Rare Skin Reaction Reported With Tirzepatide
A single case report described possible lichen planus pigmentosus inversus following tirzepatide initiation.
By
Andrea Surnit
May 7, 2026
Clinical Scorecard: Tirzepatide's Surprising Skin Side Effect
At a Glance
Category Detail
Condition Lichen Planus Pigmentosus Inversus Key Mechanisms Potential immune-mediated interface injury leading to pigment incontinence. Target Population Patients using tirzepatide, particularly those with Fitzpatrick skin types II-IV. Care Setting Dermatology outpatient setting.
Key Highlights
Temporal association between tirzepatide and lichen planus pigmentosus inversus. Notable presentation in a patient with Fitzpatrick skin type II. Lesions developed 6 to 7 months after initiating tirzepatide. Topical tacrolimus ointment resolved pruritus but hyperpigmentation persisted. No prior reports of lichen planus pigmentosus linked to GLP-1 receptor agonists. Guideline-Based Recommendations
Diagnosis
Consider biopsy for confirmation of lichen planus pigmentosus in patients on tirzepatide. Management
Topical treatments such as tacrolimus ointment may alleviate pruritus. Monitoring & Follow-up
Monitor for skin changes in patients receiving tirzepatide. Risks
Potential for drug-induced lichenoid eruptions, particularly within the first year of treatment. Patient & Prescribing Data
Adult female patient with a history of weight loss treatment.
Patient opted to continue tirzepatide despite skin side effects.
Clinical Best Practices
Educate patients on potential skin reactions when prescribing tirzepatide. Document any skin changes during follow-up visits for patients on GLP-1 receptor agonists. Related Resources & Content
