Does Zepbound cause acne?

If you have noticed more breakouts since starting Zepbound, you may be wondering: does Zepbound cause acne? No, not directly. There has been no scientific evidence that tirzepatide, the active ingredient in Zepbound, causes acne.

Here is what to know about Zepbound and acne, including how to manage breakouts while taking this weight loss medication.

No,  Zepbound does not cause acne. 

The data:

• Zepbound's drug label does not list acne as a side effect.

• Acne was not reported as an adverse event in clinical trials.

• One study also found that Zepbound is actually less likely than other GLP-1s to cause skin-related reactions.

That said, researchers acknowledge the social media reports of acne on GLP-1s, pinpointing some possible reasons Zepbound might indirectly contribute to temporary breakouts rather than directly cause acne.

Fastest-working GLP-1 for faster weight loss

See if you qualify

Zepbound itself does not cause acne. But new or worsening breakouts on Zepbound might be explained by hormonal fluctuations from rapid weight loss, an injection site reaction mistaken for acne, or, if applicable, dietary changes since starting Zepbound.

Researchers have identified several potential reasons acne may occur on Zepbound: 

• Rapid weight loss. Zepbound can promote rapid, significant weight loss — nearly 21% of body weight in 36 weeks for some people. Rapid weight loss can cause hormonal changes that trigger or exacerbate acne.

• Injection site reaction. A tirzepatide injection site reaction can cause localized redness and swelling that might look a bit like acne. A breakout that develops exactly where a shot was last given may point to this cause rather than acne.

• Dietary changes. Zepbound affects appetite, which can change eating habits. Some research suggests that high-glycemic foods (mostly refined carbs and starches) can increase the risk of acne.

• Nutritional supplements. Some people taking Zepbound turn to supplements to help meet their nutrient needs. High doses of certain dietary supplements, including B12, are known to trigger acne in some people.

Research is limited, but there are plausible reasons Zepbound may indirectly improve acne. Insulin resistance and high insulin levels can worsen acne, and Zepbound is known to have positive  effects on body mass index (BMI), blood sugar control, and insulin sensitivity.

Research also suggests that GLP-1 treatment reduce testosterone levels in women with PCOS. Higher testosterone levels in these women have been linked to increased acne  in women with PCOS. This suggests that Zepbound is probably more likely to improve hormonal acne than fungal acne, which is caused by yeast overgrowth rather than hormonal imbalances.

There is no definitive answer to how long Zepbound acne lasts since there is limited research actually linking the medication to acne. But anecdotal reports suggest that acne does improve over time on Zepbound.​

Acne duration may vary depending on the underlying cause. Acne that becomes severe, painful, or concerning may warrant a conversation with a dermatologist or other healthcare provider.

The first step is ruling out an injection site reaction or an external acne trigger. From there, tried-and-true acne management strategies can help, such as a good skincare routine, over-the-counter (OTC) topicals, and, potentially, prescription acne medications.

Identify triggers

There is no evidence that Zepbound causes acne — but other things do. Taking stock of new supplements, medications, or cosmetic products can help identify what may be triggering or exacerbating breakouts. Certain comedogenic (pore-clogging) ingredients in skincare products and cosmetics are known acne triggers. 

Healthy skin care

Skincare for clear, healthy skin does not have to be complicated. Covering the basics can help manage and prevent breakouts:​

• A gentle cleanser can help minimize irritation, since vigorous cleansing can contribute to irritation and oil production.

• Avoiding touching the face,  including pimple-popping, can help prevent the spread of bacteria and reduce the risk of scarring.

• Regularly cleaning washcloths and makeup brushes can help avoid introducing new bacteria to clean skin.

• Moisturizing also matters: research suggests that moisturizers with ceramide and niacinamide may improve acne.

OTC topicals

Expert guidelines suggest looking for topical products with acne-fighting ingredients, including:

• Adapalene

• Benzoyl peroxide

• Azelaic acid

Trying one new product at a time can help identify which ingredients work well or which may be causing a reaction.

Rx acne treatments

Severe or painful acne may warrant a conversation with a dermatologist, who can help pinpoint whether it may be triggered by hormone imbalance, a dietary trigger, or something else.

If appropriate, a dermatologist may recommend a prescription acne treatment such as:

• Antibiotics (such as doxycycline or minocycline)

• Oral contraceptives

• Spironolactone

• Isotretinoin

These medications have side effects and if you are a woman, some of them may require you to be on birth control since they are unsafe in pregnancy. 

It can. Zepbound can potentially cause two distinct skin issues:

• Injection site reactions (localized bruising, itching, redness, swelling, rash, or pain)

• Hypersensitivity reactions (allergic rash or itching)

If you don’t follow proper injection technique, you may also run the risk of:

• Lipodystrophy (pitted or thickened skin from repeated injections at the same site)

• Cutaneous amyloidosis (skin lumps from repeated injections)

Unlike Wegovy (semaglutide), Zepbound is not known to cause skin sensitivity.

See if you qualify

So, does Zepbound cause acne? No, not exactly. But new or worsening acne since starting Zepbound may point to an indirect link.

Here’s the recap:

• There is no evidence that Zepbound directly causes acne. Acne is not a side effect on the drug label, and no link has been found in clinical trials.

• Zepbound does stimulate weight loss, which can impact hormone balance. And hormone fluctuations can trigger acne.

• Dietary changes may also play a role.  Most people change their diets on Zepbound, and certain foods and supplements can contribute to acne.

• But Zepbound might also help acne. Some people experience significant acne improvement on GLP-1s.

• There are ways to manage acne on Zepbound, including a solid skincare routine, OTC acne-fighting topicals, and dermatologist input if acne becomes painful or severe.

• A healthcare provider can offer personalized medical advice about acne concerns related to Zepbound, weight loss, and more.