Detached Nails More Than 4 Times Higher Among GLP-1 Users, Study Finds
In a new study, GLP-1 users reported nail detachment more than four times as often as nonusers. Waishaw/Getty Images
GLP-1 drugs like Ozempic have been linked to unusual nail changes in a new study.
GLP-1 users reported nail detachment more than four times as often as nonusers, and nail discoloration affected 46% of GLP-1 users, compared with 17% of nonusers.
The differences held up among people who had lost weight, suggesting weight loss alone may not explain them.
A companion study also notes that hair loss is a common side effect of GLP-1s.
Experts share tips for preserving skin and hair health while taking GLP-1 medications.
GLP-1 users have reported various unusual side effects like “Ozempic feet,” “Ozempic butt,” and “Ozempic breasts.” These changes have been largely tied to rapid weight loss.
Now, fingernails have entered the conversation. Nails detaching from the nail bed or changing color may be more common among people taking GLP-1 drugs, according to a new study. In the study, which researchers presented in October at the European Academy of Dermatology and Venereology (EADV) Congress 2026 in Vienna, people taking GLP-1 drugs such as semaglutide — Ozempic, Wegovy — and tirzepatide — Mounjaro, Zepbound — reported nail detachment and nail discoloration more often than people who didn’t take the drugs.
When the researchers counted only nail changes that started after treatment began, the link between GLP-1 use and nail detachment nearly disappeared, study author Charles Taïeb, MD, PhD, told Healthline.
“This is why we insist that a substantial part of the nail excess reflects the patients’ overall health rather than the drug itself, while a modest drug-specific effect remains plausible,” Taïeb said.Earlier research has also linked GLP-1 use to hair loss. In the new study, the researchers explained why they examined nails, noting that nails and hair both grow from cells that divide quickly.
However, the researchers cautioned in a press release that the study can’t establish that the drugs caused the nail changes. Both the nail study and a companion hair study captured self-reported symptoms at a single point in time, a design that can identify associations only, they said.
Nail changes reported among GLP-1 users
For the study, researchers examined a representative sample of people in France, the United States, Brazil, and Mexico.
Participants included 575 people taking GLP-1 drugs and 1,329 people with type 2 diabetes, obesity, or both conditions, who had never taken GLP-1 drugs.
The average treatment duration was 18.5 months, and researchers tracked weight loss over three months.
They also looked separately at people who had lost weight, to help tell whether the drugs or the weight loss explained the changes. However, the abstract didn’t specify which GLP-1 drugs participants took.
The researchers have submitted the findings to peer-reviewed dermatology journals, where they are under review, Taïeb told Healthline. Here’s what they found.
Nail separation found in 39% of GLP-1 users
According to the American Academy of Dermatology (AAD), nail detachment, or onycholysis, occurs when a nail lifts, and the lifted area often appears white.
Taïeb told Healthline that the study asked about “nail detachment” because patients, not doctors, filled out the questionnaire. Nail detachment was the strongest signal among the five nail changes the researchers asked about, Taïeb said.
According to the abstract, 39% of GLP-1 users reported nail separation or detachment (onycholysis), compared with 9% of nonusers.
Nail discoloration, other nail changes found in 17% of GLP-1 users
Nail discoloration is a change in a nail’s usual color, such as white, yellow, or greenish-black, according to the AAD.According to the abstract, 46% of GLP-1 users reported discoloration, compared with 17% of nonusers. Ridges or grooves and fragile nails were also more common among GLP-1 users.
Mir B. Ali, MD, a bariatric surgeon and medical director of the MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Los Angeles, said that while he prescribes GLP-1s, nail detachment hasn’t come up in his practice. Ali wasn’t involved in the research.“I haven’t had anybody complain of that. It’s not something we really see,” he told Healthline. He said his patients more often mention brittle nails or minor changes in nail color.
Weight loss alone didn’t explain GLP-1 nail changes
Over a three-month period, 76% of GLP-1 users reported weight loss, compared with 47% of nonusers, according to the abstract.Weight loss alone didn’t appear to explain the nail findings, the researchers said in the press release. The differences between users and nonusers held up when they looked only at people who had lost weight.The researchers also cautioned in the press release that the study can’t show the drugs caused the changes. They noted that about half of GLP-1 users had nail problems before starting treatment.
Adjusting for skin conditions and nutritional deficiencies weakened some of the associations, they said, though nail detachment and discoloration stayed about two to three times as common among users.Those adjustments relied on conditions participants reported, including iron, vitamin B12, zinc, and vitamin D deficiencies, as well as psoriasis, eczema, and other skin conditions, Taïeb said.“GLP-1 medications may affect the nails indirectly rather than directly,” said Tanya Evans, MD, a board certified dermatologist and medical director of the Skin Cancer Program at the Melanoma Clinic at MemorialCare Saddleback Medical Center in Laguna Hills, CA, who wasn’t involved in the research.Because the drugs reduce appetite, some people may eat less protein, iron, and zinc, which can contribute to brittle nails, discoloration, or nail detachment, Evans told Healthline. Rapid weight loss may also temporarily disrupt nail growth, much as it can trigger hair shedding, she said.Ali said the total amount of weight a person loses plays a bigger role in hair and nail changes than the rate at which they lose it.
GLP-1 hair loss and scalp changes
The U.S. labels for Wegovy and Zepbound list hair loss as a side effect reported in clinical trials.
The labels for the Ozempic, both injectable and pill form, as well as Mounjaro, list hair loss as a side effect, based on reports received after the drugs entered the market. Those reports don’t establish how often it happens or whether the drugs caused it.
As such, researchers have been examining GLP-1-related hair loss.
A companion study of the same participants found hair and scalp changes were also more common among GLP-1 users, according to that study’s abstract, also provided to Healthline:
Unusual hair loss: 50% of users versus 34% of nonusers
Loss of hair volume or density: 42% versus 19%
Hair loss that started after treatment began: 26% versus 12%
Scalp redness was about three times as common among users, and most users with hair loss also had scalp symptoms such as itching, redness, or scaling.Scalp inflammation may play a role in hair changes among GLP-1 users, in addition to the shedding that often follows rapid weight loss, one of the study’s authors stated in the news release.“This raises the possibility that inflammation may be contributing in some patients, rather than the problem being solely the classic temporary hair shedding associated with rapid weight loss,” Evans said.Experts have told Healthline that hair loss on GLP-1 drugs is often temporary and tied to weight loss.“Hair loss, we see commonly, not only in patients who are on GLP-1 medications, but also in our surgical weight loss patients,” Ali said.
“When you lose weight, especially in women, it releases hormones. You’re getting metabolic changes, and all these things can lead to hair loss and some changes in the nails.” Ali said he tells patients that “as the weight stabilizes at a healthy weight, the hormones stabilize and the hair tends to come back to where it was before.”
How to protect your hair and nails while using GLP-1s
Nail detachment and discoloration don’t appear as adverse reactions in the current U.S. prescribing information for Ozempic, Wegovy, Mounjaro, or Zepbound.
Ali said the best thing patients can do is get the right nutrition, including enough protein. He said he also advises patients to take a multivitamin along with B-complex, vitamin D, and calcium.
“I would not recommend stopping the GLP-1 medication simply because nail detachment occurs,” Evans said. She advised people to tell their doctor about any new changes in hair, scalp, or nails.Treatment for nail detachment or discoloration depends on the cause, Evans said. A dermatologist can check for an infection, an inflammatory nail disorder, a nutritional problem, an injury, or another explanation, she said.A detached nail recovers as a new nail grows out from its base, Evans said. That takes about 4 to 6 months for a fingernail and 9 to 12 months for a toenail.
Lastly, the AAD recommends having a board certified dermatologist examine any nail that’s lifting.
The AAD also recommends seeing a dermatologist if skin, hair, or nail side effects don’t improve, as they can help determine whether symptoms are due to the medication or another condition.“The important message is don’t panic, but don’t ignore persistent nail changes either,” Evans said.
