Nail detachment and discoloration appear to be more common among people on glucagon-like peptide-1 (GLP-1) weight-loss and diabetes drugs, a recent study has found, but its authors have said that that shouldn’t stop patients from taking them.
GLP-1 drugs have been tied to a range of skin and hair side effects, from dry skin to hair thinning—as well as some positive effects on certain skin conditions.
The new study, presented at the 2026 European Academy of Dermatology and Venereology conference, compared 575 GLP-1 users to 1,329 people who had Type 2 diabetes, obesity, or both who had never taken the drugs. Researchers recruited participants in France, the United States, Brazil, and Mexico.
The biggest gap was in nail detachment, in which the nail separates from the nail bed. Thirty-nine percent of GLP-1 users reported this, compared with 9 percent of non-users. Nail discoloration was reported by 46 percent of users and 17 percent of non-users.
Overall, 66 percent of GLP-1 users reported at least one nail problem, compared with 53 percent of those who had not taken the drugs.
The study is the first controlled study to examine the potential effects of GLP-1s on nail health, according to the researchers.
It was cross-sectional, meaning that it examined participants at one point in time, and relied on symptoms participants reported rather than observation.
What’s Behind the Changes
According to the researchers, weight loss alone did not appear to explain differences in nail problems. The gap remained significant when researchers compared only participants who had lost weight.
After accounting for skin conditions and nutritional deficiencies, nail detachment and discoloration were still about two to three times more common among GLP-1 users.
Study author Dr. Charles Taïeb of Necker University Hospital in Paris cautioned against reading too much into the results. Some of the associations weakened after those adjustments, he said, suggesting that part of what the study showed could be attributed to factors other than GLP-1s.
“Not everything that happens during GLP-1 treatment is necessarily caused by the treatment,” he said, but he noted that the association did not disappear.
“Our study cannot go further than that on the explanation,” he told The Epoch Times.
Another caveat: About half of GLP-1 users said they had nail problems before they started treatment.
Diabetes can affect a person’s nails.
Diabetes is linked to yellow, thickened, or misshapen nails, more fungal infections, buildup of debris, and tiny spots of bleeding under the nail, Dr. Tanya Kormeili, a board-certified dermatologist in Santa Monica, California, who was not involved in the study, told The Epoch Times. These changes can show up under magnification even when nails look normal to the naked eye, she said.
Companion Study Finds Unusual Hair Loss
A companion study of the same participants, also presented at the conference, found that 50 percent of GLP-1 users and 34 percent of non-users reported unusual hair loss.
The researchers said hair loss often occurred alongside scalp symptoms in GLP-1 users, including itching, redness, or scaling, and suggested that factors beyond weight loss could contribute to hair, scalp, and nail changes.
“Scalp inflammation was the rule rather than the exception [with GLP-1 users], which clinicians do not currently look for and which may be treatable,” study author Dr. Bruno Halioua, a dermatologist with a private practice in Paris, said in a statement.
What Patients Should Do
The findings should raise awareness, not alarm, Halioua said.
“These changes are frequent, usually benign, and are not a reason to stop an effective treatment on one’s own initiative,” Halioua said. “Anyone who notices hair shedding, an itchy or red scalp, or nail changes should mention it to their doctor rather than discontinue therapy.”
If you notice changes in your nails—such as swelling, drainage, or pigment around the nail—or experience pain, bring it to your doctor’s attention, Kormeili said.
Telehealth patients, she added, need to be monitored by their healthcare providers.
“You need to be examined,” Kormeili said. “And they need to see changes in your body visibly. It is a disservice to the patient to be prescribed medications and renewals without a complete physical exam.”
Taïeb and his team plan to follow patients as they start taking GLP-1s, using standardized skin and nail exams and lab monitoring. They hope to learn when the changes develop, why they occur, and whether they can be reversed.
