Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have generated growing interest in dermatology for their potential anti-inflammatory and immunomodulatory effects on skin disease, in addition to their metabolic benefits. As their use expands beyond established indications for type 2 diabetes and obesity, important ethical challenges have emerged. This review explores the ethical considerations surrounding GLP-1 RA use in dermatology through the principles of autonomy, beneficence, non maleficence, and justice. Notable issues include disparities in access and affordability, compounded formulations, social media misinformation, scope-of-practice considerations in prescribing, and informed consent. Evidence suggests that racial, ethnic, socioeconomic, and insurance-related disparities limit access to GLP-1 RAs, while increasing off-label and cosmetic use may worsen medication shortages and inequitable distribution. Compounded agents may improve access but introduce concerns about product quality, safety, counterfeit medications, and inadequate patient counseling. Social media and direct-to-consumer marketing contribute to misinformation, unrealistic outcome expectations, and demand-driven shortages. Emerging dermatologic evidence supports potential benefits of GLP-1 RAs for hidradenitis suppurativa and psoriasis, raising questions about appropriate prescribing authority and side effect monitoring responsibilities for dermatologists. Limited long term safety data for off-label GLP-1 RA use highlights the importance of transparent patient counseling and shared decision-making when prescribing these agents. As GLP-1 RA use continues to expand, dermatologists must balance potential therapeutic benefits with broader societal considerations. Ethical stewardship through evidence based prescribing, informed consent, adverse effect monitoring, patient education, and advocacy for equitable treatment access is essential to maximizing patient benefit, minimizing harm, and preserving fair access.
