Cutaneous Adverse Events Associated with Semaglutide, Liraglutide and Tirzepatide: A Systematic Review
- Design
- Systematic review · Mixed outcome
- Match to healthy normal-weight adults aged 55–75
- Population unclearUNKNOWN: a review whose included populations are not described beyond the drugs' use for weight management and diabetes.
- Could weight loss explain it?
- PossiblyPossibly by the no-data default (IN-062): the abstract reports no weight or HbA1c data; for injection-site and immune-mediated skin reactions weight mediation seems implausible, and dysesthesia occurred mainly during dose escalation.
- Study tier
- Not ratedNOT_RATED: a systematic review of one hundred and one studies (trials, cohorts, pharmacovigilance and case reports) with no pooled estimate.
- Assessment
- Version 3 · Two reviewers differed; settled by a recorded ruling · Nov 7, 2026
Study facts come from the paper. Population match, weight-loss explanation and study tier are our judgments, made against the reference group of healthy normal-weight adults aged 55–75.
This systematic review collected one hundred and one studies, from randomized trials to case reports, describing skin side effects of semaglutide, liraglutide and tirzepatide. Injection-site reactions were most often reported with tirzepatide (2-7%), and a burning or tingling skin sensation (dysesthesia) with semaglutide, in about 5% at standard doses and up to 20% at high-dose formulations. Rare but serious reactions were also reported; most skin effects were mild, and no pooled estimate or comparison with untreated people was made.
01Findings
What the study reported
- Drugs
- Semaglutide, Liraglutide, Tirzepatide
- Comparator
- not reported in abstract
- Primary outcome
- spectrum, frequency and clinical characteristics of cutaneous adverse events
- Effect
- No pooled estimate: injection-site reactions most frequent with tirzepatide (2-7%); dysesthesia approximately 5% with semaglutide at standard doses and up to 20% with high-dose formulations
- 95% confidence interval
- Not extracted
- Follow-up
- Not stated
- Adverse events
- Injection-site reactions most frequent with tirzepatide (2-7%), then liraglutide, less with semaglutide; dysesthesia approximately 5% with semaglutide at standard doses, up to 20% at high doses; rare angioedema, hypersensitivity, blistering disease, vasculitis and severe cutaneous reactions.
- Limitations
- A narrative systematic review with no pooled estimate, mixing trials with pharmacovigilance and case reports, so frequencies are not comparable across sources.
Who was studied
- Baseline condition
- not reported in abstract
- Inclusion exclusion
- clinical trials, observational, pharmacovigilance studies and case reports reporting skin-related AEs with semaglutide, liraglutide or tirzepatide
Study quality details
- Study design
- Systematic review
- Sample size
- not extracted
- Randomization
- n/a
- Blinding
- n/a
- Comparator
- not reported in abstract
- Follow up duration
- not stated
- Outcome type
- mixed
- Replication
- not assessed
- Consistency with other evidence
- not assessed
- Population applicability
- UNKNOWN
- Statistical precision
- no CI reported; narrative synthesis of one hundred and one studies
- Risk of bias
- not assessed
- Peer review status
- yes
02Funding
Funding and conflicts
- Funding
- not reported in abstract
- Industry funded
- Unclear
- Manufacturer
- not stated in source
- Sponsor role
- The sponsors had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.
- Author conflicts
- Three authors declare no conflicts; two report grants, honoraria, advisory or consulting relationships with many companies, including Eli Lilly, Sanofi, Novartis, Pfizer and AbbVie.
- Independent replication
- unknown
- Notes
- Authors declare relationships with the drug's manufacturer: Eli Lilly
Funding is shown on every study and never used to score it.
04Source
The source, as retrieved
Abstract
[BACKGROUND/OBJECTIVES] Incretin-based therapies, including glucagon like peptide-1 receptor agonists (GLP-1 RAs) and glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 RAs, are increasingly prescribed for obesity, leading to greater recognition of associated dermatological adverse events (AEs). We aimed to characterize the spectrum, frequency, and clinical characteristics of cutaneous AEs reported with semaglutide, liraglutide and tirzepatide, focusing on these agents because of their established use in both weight management and diabetes mellitus. [METHODS] A systematic literature search was conducted in MEDLINE (via PubMed), Embase, and Web of Science. Search terms combined skin-related manifestations (e.g., skin, dermatologic, injection-site reactions, pruritus, rash, hypersensitivity, dysesthesia, vasculitis) with GLP-1 RA and GIP/GLP-1 RAs (semaglutide, tirzepatide, liraglutide). Clinical trials, observational studies, pharmacovigilance studies, and case reports reporting skin-related AEs associated with semaglutide, liraglutide and tirzepatide were included. [RESULTS] One hundred and one studies were included (32 randomized controlled trials, 6 retrospective cohort/cross-sectional studies, 20 pharmacovigilance studies, and 43 case series/reports). Cutaneous AEs ranged from generally common but mild reactions to rare but potentially severe immune-mediated disorders. Injection-site reactions, including erythema, pruritus, and hemorrhage, were reported most frequently with tirzepatide (2-7%), then liraglutide, and less commonly with semaglutide, with evidence of dose dependence. Dysesthesia was most strongly associated with semaglutide, occurring in approximately 5% of patients at standard doses and up to 20% with high-dose formulations indicated for weight management, with events frequently occurring during dose escalation. Uncommon reactions reported in association with GLP-1 or GIP/GLP-1 RA use included angioedema, hypersensitivity reactions, autoimmune blistering diseases, drug eruptions, vasculitis, and severe cutaneous reactions. [CONCLUSIONS] Although most cutaneous AEs associated with GLP-1 and GIP/GLP-1 RAs are mild and manageable, clinically relevant drug-specific differences exist. The recognition of common and uncommon skin manifestations may facilitate earlier diagnosis, support treatment adherence, and reduce the adverse outcomes.
Where this record came from
| Source | Retrieved | Identifier |
|---|---|---|
| pubmed | Nov 1, 2026 | 42930571 first ingestion |
| pubmed | Nov 1, 2026 | 42930571 duplicate matched on doi |
| owner-review | Nov 6, 2026 | reviewed_by set to Carrie Schluter (2026-11-05) on the owner's own confirmation. The assessment is unchanged and still the auto-classifier's, so its extracted values stay withheld under the 2026-10-18 decision. |
| reextract | Nov 6, 2026 | manufacturer: 'Eli Lilly, Lilly, Sanofi, Boehringer Ingelheim, Amgen, Pfizer' -> None. Q-043: manufacturer and drug_details.dose re-extracted by auto-classifier-v1.2. manufacturer no longer reads companies named only in the authors' conflicts statement (IN-062) and refuses a multi-company roster; dose is tied to the GLP-1 agent by name, never reads a concentration, and records a multi-dose design whole. Every other value is carried forward unchanged. Owner decision IN-064 option 1, 2026-11-06. |
| pubmed | Nov 8, 2026 | 42930571 duplicate matched on doi |
| pubmed | Nov 8, 2026 | 42930571 duplicate matched on doi |