Ozempic users notice a surprising side effect affecting their hair
These days, it seems like nearly everyone I talk to is either on Ozempic or knows someone who is.
Ozempic is actually one brand name for a drug called semaglutide, and it’s FDA-approved to help manage insulin levels in patients with type 2 diabetes. A separate version of medication, called Wegovy, has a higher maximum dose (2.4 mg versus 2 mg with Ozempic) and is indicated for weight management (though some doctors are prescribing Ozempic off-label for this purpose). Its buzzed-about effects on weight and the glut of celebrities who've admitted to using it have resulted in an ongoing shortage of the drugs.
Now, chatter about the side effects—nausea, constipation, a strange phenomenon known as 'Ozempic face' —is also hitting a fever pitch, and one that seems to be emerging as part of that discussion: hair loss.
Last week, popular Girl With No Job influencer Claudia Oshry (three million followers and counting) shared on her IG stories that Ozempic caused her to shed hair—and she’s just one voice in a growing chorus of people who claim they’re experiencing these effects.
Meet the experts: Anthony Rossi, MD, is the founder of Dr. Rossi Derm MD, and an assistant professor of dermatology at Weill Cornell Medical College. Amy Freeman, MD, is a New Jersey-based dermatologist with Millburn Laser Center and a member of the American Academy of Dermatology. Fatima Cody Stanford, MD, is an obesity medicine physician and associate professor of medicine and pediatrics at Massachusetts General Hospital and Harvard Medical School.
The talk isn't limited to social media, either: Dermatologists who treat hair loss are reporting that they’re seeing the phenomena in their offices, too.
'I do have patients on semaglutide, and some are noticing that their hair is thinner and more brittle and that the texture has changed while on the medication,' says Anthony Rossi, MD, an assistant professor of dermatology at Weill Cornell Medical College.
But what’s exactly behind this shedding? To find out, I talked to Dr. Rossi and other top experts.
Here’s what they had to say—and how you can stop the hair fall if it’s happening to you. Read on for their fairly reassuring advice.
Does Ozempic cause hair loss?
It’s possible—but the medication probably isn't the direct culprit. It’s more likely the weight loss itself that's behind your shedding strands.
'There's a form of stress-induced hair loss called telogen effluvium, and any stressor on the body, whether it’s pregnancy, surgery, emotional stress, or rapid weight loss, can cause it,' says New Jersey-based dermatologist Amy Freeman, MD of Millburn Laser Center, a member of the American Academy of Dermatology. 'It’s more of a connection than a causation—it's not the drug that’s making your hair fall out, it's the associated weight loss.'
It's important to note, however, that despite online chatter, studies on semaglutide suggest the effect is pretty rare. Take Wegovy, for example: In those clinical trials, only 3% of adults reported hair loss as an adverse reaction versus one percent on a placebo (hair loss was not a reported side effect of on-label Ozempic use). And in studies conducted on another popular weight loss drug called terzepatide (aka, Mounjaro), 5.7% of patients reported experiencing hair loss versus less than 1% on a placebo. So, sure, it’s a possibility, but those aren’t odds I’d bet on.
How can Ozempic cause hair loss?
Semaglutide injections mimic the effects of a hormone called glucagon-like peptide-1 (GLP-1), which plays a role in suppressing appetite, slowing digestion, and affecting how much fat our bodies store. Translation: It’s very possible that if you’re using semaglutide, you’re going to eat a whole lot less.
'When you look at the data, the average patient will lose 15% of their total body weight,' says Fatima Cody Stanford, MD, an obesity medicine physician and associate professor of medicine and paediatrics at Massachusetts General Hospital and Harvard Medical School. 'But you're going to have high responders who lose up to 35%.'
And if you’re eating a lot less, you may not be getting the ideal balance of nutrients, which can cause telogen effluvium, especially in the case of decreased protein intake or zinc deficiency, research shows.
'The hair is a dividing cell—you need proper nutrition for it to grow,' says Dr. Rossi. 'So, when you’re in a state of malnourishment, your body's going divert nutrients away from hair growth to perform other more essential functions. In a way, your hair is an innocent bystander of this process.'
Typically, telogen effluvium is characterised by a rapid shedding that occurs about three months after the inciting incident.
'Hair goes through many different growth cycles—there's an active growth cycle, called the anagen phase, and there's a rest phase, called telogen,' says Dr. Freeman. 'With rapid weight loss or nutrient deficiency, the body thinks it's under stress and duress and it shuts down, pushing all hair follicles into the rest phase at the same time. That prompts an exaggerated shedding event.'
If you stop taking Ozempic, will your hair grow back?
The good news: Yes, that’s likely. The vast majority of telogen effluvium is temporary, Drs. Rossi and Freeman say. There is a chronic form of the condition characterised by hairs that remain in the resting phase for a longer period, but shedding related to weight loss is typically more a sign of acute telogen effluvium.
Likewise, if you remain on semaglutide and your weight stabilises, your hair loss should do the same, says Dr. Rossi. So, take a deep breath and take heart—it will grow back. That being said, it can take a while—months, even—so you may want to enlist a little help in the meantime.
What to do if you experience hair loss from Ozempic
Hair loss is a complicated issue, and while there are effective solutions, they require time and consistency. The solutions here are solid suggestions for many different types of hair loss, telogen effluvium included:
Topical minoxidil
This is the only FDA-approved topical treatment for hair loss and is available for women in 2% and 5% concentrations: 'Minoxidil pushes hairs into the anagen, or growth, phase of the cycle,' says Dr. Rossi. 'You’re not curing telogen effluvium so much as you’re helping the hair growth cycle to move along so new hairs can sprout.' Oral minoxidil is a more aggressive option and is available by prescription—discuss it with your doctor.
Proper nutrition
A lot of time in patients that are high responders to these medications, they just consume a lot less of everything, including things they need," says Dr. Stanford, who closely monitors her patients' levels of vitamins D and B12, in particular (your doctor should be doing the same). If you choose to remain on semaglutide, Dr. Freeman urges you 'to work closely with a nutritionist to ensure you’re eating enough protein, which is one way to manage hair loss,' she says. 'You’ll also want to make sure you're getting enough iron and zinc because deficiencies of those nutrients are also related to shedding.'
Supplementation
If you’re not getting enough fatty acids, in particular, that can affect the quality and density of your hair,” says Dr. Rossi. In this case, fish oil capsules may help. Dr. Stanford will often recommend a multi-vitamin to her high-responding patients who may be at risk of overall nutrient deficiencies. And both Drs. Rossi and Freeman also recommend trying Nutrafol, a supplement specifically designed to address hair loss with strong data to support its effectiveness. The brand has several women-specific formulations to choose from. But—and this is important—it’s always best to consult with your doctor before beginning any supplement regimen: Over-supplementation of certain nutrients can contribute to hair loss, some research suggests. So, please, don’t go it alone.
Anti-fungal shampoo
You may not be struggling with dandruff or seborrheic dermatitis, but if you’re looking for a solution to hair loss, pick up a shampoo with ketoconazole, which is commonly used to treat those conditions—and may help with hair loss too. 'Ketoconazole can lower levels of dihydrotestosterone (DHT), a hormone that can shrink hair follicles and shorten hair’s growth cycle,' says Dr. Rossi.
Platelet-rich plasma injections
If your hair loss persists, talk to your dermatologist about injections of platelet-rich plasma (PRP), suggests Dr. Rossi. The treatment involves injecting a patient’s own blood cells into the scalp to promote new hair growth. 'There have now been multiple studies showing that PRP is a promising therapy for chronic telogen effluvium,' Dr. Rossi says.
The bottom line: should you be worried about hair loss if you’re on Ozempic?
Hair shedding due to rapid weight loss—and Ozempic and drugs like it can result in rapid weight loss—is certainly a possibility. But data suggests its rare, with hair loss following bariatric surgery or diagnosed eating disorders, for example, being a far greater possibility. (Fifty-seven percent of weight loss surgery patients experience hair loss, one study shows.)
Dr. Stanford puts it this way: 'Don't be concerned, per se, but do be aware—and really keep track of the volume of protein, carbohydrates, and fat you're eating—we still need those,' she says. 'And I would hope you're working with a physician who's skilled and can do a basic metabolic profile to determine where you are before—and after—starting the meds.'
If you are noticing shedding while on semaglutide, there are plenty of effective treatment options—many of which won’t cost you a fortune—that you can discuss with your doctor. But perhaps the most encouraging news: This form of hair loss tends to be very temporary. Of course, it can be traumatic to see clumps of strands in your sink or on your hairbrush, but I hope it gives you some comfort to know that this too shall pass.
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