Benefit-Risk Assessment of GLP-1 Receptor Agonists: Implications for Dermatologists and Plastic Surgeons
Stephano Cedirian, Monia Donati, Luca Rapparini, Francesca Pampaloni, M. La Plaça, Rossella Sgarzani, Luca Negosanti, Emanuel Raschi, Michela Starace
Abstract
Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) have gained prominence for their efficacy in treating type 2 diabetes and obesity. Recent evidence suggests that their pleiotropic effects-beyond glycemic control and weight loss-include anti-inflammatory, immunomodulatory, and antioxidative effects, which may beneficially support various dermatologic conditions such as psoriasis, hidradenitis suppurativa, acanthosis nigricans, and Hailey-Hailey disease. However, GLP-1 RAs are also associated with emerging cutaneous adverse drug reactions, including bullous, exanthematous and vasculitic manifestations, and other rare side effects. In aesthetic and reconstructive surgery, rapid weight loss induced by these agents has raised concerns regarding facial volume depletion, skin laxity, and impaired wound healing. In addition, perioperative management of patients on GLP-1 RAs requires careful assessment as a result of delayed gastric emptying and the associated potential risk of pulmonary aspiration. This narrative review summarizes current knowledge on the benefit/risk profile of GLP-1 RAs, highlighting their impact for dermatologists and plastic surgeons in relevant contexts.