Can Ozempic cause hair loss? 

Semaglutide—the active ingredient in brand-name medications like Ozempic and Wegovy—has revolutionized the management of type 2 diabetes and obesity, two very common chronic diseases many Americans are struggling with. But concerns about side effects, including worries about hair loss and Ozempic face, may give people pause when considering trying a new medication like the two “weight loss shots”. 

The good news is that hair loss is not a common side effect of Ozempic, although it can happen due to rapid weight loss.

Do GLP-1s cause hair loss?

Semaglutide is a type of medication called a glucagon-like peptide 1 receptor agonist—GLP-1 for short. Developed to help treat type 2 diabetes and lower people’s risk of cardiovascular events like heart attacks and stroke, it’s frequently prescribed to help people with weight loss too. It enables weight loss and blood sugar control in a few ways, mainly by slowing down digestion (helping you to feel full for longer), and increasing the release of the hormone insulin from the pancreas, which helps to control blood sugar.

GLP-1’s can produce some minor side effects, but they typically affect your stomach and intestines (which makes sense, since the drug works mainly to impact your digestive system). Hair loss, while not impossible when taking GLP-1s, is a rare side effect.

With that being said, it’s not unusual for people to experience hair loss as a side effect of weight loss in general, according to Dr. Raoul Manalac, a board-certified internal medicine physician and diplomate of the American Board of Obesity Medicine. Studies show that the sudden decrease in the calories a person eats is associated with hair loss.

Semaglutides work best for weight loss when combined with exercise and a healthy diet, which for some people means rapid weight loss (an average of up to 15% of body weight in one year when combined with diet and exercise). This means that people may experience hair loss at the same time as taking semaglutide, due to the rather quick weight loss, but not necessarily because of the drug itself. 

Also, some of the health conditions that can prompt people to take semaglutide in the first place can cause hair loss, too. We’ll explore both of these concepts in more detail below.

How common is it?

According to clinical trials on semaglutide, only 3% of adults taking the highest dose of the drug for weight loss (2.4mg per week) experienced hair loss. In other words, most people are able to lose weight while taking semaglutide without losing their hair.

So, while possible, hair loss while taking semaglutide isn’t very common. “Hair loss is more typically associated with people who lose the most weight and do so rapidly,” says Dr. Manalac. 

What could be happening?

Healthy hair growth depends on a number of factors, including a person’s nutrition and diet, hormone balance, and overall health. Hair grows in a cycle, passing through several phases as it grows and is later shed. Some disruptions to this cycle, like nutritional deficiencies and health conditions, can cause hair loss to occur.

Hair loss and dieting

Hair loss is actually not uncommon in people who lose weight by dieting. According to Dr. Manalac, the human body is highly sensitive to intense changes—especially those that are due to weight loss efforts involving severe calorie restriction. “Crash dieting can often cause hair cycling issues and decrease energy supply to the hair matrix,” says Dr. Manalac.

This type of hair loss, called telogen effluvium, is associated with weight loss, lack of nutrition, and stress. Dr. Malanac explains that, in a normal scalp, about 5 to 10% of hair follicles are in the resting or 'telogen phase' of the hair growth cycle at any given time. “If intense stress or nutritional deficiency triggers telogen effluvium, hairs get shifted into the telogen phase.”

Telogen effluvium usually results in hair shedding over the entire scalp (as opposed to hair loss in a particular shape or due to a change in the health of the hair shaft itself, as can happen with other types of hair loss). While this can be stressful, Dr. Manalac reassures that “telogen effluvium does not typically progress to balding even though it might seem like a lot of hair is being lost.” Commonly, a person will experience excess hair shedding for two or three months, after which point their hair will stabilize and begin to regrow; it can take 6 to 12 months for a person’s overall hair appearance to significantly improve.

Hair loss and diabetes

Another possible cause of hair loss can be the health issue a semaglutide user is trying to treat: Diabetes. Hair loss can be linked to diabetes, and may sometimes even occur as an early sign of type 2 diabetes.  

This can occur for a few reasons. Both type 1 and type 2 diabetes are associated with uncontrolled blood sugar levels, which may disrupt the cycle of hair growth and regrowth. High blood sugar can damage your blood vessels, especially tiny vessels called capillaries that are responsible for circulating blood, nutrients, and oxygen to organs and skin tissue—including your scalp. When the scalp can’t get the nourishment it needs, it can’t grow and replace hair like it normally would.

There may also be a link between diabetesand other autoimmune conditions that affect the thyroid, which can cause hair loss as well.

What should patients do if they’re experiencing this?

Chances are that if you’re taking semaglutide, you’ve been working to lose weight for some time. If you notice hair loss at any point in your weight loss journey, be sure to tell your healthcare provider. If you’re dieting, you could be restricting your calories too much—which can put you at risk for hair loss due to telogen effluvium.

Fortunately, since telogen effluvium tends to resolve on its own, you may not have to worry much about taking extra steps to regrow your hair. Semaglutide is designed to be used in conjunction with exercise and a healthy diet, so you won’t be doing your health (or your hair) any favors by crash dieting along with your prescribed dose of medication. Try to eat a balance of fruits, vegetables, whole grains, lean proteins, and healthy fats.

Your provider can help to evaluate your diet as well as guide your next steps for managing hair loss. An understanding of where hair loss is occurring on your head and establishing how much hair you’re losing will inform what treatment options may be available, such as a topical medication like minoxidil or finasteride.

Again, hair loss that’s due to rapid weight loss tends to be short-term and improves over time. However, Dr. Manalac emphasizes that a healthcare provider should be made aware of hair loss that continues or becomes more severe in case there’s an underlying health issue. 

Felix Gussone, MD

Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.