用 GLP-1 的人指甲更容易脱离、变色？维也纳大会新调查先别急着下结论

If you’re taking a GLP-1, you’ve probably heard plenty about the potential side effects, ranging from nausea and constipation to pancreatitis. And the longer they’re on the market, the more side effects researchers are noticing and exploring, like hair loss and vision changes. The latest addition to the list: Nail changes.

A study presented this month at the European Academy of Dermatology and Venereology’s 2026 Congress in Vienna discovered nail problems among GLP-1 users, with two-thirds of them experiencing a nail disorder. Some people are experiencing their nails lifting up from their bed, while others’ nails are changing color. It may sound alarming, but the research is very preliminary.

Here’s what three experts—including a study coauthor—say you should know.

Meet the experts: Bianca Maria Piraccini, MD, PhD, is a dermatologist and coauthor of the study. Dana Stern, MD, is a dermatologist specializing in nail health and an assistant clinical professor of dermatology at Mount Sinai Medical Center. Fatima Cody Stanford, MD, is an obesity medicine physician-scientist at Massachusetts General Hospital and an associate professor of medicine and pediatrics at Harvard Medical School.

What did the study find?

The researchers surveyed 575 people taking GLP-1s and 1,329 people with obesity and/or type 2 diabetes who had never taken them. Nearly 40 percent in the GLP-1 group reported that their nails were lifting away from the nail bed, compared with about 10 percent in the other group. Changes in nail color were more common, too, with 46 percent of people taking GLP-1s reporting them, compared with 17 percent of those who weren’t.

“This is an important signal that warrants further investigation, but it does not establish that GLP-1 medications cause nail detachment or discoloration,” says Fatima Cody Stanford, MD, an obesity medicine physician-scientist at Massachusetts General Hospital and associate professor of medicine and pediatrics at Harvard Medical School.

For starters, around half of GLP-1 users said they had nail problems before taking the med. Other health conditions and nutritional deficiencies, like psoriasis and iron deficiency, also explained some of the difference between groups, according to dermatologist and study coauthor Bianca Maria Piraccini, MD, PhD. Psoriasis can cause nails to change color or lift away from the nail bed, while iron deficiency can leave them thin and spoon-shaped, per the American Academy of Dermatology Association.

After researchers accounted for those factors, nail lifting and discoloration were still associated with GLP-1 use, although the links were weaker, Dr. Piraccini says. In a separate analysis that focused only on changes reported to have started after treatment began, neither association was statistically significant—another reason the findings can’t establish that the medication itself caused the problems.

Still, there are reasons to keep examining the phenomenon, Dr. Piraccini says. The survey relied on self-reporting, and there’s always room for error when asking patients to recall symptoms and how they relate to treatment. Having a dermatologist check participants’ nails before treatment and following them over time would help researchers better understand whether the drugs play a role, Dr. Stanford explains.

As for why GLP-1 users might be experiencing nail problems, researchers aren’t so sure. The medications are known to reduce appetite, which can make it harder to get enough protein, vitamins, and minerals, Dr. Stanford explains. Rapid weight loss can also put stress on the body, potentially affecting hair, skin, and nails. But those possibilities don’t necessarily explain nail lifting, which Dr. Stern says isn’t associated with weight loss or not getting enough calories or protein. A direct medication effect is another possibility, she says, although researchers don’t yet understand how that would happen.

What else could explain nail changes?

When a nail lifts (a condition called onycholysis), it separates from the skin underneath it. One sign it’s happened to you? The white part at the tip might look like it’s creeping back toward your cuticle, says Dana Stern, MD, a dermatologist specializing in nail health and an assistant clinical professor of dermatology at Mount Sinai Medical Center.

And, it’s not so hard for a nail to lift. Even using a tool to clean underneath your nails can loosen their attachment, which weakens with age, Dr. Stern explains. Toenails can lift from repeatedly hitting the front of your shoes during exercise. Psoriasis can cause lifting, too.

Color changes can have different explanations too. When a nail lifts, the separated area can look white, Dr. Stern explains, adding that brown lengthwise bands can also develop when pigment-producing cells in the nail become more active, sometimes after irritation from cuticle picking or aggressive manicures. These bands are often harmless, but any new pigmented band in an adult should be evaluated by a derm, she notes.

What should you do if your nails look different?

Whether your nails are lifting or changing color, take a clear photo, write down when it started, and contact your prescriber or a dermatologist. You shouldn’t stop taking your medication on your own because of a nail change alone, says Dr. Stanford, but do let your doctor know what’s happening so they can help determine the cause and whether you need treatment.

While awaiting evaluation, avoid nail cosmetics, filing, and buffing if your nails are lifting, Dr. Stern recommends. Avoid picking, cutting, or aggressively pushing back your cuticles, too, since that irritation can trigger pigment changes, she explains. Treatment for lifting or discoloration will depend on the underlying cause.

If you notice any pain, swelling, warmth, pus, bleeding, or a rapid change in pigment, contact your provider right away. “A new brown or black lengthwise band should also be checked by a dermatologist,” Dr. Stern says. “Many are harmless, but some need evaluation for nail melanoma.”

Is a nail supplement worth trying for nail changes?

It’s tempting to pick up a bottle of vitamins that promises stronger nails and see if it delivers, but there’s no evidence it’ll fix the lifting or discoloration, says Dr. Stern: “Don’t waste your time and money!”

A supplement could help if you’re short on nutrients your body needs—which is something your doctor can help figure out. If you’re struggling to eat because you feel nauseated or barely hungry, mention that to them, too. Your prescriber may be able to adjust your treatment so eating enough feels more manageable. And, yes, they could recommend a supplement if it would be appropriate in your case.

Treatment depends on what’s actually causing the change. Evaluation may include your doctor taking a nail clipping, testing for fungus, or taking blood to check for a nutritional deficiency, Dr. Stanford says.

And, if you’re taking a GLP-1 or considering one, you don’t need to worry too much about this new link. “Patients noticing nail changes should not automatically attribute them to GLP-1 treatment or prematurely discontinue an effective drug,” Dr. Piraccini says.