Karan Lal, DO, Shares Evolving Perspective on GLP-1 Agonists in Dermatology at SDPA Fall 2025

At the 2025 Society of Dermatology Physician Associates Fall Conference in San Antonio, Texas, Karan Lal, DO, shared an evolving perspective on the use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in medical and cosmetic dermatology.¹ While initially developed for diabetes and weight management, GLP-1 agents may hold significant potential in inflammatory skin disease and as adjuncts to aesthetic care, according to Lal’s presentation.

Lal, a double-board-certified pediatric and cosmetic dermatologist at Affiliated Dermatology in Scottsdale, Arizona, began by describing how experience in body contouring led to an interest in GLP-1–based therapy. Many patients seeking fat-reduction procedures were poor candidates because their adiposity was primarily visceral, not subcutaneous. Having personally experienced major weight loss, Lal sought safer, evidence-based ways to help patients address systemic metabolic dysfunction rather than offering procedures unlikely to meet expectations.

“I wanted to help these people...Because I used to be 300 pounds 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 to attendees.

Commonly Used GLP-1–Based Therapies

Lal then reviewed the major agents in current use. Liraglutide, now available generically, is FDA-approved for both diabetes and weight loss and administered by daily injection. Semaglutide is dosed weekly and marketed for both indications, while tirzepatide (Zepbound) is a dual GLP-1/GIP agonist with robust weight-reduction and metabolic effects. Newer “triple agonists” that combine GLP-1, GIP, and glucagon-receptor activity are also in development. Dosing schedules vary markedly: semaglutide is typically initiated at 0.25 mg weekly and titrated upward, while tirzepatide starts at 2.5 mg weekly and increases gradually. Among these, tirzepatide produces the greatest mean weight loss, followed by semaglutide and liraglutide.

GLP-1s in Patients with Psoriasis

In a murine imiquimod-induced psoriasis model, liraglutide therapy decreased epidermal hyperplasia and inflammatory cytokines compared with controls. In human studies, Improvements in patients’ Psoriasis Area and Severity Index (PASI) scores, BMI, absolute neutrophil count (ANC), and Dermatology Life Quality Index (DLQI) were noted.

Emerging research suggests GLP-1 receptors may be expressed in psoriatic—but not healthy—skin. In one small study, biopsies from lesional skin of psoriasis patients demonstrated GLP-1 receptor expression in 5 of 6 samples, whereas unaffected skin showed minimal or absent expression. This finding raises the possibility of a direct cutaneous mechanism of action. Clinically, semaglutide has shown promise as an adjunctive treatment in obese psoriasis patients with diabetes, improving PASI scores and metabolic parameters, including triglycerides, glucose, and uric acid. Ongoing large-scale trials, such as the TOGETHER study investigating ixekizumab combined with tirzepatide, may clarify additive effects between GLP-1 agonists and biologic agents by 2026.

GLP-1s in Patients with HS

Beyond psoriasis, Lal highlighted expanding interest in GLP-1–based therapy for hidradenitis suppurativa (HS). In a small prospective study, liraglutide (3 mg daily for 12 weeks) reduced BMI, waist circumference, C-reactive protein, and homocysteine while improving HS severity scores. Another 2024 series reported that adding semaglutide to ongoing biologic therapy in obese HS patients lengthened flare-free intervals by 4 weeks and decreased lesion frequency, even at modest doses.

The Future of GLP-1s in Dermatology

In practice, Lal advocates individualized integration of GLP-1 therapy—initiating treatment concurrently with biologics in appropriate obese or metabolically at-risk patients to enhance response and overall health outcomes. Lower doses may suffice for anti-inflammatory benefit without triggering weight-loss-related adverse effects. He concluded with a call for dermatologists to recognize the systemic nature of inflammatory skin disease and to view GLP-1–based agents as tools for holistic, inflammation-targeted care.

“A lot of people are on these drugs, even people that probably don't need to be on these drugs, but they're using it probably for a different reason. And I think these drugs are being studied for alcohol abuse, a lot of addiction issues, depression...so I think there's so much more to come. I think everyone's going to be on these [GLP-1s] at some point in the future,” Lal told the audience.

Reference

1. Lal, K. GLP1 Agonist Therapy in Dermatology. Presented at: Society of Dermatology Physician Associates Fall 2025 Conference; November 5-9, 2025; San Antonio, Texas.