Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have rapidly expanded beyond the treatment of type 2 diabetes mellitus (T2DM) and obesity, with increasing relevance to dermatologic practice as more patients present while receiving these therapies. This medication class now includes oral formulations including oral semaglutide and the first non-peptide oral GLP-1RA, orforglipron as well as next-generation triple agonists such as retatrutide, which demonstrated up to 24.2% body weight reduction in phase 2 trials and a favorable body composition profile, with preferential fat over lean mass loss. Although GLP-1 RAs provide substantial metabolic and weight reduction benefits, their growing use has introduced a broad spectrum of systemic and cutaneous adverse effects that dermatologists must recognize and monitor. This review summarizes the current evidence regarding the safety profile of GLP-1RAs with emphasis on dermatologic implications and interdisciplinary monitoring considerations. Common adverse effects include gastrointestinal (GI) intolerance, nutritional deficiencies, gallbladder disease, pancreatitis, and loss of lean body mass. Other rarer potential side effects include anemia, neuropsychiatric, and sexual health effects. Emerging data also suggest associations with ophthalmologic complications, skeletal fragility in older adults, and alterations in body composition that may influence cosmetic and procedural outcomes. Dermatologic adverse events include alopecia, eczematous and hypersensitivity eruptions, bullous and pustular dermatoses, acneiform eruptions, hyperhidrosis, and significant facial volume loss ("Ozempic face"). Current evidence regarding GLP-1RA use in pregnancy remains limited and evolving, with recommendations generally advising discontinuation prior to conception. Given the increasing overlap between metabolic disease management and dermatologic care, dermatologists should understand contraindications, screening strategies, nutritional monitoring, and counseling considerations associated with GLP-1RA therapy. A multidisciplinary approach involving primary care physicians, endocrinologists, ophthalmologists, dietitians, and dermatologists is essential to optimize patient safety while maintaining the substantial therapeutic benefits of these medications.
