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.
