First Controlled Study Links GLP-1 Use to Fourfold Higher Nail Detachment Risk

Nail detachment may be more common among people taking GLP-1 receptor agonists, according to a multinational study presented at the European Academy of Dermatology and Venereology Congress 2026.

Researchers compared 575 GLP-1 users with 1,329 people with obesity and/or type 2 diabetes who had never used them. Participants came from France, the United States, Brazil and Mexico.

Overall, 66% of GLP-1 users reported at least one nail disorder, compared with 53% of controls. Nail detachment was reported by 39% of users versus 9% of controls, making it more than four times as common. Nail discolouration was also more frequent, affecting 46% of users compared with 17% of controls.

The differences remained significant among participants who had lost weight, suggesting that weight loss alone may not fully explain the findings.

However, the study cannot prove that GLP-1 receptor agonists caused the nail changes. Around half of users reported nail problems before starting treatment. Adjusting for dermatological conditions and nutritional deficiencies reduced some associations. Nail detachment and discolouration remained around two to three times more common among users.

A companion analysis also found more hair and scalp problems among GLP-1 users. Unusual hair loss was reported by 50% of users compared with 34% of controls, while reduced hair volume or density affected 42% versus 19%. Hair loss after treatment was more than twice as common among users, at 26% versus 12%. Scalp redness was also more frequent.

Researchers said scalp symptoms including itching, redness and scaling were common, suggesting that inflammation may contribute.

Both studies were cross-sectional studies based on self-reported symptoms. Prospective clinical studies in larger patient groups are needed to determine whether these changes are caused by treatment, weight loss, nutritional factors or other mechanisms.

REFERENCE: Piraccini, B. M., Mengeaud, V., Ribet, V., Couttet, A., Perez Cullell, N., Taïeb, C., & Halioua, B. (2026, September 30–October 3). Association between GLP-1 receptor agonists and nail disorders: Results from a multinational case-control study. EADV Congress 2026, Vienna, Austria.