By Olivia Hart

Men genetically prone to male-pattern baldness face a 7 percent higher risk of losing hair when taking GLP-1 receptor agonists (drugs that mimic a gut hormone to lower blood sugar and curb appetite) such as Ozempic, Wegovy, and Zepbound, a NYU Langone Health team reports in the Journal of Investigative Dermatology.

The study, published online Sept. 3, used a Mendelian randomization design (a method that tests whether a gene-based proxy for one trait causally drives another) to compare genetic variants linked to GLP1R activity — the gene that controls how many GLP-1 receptor proteins the body makes — against variants tied to androgenetic alopecia, the inherited thinning that typically hits the vertex (crown) and frontal scalp.

"Our study provides the first genetic link between GLP-1 use and an increased risk of male-pattern hair loss from androgenetic alopecia, an association long suspected but until now not shown scientifically," said senior investigator Lynn Petukhova, PhD, assistant professor in the Ronald O. Perelman Department of Dermatology and the Department of Population Health at NYU Grossman School of Medicine.

What did the researchers actually measure?

The team drew on two large public biobanks: the eQTLGen database, which holds expression data from 31,684 mostly White men and women, and the Complex Traits Genetics group database, covering 205,327 mostly White men. By weighting genetic variants against known drivers of androgenetic alopecia, they isolated the GLP1R signal from confounders (variables that could otherwise explain away the result).

High blood pressure, which can choke blood flow to the follicle, did not explain the 7 percent bump. Neither did insulin resistance (the precursor to type 2 diabetes) nor reduced testosterone, both tested separately in the analysis.

What does the 7 percent figure mean for a client in the chair?

It is an absolute risk increment layered on top of an already high baseline. Androgenetic alopecia affects roughly half of White American men over age 50, the researchers note, and a near-identical share of postmenopausal White women. The 7 percent figure emerged only after restricting the analysis to men whose DNA already carried androgenetic alopecia variants; men without that genetic profile showed no additional GLP-1 driven risk in the data.

Because male-pattern hair loss has been mapped far more thoroughly than female-pattern loss in the genetic literature, Petukhova's group could not run the same causal test in women. Hair shedding has nonetheless surfaced in patient reports from both sexes since Ozempic's 2017 launch for type 2 diabetes, with regrowth often following weight stabilization. The new finding suggests shedding in genetically susceptible users may not trace solely to weight loss itself.

Could screening arrive before prescriptions?

Petukhova argues it could. "Our findings suggest that, if future experiments prove successful, some men, and possibly women too, could be screened and benchmarked for their risk of hair loss before being prescribed GLP-1 medications," she said. "We could also envision these findings leading to some GLP-1 users being prescribed combination treatments to prevent hair loss, such as minoxidil or some other drug."

Minoxidil, sold over the counter in 2 percent and 5 percent strengths, is the standard topical treatment for androgenetic alopecia. Combining it with finasteride (an oral prescription that blocks the androgen hormone driving follicle shrinkage) is a common dermatologist-led protocol for early-stage male thinning.

How big is the GLP-1 exposure problem?

Roughly 12 percent of U.S. adults have taken a GLP-1 agonist solely for weight loss, including one in five women between ages 50 and 64, surveys indicate. Prescriptions have more than tripled since the FDA cleared Ozempic in 2020.

What should stylists and trichologists flag now?

Petukhova plans to extend the genetic work to women, whose androgenetic alopecia data is thinner but whose GLP-1 use is rising fastest. Co-investigators Jerry Shapiro, MD, and Kristen Lo Sicco, MD, both dermatologists at NYU Langone, have previously consulted for Pfizer, Lilly, and other manufacturers of hair-loss drugs, terms disclosed under NYU Langone policy.

For now, the practical signal is narrow: stylists counseling clients on sudden postpartum or weight-loss-related telogen effluvium (temporary diffuse shedding triggered by metabolic or hormonal stress) may want to ask whether a GLP-1 prescription sits in the picture, especially when the client carries a family history of crown or frontal thinning. That history, the new data argue, may matter as much as the dose on the pen.

Funding came from NIH grants R01AR080796 and K01AR075111. Co-authors include Derek Maas, Mary Casagrande, Poppy Gould, and Archie Spindler at NYU Langone, plus Ravi Ramessur at the University of Pennsylvania and King's College London and Atlas Khan at Columbia University.