A study found a more than 50% higher likelihood in non-diabetic obese women, but not men.
GLP1-RAs have been associated with increased rates of acne vulgaris in non-diabetic obese women but not men, according to a retrospective cohort study.
And while an Australian dermatologist has welcomed the study, a larger cohort size was needed “to prove a definite association”.
Dr Pooja Kadam, a dermatologist at the Skin Hospital with a special interest in acne vulgaris, said she had not personally seen the issue in her practice.
“This is an interesting study linking the GLP1-RAs to acne, but I haven’t come across any patients yet on these drugs who are getting acne,” she told TMR sister publication Dermatology Republic.
“This is probably because the age group getting acne is different to the age group who are required to go on these drugs.”
In a brief report published in the Journal of the American Academy of Dermatology last month, researchers explored the link between acne vulgaris and medications like semaglutide, liraglutide and tirzepatide, which are approved for weight loss in people who are obese but not diabetic.
“Potential dermatologic adverse events in this population remain underexplored,” the authors wrote.
“Although GLP1-RAs have not been linked to acne vulgaris in clinical trials, many patients have reported acne vulgaris breakouts on social media after starting these medications.”
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The researchers used a large database to analyse data from obese adults who took GLP1-RAs and compared them to those who didn’t use these drugs.
They found that people who used GLP1-RAs had a slightly higher risk of being diagnosed with acne vulgaris within 90 days and one year after starting the medication. The risk was higher for women (53% more likely) but not for men.
The researchers suggested that hormonal differences between men and women might explain why women are more likely to develop acne when taking GLP1-RAs.
“As GLP-1 receptor expression positively correlates with serum androgen levels, the hyperandrogenic state seen in obese women may heighten their responsiveness to GLP1-RAs,” they wrote.
“Subsequently, GLP1-RAs induce growth hormone secretion, stimulating the production of insulin-like growth factor-1 (IGF-1) by the liver.
“IGF-1 has been implicated in the development of acne vulgaris by stimulating sebum production.”
The authors noted the study had limitations, including the fact that it only looked at formally diagnosed acne, which might miss milder cases. Also, the data could have errors in how acne was diagnosed.
“Although the observed increase in risk is small on an individual level, the broad adoption of GLP1-RAs for weight management amplifies its potential implications at the population level, underscoring the need for heightened awareness among clinicians and patients about the dermatologic effects of these medications,” the authors wrote.
Dr Kadam said the study was relevant to Australia as more and more people were now on GLP1-RA drugs.
“It would be interesting to see if they develop acne after being on it,” she said.
“More people I see are on these drugs. Acne has a multifactorial etiology and sometimes is drug-induced. So, it would be useful to see what age groups getting onto these drugs are developing acne.”
For patients who are on the medication and develop acne, but are advised against stopping the GLP-1RAs, Dr Kadam had this advice:
“Optimise topical acne treatment, encourage good skin hygiene, avoid any potential food triggers and reserve systemic medications for refractory cases.”
Journal of the American Academy of Dermatology, 7 February 2025
