused by the treatment itself.”
The researchers emphasized that their results do not prove that GLP-1 drugs cause nail disorders. About half of drug users reported having nail problems before even starting treatment.
When the researchers took into account existing skin conditions and nutritional deficiencies, some differences between the groups lessened. Nonetheless, nail peeling and discoloration remained approximately two to three times more common among GLP-1 users after these adjustments.
Scientists also see higher rates of hair loss and scalp problems
Unexpected discoveries aren’t limited to nails.
A follow-up study of the same participants identified significant differences in hair and scalp health among people taking GLP-1 medications.
Half of GLP-1 users reported unusual hair loss, compared to 34% of non-users. Reduction in hair volume or density was also much more common, affecting 42% of users compared to 19% of the control group.
The researchers also looked at hair loss that began after treatment began. This was reported by 26% of GLP-1 users, compared to 12% of non-users, making it more than twice as common in the medication group.
Scalp redness was about three times more common among GLP-1 users.
A particularly interesting finding is that hair loss rarely appears on its own. Most users who reported shedding also experienced other scalp symptoms, including itching, redness, or flaking of the skin.
These associated symptoms raise the possibility that inflammation may contribute to the changes, rather than hair loss being explained entirely by rapid weight loss.
“This suggests that what is happening on the scalp could go beyond the classic weight loss observed after rapid weight loss and involve an inflammatory component,” explained study author Dr. Bruno Halioua. “Scalp inflammation was the rule rather than the exception, which clinicians are not currently looking for and which is treatable. Taken together, our results suggest that factors other than weight loss may contribute to the hair, scalp, and nail changes seen in GLP-1 users.”
What the results mean for people taking GLP-1 drugs
Despite the relatively high frequency of reported symptoms, the researchers stressed that the findings should encourage awareness rather than alarm.
“These changes are common, usually benign, and are not a reason to stop effective treatment on your own,” he said. “Anyone who notices hair loss, itching or redness on the scalp, or nail changes should talk to their doctor rather than discontinuing treatment.”
There are also important limitations to consider. Both surveys were cross-sectional studies, meaning they looked at participants’ experiences without following them over time to establish how symptoms developed. Results were also based on participant-reported symptoms rather than standardized clinical examinations.
As a result, studies can reveal patterns and associations, but they cannot determine whether GLP-1 drugs directly caused the reported nail, hair, or scalp problems.
To explore these questions further, the research team plans to conduct prospective studies that will follow patients from the start of treatment. These investigations will include standardized examinations of the skin, hair and nails as well as biological monitoring.
The goal is to establish when changes first appear, identify the mechanisms underlying them, and determine whether they improve or disappear over time.
The research benefited from institutional support from Laboratoires DUCRAY (Pierre Fabre Group), a company specializing in dermatological and hair products developed to help manage skin and scalp conditions and improve quality of life.
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