GLP-1s May Have This Unexpected Impact On Your Nails

As the use of GLP-1 drugs becomes widespread, various side effects have been reported—in both clinical settings and through anecdotal accounts—ranging from nausea and diarrhea to hair loss. A new study points to another possible consequence of GLP-1 use: nail bed detachment.

The study, presented at the 2026 Congress of the European Academy of Dermatology and Venereology, compared health data from 575 individuals in the United States, France, Brazil, and Mexico who used GLP-1 receptor agonists—such as semaglutide (Ozempic and Wegovy) and tirzepatide (Mounjaro and Zepbound)—with data from 1,329 individuals with type 2 diabetes or obesity who had never used such medications.Researchers found that 66% of people who used a GLP-1 medication reported at least one nail condition, representing a 13% increase compared to those who had never used this class of drugs. These complications included nail detachment (also known as onycholysis—which occurs when the nail separates from the nail bed, according to the Cleveland Clinic), affecting 39% of GLP-1 users and 9% of the control group. Nail discoloration affected 46% of GLP-1 users, compared to 17% of the control group.

Why GLP-1 drugs might cause nail shedding.

Many side effects associated with GLP-1 use are linked to weight loss rather than the medications themselves. However, in this instance, the increase in nail issues was greater among GLP-1 users regardless of the amount of weight lost, suggesting a more direct effect of the drug—though the study notes that further research is needed.

That said, nail problems following weight loss are not unprecedented. "It is generally rare, but we also see it in our bariatric surgery patients," says Dr. Mir Ali, medical director of the MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, California. Dr. Ali agrees that nail shedding "appears to be independent of weight loss," based on both the study's findings and his own experience with patients. Dr. Ife J. Rodney, founding director of Eternal Dermatology + Aesthetics in the Baltimore-Washington area, notes that the increased risk of nail shedding is not "surprising" to her; she compares this side effect to the hair loss that can accompany GLP-1 use due to both weight loss and genetic factors. (Both nails and hair are primarily composed of the protein keratin, and protein intake often decreases with GLP-1 use as patients experience reduced appetite—a common concern among healthcare professionals.)

Doctors explain to *Allure* that nail shedding could also be linked to nutritional deficiencies. People using GLP-1 medications often consume fewer calories than usual, making it difficult to meet requirements for vital nutrients such as protein, iron, and B vitamins—all essential for nail growth—according to Dr. Ali. "As a result, the body may not produce nail plates as efficiently, or it might even temporarily stop producing them altogether," leading to nail breakage and detachment, notes Dr. Rodney. "It’s not that GLP-1s are directly toxic to the nails; rather, the body prioritizes other needs over them when in this state of nutritional deficiency."

It is important to consult a dermatologist if you experience nail separation.

Nail separation can be uncomfortable, but it should also prompt an evaluation by a healthcare professional. "True nail separation warrants a visit to the dermatologist to ensure there is no infection or inflammation," says Dr. Gary Goldenberg, an assistant clinical professor of dermatology at the Icahn School of Medicine at Mount Sinai in New York City.

Separation from the nail bed can be caused by other medications—including the antibiotic tetracycline and oral retinoids like Accutane—as well as underlying thyroid disorders; therefore, determining the cause of the symptom is important, according to Dr. Rodney. Nail separation is treatable, and the approach depends on the severity of the condition. "There is a risk that the nail could snag on something and be torn off, causing pain and bleeding," notes Dr. Rodney, adding that a dermatologist might trim the nail or surgically remove the detached portion to prevent further injury.

Additionally, a dermatologist might recommend taking biotin supplements alongside a prescription topical nail medication called Genadur, which helps strengthen the nails, according to Dr. Goldenberg. The doctor might even suggest applying minoxidil—the active ingredient in Rogaine—to the nails or taking it orally, according to Dr. Farah Moustafa, a dermatologist and director of laser and cosmetic services at Tufts Medical Center in Boston.

Small adjustments can reduce the risk of nail shedding.

More research is needed on the link between GLP-1 use and nail shedding, but doctors agree that maintaining a balanced diet during treatment with these medications can support nail health. This includes consuming sufficient protein and taking supplements as directed by the prescribing physician, notes Dr. Ali.

Dr. Moustafa also recommends following a diet that provides a wide variety of nutrients. "Biotin, vitamin B12, vitamins A, C, and E, as well as minerals like iron and zinc, can play an important role in the formation of both hair and nails," she states. Eggs, salmon, sunflower seeds, and almonds are good choices.

Dr. Ali recommends regular follow-ups with a healthcare professional while taking GLP-1 medications and paying attention to any new side effects. "If necessary, they will order blood tests and evaluate other parameters to reduce the risk of future side effects," explains Dr. Ali.