Investigating the Use of GLP-1 Receptor Agonists in Psoriasis and Hidradenitis Suppurativa

In the first part of this interview with Dermatology Times, Daniel Walker, MD, FAAD, board-certified dermatologist at U.S. Dermatology Partners Keller and Grapevine in Texas, discussed the emerging role of GLP-1 receptor agonists in the management of inflammatory dermatologic diseases, particularly psoriasis and hidradenitis suppurativa (HS). While these agents are widely used for type 2 diabetes and weight management, their potential anti-inflammatory effects have generated increasing interest within dermatology. However, Walker emphasized that their use in skin disease remains investigational, with current evidence largely derived from retrospective analyses and anecdotal reports rather than robust, prospective clinical trials.

Mechanistically, GLP-1 receptor agonists appear to modulate key inflammatory pathways by reducing proinflammatory cytokines implicated in the pathogenesis of psoriasis and HS. These observations align with the broader understanding that both conditions are systemic inflammatory disorders, often associated with metabolic comorbidities like obesity, insulin resistance, hypertension, and cardiovascular disease. By addressing these underlying metabolic drivers, GLP-1 receptor agonists may indirectly contribute to improvements in cutaneous disease activity.

“Psoriasis and HS are much more than just skin conditions,” Walker noted. “So it's probably not a huge surprise to physicians and clinicians that when patients lose weight, their psoriasis or HS can often improve.”

Despite these promising signals, Walker noted that the efficacy and consistency observed with GLP-1 receptor agonists do not yet match those achieved with established therapies, particularly biologics, which can induce high levels of skin clearance in psoriasis. As such, these agents are not currently FDA-approved for dermatologic indications and should not be considered first-line or standalone therapies at this time.

Instead, Walker positions GLP-1 receptor agonists as potentially valuable adjunctive treatments within a comprehensive, multimodal management strategy. Their greatest utility may lie in patients with concomitant metabolic syndrome, where weight loss and improved cardiometabolic health are known to correlate with better dermatologic outcomes. This holistic approach reinforces the concept of psoriasis and HS as multisystem diseases requiring integrated care beyond skin-directed therapy alone.

Further investigation through well-designed clinical trials will be critical to better define the efficacy, safety, and optimal role of GLP-1 receptor agonists in dermatology. “There might be a day when that is a monotherapy, but I don't think we're there yet,” Walker concluded.