Ethical Considerations of Cosmetic GLP-1 Receptor Agonist Prescribing in Dermatology.

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly used beyond approved metabolic indications, including for elective weight loss and aesthetic optimization. Dermatologists may encounter both requests to prescribe these agents and downstream consequences such as facial volume loss and telogen effluvium. Although prescribing these medications for hidradenitis suppurative or psoriasis can be medically rationalized and helpful, elective prescribing raises ethical concerns related to nonmaleficence, scope of practice, prescribing cascades, patient autonomy, justice, and stewardship of limited resources. We discuss the ethical responsibilities of dermatologists considering GLP-1 RA prescribing for cosmetic purposes and propose practical guardrails for balancing patient preferences with professional judgment and avoidance of iatrogenic harm.