用 GLP-1 减重的人，指甲脱落变多了：一项 1900 人研究

As GLP-1 usage becomes more mainstream, a range of side effects have been reported both clinically and anecdotally, from nausea and diarrhea, to hair loss. A new study flags yet another potential repercussion of using a GLP-1: detached nail beds.

The study, which was presented at the European Academy of Dermatology and Venereology Congress 2026, compared health data from 575 people in the U.S., France, Brazil, and Mexico who used GLP-1 receptor agonists like semaglutide (Ozempic and Wegovy) and tirzepatide (Mounjaro and Zepbound) to 1,329 people with type 2 diabetes or obesity who had never used the medications.

The researchers discovered that 66% of people who used a GLP-1 medication reported having at least one nail disorder, a 13% uptick from people who had never used this medication class. Those complications included nail detachment (also known as onycholysis, which is when the nail separates from the nail bed, per the Cleveland Clinic) which impacted 39% of GLP-1 users and 9% of controls. Nail discoloration affected 46% of GLP-1 users vs. 17% of controls.

The study didn’t prove that GLP-1 medications directly caused these nail health complications. Rather, it found a link. “Until now, nail changes associated with GLP-1 therapies had essentially been anecdotal,” study co-author Charles Taïeb, MD, a dermatologist at Necker University Hospital in Paris, said in a statement. “Our findings show a clear association, but they also underline an important point: Not everything that happens during GLP-1 treatment is necessarily caused by the treatment itself.”

Still, dermatologists and a doctor who prescribes GLP-1s tell Allure they’ve seen this before.

Why GLP-1s may lead to nail detachment.

Many of the side effects that can come with GLP-1 use are linked to weight loss, not the medications themselves. In this case, though, the uptick in nail issues was higher among GLP-1 users regardless of the weight lost, suggesting a more direct impact from the medication, although the study cautions more research is needed.

However, nail issues following weight loss isn’t unheard of. “This is uncommon overall, but we do see it with our surgical weight loss patients as well,” says Mir Ali, MD, medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA. That being said, Dr. Ali agrees that nail detachment “seems to be independent of the weight lost,” based on the findings and his personal experience with patients.

Ife J. Rodney, MD, founding director of Eternal Dermatology + Aesthetics in the Baltimore-Washington metropolitan area, says that the higher risk of nail detachment is “not surprising” to her, comparing this side effect with the hair loss that can come with GLP-1 use due to both weight loss and genetic factors. (Nails and hair are both primarily made of the protein keratin, and protein intake often drops with GLP-1 use as patients have a reduced appetite, which is often a concern for providers.)

Doctors tell Allure that nail detachment is likely related to nutritional deficiencies, too. People using GLP-1 medications often take in less calories than usual, which makes it harder to meet thresholds for vital nutrients like protein, iron, and B vitamins, all of which support nail growth, per Dr. Ali.

“As a result, your body may not produce nail plates as efficiently or may even stop producing the nails temporarily,” which leads to nail breakage and detachment, Dr. Rodney says. “It’s not that GLP-1s are directly toxic to the nails, but the body has other concerns outside the nails when you’re in this state of nutritional deficiency.”.

It’s important to see a dermatologist if you experience nail detachment.

Nail detachment can be uncomfortable, but it also should prompt an evaluation by a healthcare professional. “A true nail detachment warrants a visit to your dermatologist to make sure there is no infection or inflammation” says Gary Goldenberg, MD, assistant clinical professor of dermatology at Icahn School of Medicine at Mount Sinai Hospital in New York City.

Nail bed detachment can be caused by other medications, including the antibiotic tetracycline and oral retinoids like Accutane, along with underlying thyroid disease, making it important to determine what’s driving the symptom, according to Dr. Rodney.

Nail detachment is treatable, and treatment depends on the severity of detachment. “There is a risk that the nail could hook on something and rip off, leading to pain and bleeding,” Dr. Rodney says, adding that a dermatologist may trim the nail or surgically remove the part that is detached to prevent further injury.

A dermatologist may also recommend taking supplemental biotin, along with a prescription topical nail medication called Genadur that strengthens nails, according to Dr. Goldenberg. A doctor may even suggest putting minoxidil, the active ingredient in Rogaine, on nails, or take an oral form of minoxidil, according to Farah Moustafa, MD, dermatologist and director of Laser and Cosmetics at Tufts Medical Center in Boston.

Simple adjustments may lower the risk of nail detachment.

More research into the link between GLP-1 usage and nail detachment is needed, but doctors agree that focusing on balanced nutrition while using these medications can help support nail health. That includes having ample protein intake and taking supplements as directed by the prescribing doctor, Dr. Ali says.

At the same time, Dr. Moustafa encourages eating a diet with a wide variety of nutrients. “Biotin, vitamin B12, vitamins A, C, and E, and minerals such as iron and zinc can play a role for hair and also nail formation,” she says. Eggs, salmon, sunflower seeds, and almonds are all good options.

Dr. Ali recommends continuing to follow up regularly with your healthcare provider while taking a GLP-1 and noting any new side effects. “If necessary, they will order blood work and check other parameters to lower the risk of future side effects,” Dr. Ali says.

For more GLP-1 news and findings: