Could GLP-1 medications be the missing piece in treating inflammatory skin disease? In this episode of Science is Skin, Dr. Ted Lain sits down with Dr. Lindsey Bordone — former Columbia University associate professor of dermatology, now in private practice at Bordone Dermatology in Scottsdale, Arizona — for a deep dive into metabolic disease and the skin.

Dr. Bordone was among the first dermatologists to prescribe GLP-1 agonists for her patients, and in this conversation she explains exactly why. From the link between hyperinsulinemia and chronic inflammation to the visible skin signs of insulin resistance — skin tags, acanthosis nigricans, forearm hair loss — she makes the case that dermatologists are uniquely positioned to catch metabolic disease before any other specialty.

Dr. Bordone walks through how she uses tirzepatide (Mounjaro/Zepbound), semaglutide (Ozempic/Wegovy), and the emerging triple-G drug retatrutide, including her lab protocols, dosing philosophy, how to manage GI side effects, and the surprising interaction between GLP-1s and estrogen therapy.

In this episode:

• Why high BMI reduces biologic efficacy in psoriasis patients
• How to check fasting insulin (HOMA-IR) and why most physicians aren't doing it
• Skin signs of insulin resistance: skin tags, forearm hair loss, and neck skin thickening
• Tirzepatide vs. semaglutide vs. retatrutide — how to choose and when
• Retatrutide's remarkable 93% fatty liver clearance rate in clinical trials
• The truth about sarcopenia and muscle loss on GLP-1 medications
• Dosing protocols, side effect management, and when NOT to escalate quickly
• Protein intake recommendations during active weight loss
• Estrogen and GLP-1 synergy — what dermatologists need to know
• Lab work to run before and during GLP-1 therapy
• How to build an insurance case for continued medication coverage

Resources mentioned:

• HOMA-IR fasting insulin/glucose testing
• AAD resources on metabolic dermatology
• Bordone Dermatology — Scottsdale, Arizona

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