As GLP-1 receptor agonists saturate clinical practice, dermatologists are now encountering their patients' full adverse-effect burden firsthand. This review catalogs the dermatologic toll: alopecia, eczematous and hypersensitivity eruptions, bullous and pustular dermatoses, acneiform eruptions, hyperhidrosis, and the now-colloquially-named 'Ozempic face'—significant periorbital and mid-face volume loss tied to rapid fat redistribution. Next-generation triple agonist retatrutide demonstrated 24.2% body weight reduction in phase 2 trials, amplifying concerns about lean mass depletion and skeletal fragility that cascade into cosmetic and procedural considerations.
The significance here extends well beyond aesthetics. GLP-1RA-associated nutritional deficiencies—including protein, zinc, and B-vitamins—likely drive much of the alopecia and skin barrier disruption clinicians are observing, yet most prescribers are not dermatologists and may not connect these downstream effects to the originating drug class. The review's framing of dermatologists as essential nodes in a multidisciplinary monitoring network is clinically sound but operationally underdeveloped in current practice. Critically, this is a narrative review synthesizing existing evidence, not original trial data, so causal hierarchies remain soft—particularly for rarer events like bullous dermatoses. Still, the consolidation of emerging signals around ophthalmologic complications, skeletal fragility, and pregnancy safety gaps adds genuine practical utility. For clinicians managing patients on semaglutide or tirzepatide, this represents a necessary orientation to a systemic drug class that now reaches every specialty, dermatology included.