Beyond Weight Loss: Clinical Perspectives on GLP-1s for Inflammatory Dermatoses

As glucagon-like peptide-1 receptor agonists (GLP-1 RAs) reshape the management of obesity and metabolic disease, dermatology clinicians are beginning to explore their relevance far beyond weight loss. GLP-1–based therapies are now drawing attention for their potential anti-inflammatory and immunomodulatory effects—factors highly relevant to chronic dermatologic disease. Drawing on clinical experience and emerging research, clinicians are now examining how GLP-1–based therapies may influence conditions such as psoriasis and hidradenitis suppurativa (HS), signaling a potential clinical shift in the systemic approach to chronic inflammatory skin disorders.

From Body Contouring to Metabolic Intervention

Karan Lal, DO, MS, became interested in systemic metabolic therapies through his clinical experience in body-contouring consultations. Many of his patients seeking fat-reduction procedures were not ideal candidates because their adiposity was predominantly visceral rather than subcutaneous. Recognizing the limitations of procedural options and drawing from his personal experience with weight loss, Lal, a double–board-certified pediatric and cosmetic dermatologist at Affiliated Dermatology in Scottsdale, Arizona, began incorporating GLP-1 therapy to address underlying metabolic dysfunction in select patients.

“I wanted to help these people.... Because I used to be 300 lb and I’ve gone through my journey, I want to do something, but I don’t think that the procedure is the right thing for them. So, I said, ‘Why don’t we start doing GLP-1s?’” he said during a recent conference presentation.

Psoriasis and the Skin-Metabolism Interface

“We are still at the frontier of understanding how GLP-1 RAs influence cutaneous biology, from immune modulation [and] adipokine signaling to possible effects on skin-resident stem cells and wound healing,” Adam Friedman, MD, professor and chair of dermatology at the George Washington University School of Medicine and Health Sciences in Washington, DC, told Dermatology Times.

Growing evidence suggests that GLP-1 RAs may have direct dermatologic benefit in inflammatory diseases such as psoriasis. Preclinical work with liraglutide has shown reductions in epidermal hyperplasia and inflammatory cytokines in murine models and early human studies have reported improvements in Psoriasis Area and Severity Index (PASI) scores, body mass index (BMI), neutrophil counts, and quality-of-life indices.¹

One intriguing research direction presented by Lal focused on GLP-1 receptor expression in psoriatic skin. Small biopsy-based studies indicate that lesional skin may express GLP-1 receptors, whereas healthy skin does not—raising the possibility of a local mechanism of action distinct from metabolic pathways.² Clinically, semaglutide has shown promise in patients with coexisting psoriasis, obesity, and diabetes, leading to improved PASI scores and better metabolic profiles.³ Large-scale combination trials, including those evaluating GLP-1 therapy alongside biologics, are expected to yield meaningful insight in the coming years.

Emerging Evidence in Hidradenitis Suppurativa

Interest in GLP-1 RAs for HS is also increasing, as these therapies have immunomodulatory effects that reduce inflammation, including the pathways involved in HS. “For our colleagues in primary care, HS could impact the decision to start a GLP-1 in a patient with obesity/overweight, similar to weight-related conditions like hypertension and hyperlipidemia,” Steven Daveluy, MD, board-certified dermatologist at Wayne State University in Detroit, Michigan, said to Dermatology Times.

A small prospective study of liraglutide (3 mg daily for 12 weeks) showed decreases in BMI, waist circumference, inflammatory biomarkers, and HS severity.⁴ Recent case series have suggested that adding semaglutide to biologic regimens may extend flare-free intervals and decrease inflammatory lesion counts at relatively low doses.⁵ Daveluy noted that GLP1 RAs are “an exciting development in medicine,” yet he remains cautiously optimistic about their current role in HS management.

“Most of the patients currently included in studies were on other treatments for the HS, so it isn’t clear if GLP-1s will have benefit on their own or as adjunct,” Daveluy added. “Most patients with moderate to severe HS require a combination of medications to gain control anyway, but it’s best to have monotherapy data to guide us.”

Personalization and Future Directions

Right now, dermatology clinicians are emphasizing a personalized approach when integrating GLP-1 therapy into dermatologic care. For patients with obesity, metabolic syndrome, or refractory inflammatory disease, GLP-1 RAs may serve as valuable adjuncts that address systemic and cutaneous inflammation. Importantly, some individuals may benefit from subtherapeutic or anti-inflammatory doses rather than full weight-loss regimens.

“A lot of people are on these drugs, even some who may not need to be...but they’re using it probably for a different reason. These drugs are being studied for alcohol abuse, a lot of addiction issues, and depression...so there’s so much more to come. I think everyone will be on these at some point in the future,” Lal said.

GLP-1–based therapies are being investigated for an expanding range of conditions—including addiction, mood disorders, and other inflammatory pathways, suggesting their use will continue to broaden. Friedman and Daveluy agree that several questions regarding mechanism of action, optimal dosing schedules, and agent selection will need to be answered in more rigorous controlled trials and long-term, dermatology-specific research. Friedman believes, however, that this will be worth the investment. “Recognizing that metabolic health and skin inflammation are inseparable is central to managing many of our chronic inflammatory skin diseases,” he concluded.

References

1. Cedirian S, Donati M, Rapparini L, et al. Benefit-risk assessment of GLP-1 receptor agonists: implications for dermatologists and plastic surgeons. Dermatol Ther (Heidelb). 2025;15(11):3173-3193. doi:10.1007/s13555-025-01537-51.
2. Faurschou A, Pedersen J, Gyldenløve M, et al. Increased expression of glucagon-like peptide-1 receptors in psoriasis plaques. Exp Dermatol. 2013;22(2):150-152. doi:10.1111/exd.12081
3. Nicolau J, Nadal A, Sanchís P, et al. Dermatologic and metabolic benefits of semaglutide in psoriasis with obesity: a six-month prospective cohort study. Clin Exp Dermatol. Published online October 25, 2025. doi:10.1093/ced/llaf473
4. Nicolau J, Nadal A, Sanchís P, Pujol A, Masmiquel L, Nadal C. Liraglutide for the treatment of obesity among patients with hidradenitis suppurativa. Med Clin (Barc). 2024;162(3):118-122. doi:10.1016/j.medcli.2023.11.007
5. Killion L, Hughes R, Kirby B. P121 treatment with semaglutide improves the systemic inflammatory burden associated with hidradenitis suppurativa. Br J Dermatol. 2025;193(suppl 1). doi:10.1093/bjd/ljaf085.149