Does GLP-1 help with psoriasis? Emerging evidence suggests GLP-1 receptor agonists—medications licensed for type 2 diabetes and weight management—may indirectly improve psoriasis symptoms, primarily through substantial weight loss rather than direct skin effects. Psoriasis, a chronic inflammatory skin condition affecting 2–3% of the UK population, is closely linked to obesity and metabolic dysfunction. Whilst small studies report reductions in psoriasis severity among patients using GLP-1 medications, no large-scale trials have confirmed these drugs as psoriasis treatments. They remain unlicensed for dermatological conditions and are not included in NICE or British Association of Dermatologists guidance for psoriasis management.

What Are GLP-1 Medications and How Do They Work?

Glucagon-like peptide-1 (GLP-1) receptor agonists are a class of medications originally developed to manage type 2 diabetes mellitus. These drugs mimic the action of naturally occurring GLP-1, a hormone produced in the intestine that plays a crucial role in glucose regulation and appetite control.

GLP-1 medications work through several mechanisms. They stimulate insulin secretion from pancreatic beta cells in a glucose-dependent manner, meaning they only promote insulin release when blood glucose levels are elevated. This reduces the risk of hypoglycaemia compared to some other diabetes treatments. Additionally, they suppress glucagon secretion, slow gastric emptying, and act on receptors in the brain to reduce appetite and food intake.

Commonly prescribed GLP-1 agonists in the UK include:

• Semaglutide (Ozempic, Wegovy, Rybelsus [oral formulation for diabetes])

• Dulaglutide (Trulicity)

• Liraglutide (Victoza, Saxenda)

• Exenatide (Byetta, Bydureon) - availability may vary

Whilst initially licensed for glycaemic control, certain GLP-1 medications have received regulatory approval for weight management in adults with obesity or overweight with weight-related comorbidities. The MHRA has approved semaglutide (Wegovy) and liraglutide (Saxenda) specifically for this indication. NICE guidance supports their use in carefully selected patients as part of a comprehensive weight management programme delivered by specialist multidisciplinary services, typically for a time-limited period.

The medications are typically administered via subcutaneous injection, either daily or weekly depending on the specific formulation (with the exception of oral semaglutide). Common adverse effects include nausea, vomiting, diarrhoea, and constipation, which often improve over time. More serious but rare complications include pancreatitis and gallbladder disease. These medicines should be avoided in pregnancy, breastfeeding, or when planning pregnancy. People with diabetes should be aware of potential worsening of diabetic retinopathy, particularly with rapid improvements in blood glucose. Severe vomiting or diarrhoea can lead to dehydration and acute kidney injury, requiring prompt medical attention.

Suspected adverse reactions should be reported via the MHRA Yellow Card scheme (yellowcard.mhra.gov.uk).

The Link Between GLP-1 Agonists and Psoriasis

The potential connection between GLP-1 receptor agonists and psoriasis stems from emerging understanding of the complex interplay between metabolism, inflammation, and immune function. Psoriasis is a chronic inflammatory skin condition characterised by accelerated keratinocyte proliferation and immune dysregulation, affecting approximately 2–3% of the UK population.

Research has identified that people with psoriasis have a significantly higher prevalence of metabolic syndrome, type 2 diabetes, and obesity compared to the general population. This association appears bidirectional: chronic systemic inflammation in psoriasis may contribute to insulin resistance and metabolic dysfunction, whilst obesity and metabolic disturbances can exacerbate psoriatic inflammation.

GLP-1 receptors are not confined to pancreatic tissue—they are expressed in various cell types throughout the body, including immune cells and potentially within skin tissue. This widespread distribution has prompted investigation into whether GLP-1 agonists might exert anti-inflammatory effects beyond their metabolic actions. Some laboratory studies suggest GLP-1 may modulate inflammatory pathways relevant to psoriasis, including reducing pro-inflammatory cytokines such as tumour necrosis factor-alpha (TNF-α) and interleukin-17 (IL-17).

However, it is important to emphasise that there is no official indication for GLP-1 medications in treating psoriasis. The MHRA has not licensed these drugs for dermatological conditions, and they are not included in NICE guidelines (CG153) for psoriasis management. Any observed benefits in psoriatic patients are likely secondary effects, potentially mediated through weight reduction and improved metabolic health rather than direct action on skin pathology. Clinicians prescribing GLP-1 agonists do so for their approved indications—diabetes or weight management—not specifically to treat psoriasis.

People with psoriasis should be assessed for associated conditions including psoriatic arthritis and cardiovascular risk factors, in line with British Association of Dermatologists and NICE guidance.

Current Evidence: Does GLP-1 Help with Psoriasis?

The evidence base examining whether GLP-1 receptor agonists directly improve psoriasis remains limited and preliminary. Whilst several observational studies and case reports have documented improvements in psoriasis severity among patients treated with GLP-1 medications, these findings require cautious interpretation.

Reviews of available literature have identified several small studies suggesting potential benefits. Some patients with both type 2 diabetes and psoriasis experienced reductions in Psoriasis Area and Severity Index (PASI) scores after initiating GLP-1 therapy. However, these studies typically involved small sample sizes, lacked control groups, and could not definitively separate the effects of the medication itself from concurrent weight loss or improved glycaemic control.

Mechanistic studies have explored potential anti-inflammatory properties of GLP-1 agonists. Laboratory research indicates these medications may reduce oxidative stress, decrease production of pro-inflammatory cytokines, and modulate T-cell function—all relevant to psoriasis pathophysiology. Animal models have shown some promise, but translating these findings to human clinical practice remains uncertain.

Crucially, no large-scale randomised controlled trials have specifically evaluated GLP-1 agonists as a treatment for psoriasis. The improvements observed in clinical practice may be entirely attributable to weight loss and metabolic improvement rather than any direct dermatological effect. Current evidence does not support prescribing GLP-1 medications solely for psoriasis management.

The British Association of Dermatologists guidelines and NICE guidance (CG153) for psoriasis do not include GLP-1 agonists among recommended treatments. Established therapies remain the standard of care: topical treatments (corticosteroids, vitamin D analogues), phototherapy, conventional systemic agents (methotrexate, ciclosporin), and biological therapies targeting specific immune pathways (TNF-α inhibitors, IL-17 inhibitors, IL-23 inhibitors). Patients should not discontinue proven psoriasis treatments in favour of GLP-1 medications without specialist dermatology input.

How Weight Loss May Influence Psoriasis Symptoms

The relationship between obesity and psoriasis severity is well established in dermatological literature. Multiple studies demonstrate that higher body mass index (BMI) correlates with increased psoriasis severity, greater body surface area involvement, and reduced response to systemic treatments including biological therapies.

Several mechanisms explain this association. Adipose tissue is not merely an energy store but an active endocrine organ producing pro-inflammatory mediators called adipokines. In obesity, adipose tissue releases increased levels of TNF-α, IL-6, and leptin whilst producing less adiponectin, an anti-inflammatory molecule. This creates a state of chronic low-grade systemic inflammation that can trigger or worsen psoriatic disease.

Weight reduction has been shown to improve psoriasis outcomes independently of specific medications. Research published in JAMA Dermatology demonstrated that obese patients with psoriasis who achieved significant weight loss through dietary intervention experienced meaningful improvements in PASI scores compared to controls. The magnitude of improvement correlated with the amount of weight lost.

Furthermore, weight loss can enhance the efficacy of psoriasis treatments. Studies indicate that patients with lower BMI respond better to biological therapies, potentially because reduced adipose tissue decreases the inflammatory burden and may improve drug pharmacokinetics. NICE guidance on psoriasis management (CG153) acknowledges the importance of addressing obesity and recommends that clinicians discuss weight management with patients where appropriate.

If GLP-1 medications do benefit psoriasis, the effect is most plausibly mediated through substantial weight loss rather than direct drug action on skin. The significant weight reduction achievable with these medications—particularly with semaglutide 2.4mg for obesity, which can achieve 10–15% body weight reduction in clinical trials—could theoretically improve psoriatic inflammation through reduced adipokine production and decreased metabolic dysfunction. However, similar benefits might be achieved through other effective weight loss interventions, whether dietary, behavioural, or surgical.

What to Discuss with Your Doctor About GLP-1 and Psoriasis

If you have psoriasis and are considering GLP-1 therapy—or are already taking these medications for diabetes or weight management—several important points warrant discussion with your healthcare team.

Firstly, clarify your treatment goals. GLP-1 agonists should only be prescribed for their licensed indications: type 2 diabetes or weight management in appropriate patients. If you meet criteria for these conditions, the medication may be suitable, but it should not be viewed as a psoriasis treatment per se. Your GP or endocrinologist can assess whether you fulfil NICE criteria, which typically require a BMI ≥35 kg/m² with weight-related comorbidities, or ≥30 kg/m² with type 2 diabetes for weight management indications. Treatment is usually provided through specialist weight management services for a time-limited period.

Discuss realistic expectations. Whilst some patients report psoriasis improvement during GLP-1 therapy, this is not guaranteed and likely relates primarily to weight loss. Continue your prescribed psoriasis treatments unless advised otherwise by a dermatologist. Do not discontinue topical therapies, phototherapy, or systemic medications without specialist guidance.

Key questions to raise include:

• Am I eligible for GLP-1 therapy based on my metabolic health?

• What are the potential benefits and risks in my specific situation?

• How will this medication interact with my current psoriasis treatments?

• What monitoring will be required (blood tests, weight tracking)?

• What adverse effects should prompt me to seek medical attention?

Safety considerations are paramount. These medications should be avoided during pregnancy, breastfeeding, or when planning pregnancy (stop in advance according to product guidance). If you have diabetes, be aware of potential worsening of diabetic retinopathy, particularly with rapid improvements in blood glucose. Maintain adequate hydration, especially if experiencing vomiting or diarrhoea, as dehydration can affect kidney function. Contact your GP urgently if you experience severe abdominal pain (potential pancreatitis), persistent vomiting, or signs of gallbladder disease.

Seek immediate medical attention if your psoriasis suddenly worsens with widespread redness affecting most of your body (erythroderma) or develops multiple small pustules (generalised pustular psoriasis). If you develop joint pain, stiffness or swelling, discuss this with your doctor as it may indicate psoriatic arthritis requiring rheumatology assessment.

Finally, remember that comprehensive psoriasis management extends beyond medication. Discuss lifestyle modifications including smoking cessation, alcohol moderation, stress management, and maintaining a healthy weight through sustainable dietary changes and physical activity. Your dermatology team, GP, and potentially a dietitian can provide coordinated, evidence-based care tailored to your individual circumstances.

Report any suspected side effects via the MHRA Yellow Card scheme (yellowcard.mhra.gov.uk).

Frequently Asked Questions