Cutaneous Adverse Events With Semaglutide: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Authors

Samyak Ganjre, Liza Borah, Archit Khardenavis

Published in

Cureus. Volume 18. Issue 9. Pages e117270. Epub Sep 30, 2026.

Abstract

Semaglutide is widely used for metabolic disease, but cutaneous adverse events are inconsistently reported. This systematic review and meta-analysis evaluated randomized comparisons of semaglutide with placebo, usual care, or non-semaglutide active treatment. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD420261464289). PubMed, Europe PubMed Central, trial registers, sponsor reports, and regulatory sources were examined through September 9, 2026; source verification was completed on September 21, 2026. Meta-analysis required directly available, source-verified participant event counts and denominators in both groups. Reported alopecia or hair loss and source-defined participant-level injection-site reactions were analyzed separately using common-effect Mantel-Haenszel odds ratios (ORs) without continuity correction. Risk of bias and evidence certainty were assessed for the primary syntheses. Thirty-one trials contributed verified outcome data. Twenty trials formed the primary placebo/common-control evidence set, of which 19 contributed relative-effect estimates and one reported zero injection-site reactions in both groups. Eleven additional trials provided active-comparator or design-specific evidence. Across nine comparisons, alopecia or hair loss was reported in 191/11,564 semaglutide recipients and 36/9,799 comparators (OR: 2.92, 95% confidence interval (CI): 1.99-4.27; p < 0.001; low-certainty evidence). The association persisted after exclusion of the largest cardiovascular outcomes trial with restricted ascertainment; random-effects analyses supported the primary interpretations. Eleven informative comparisons reported injection-site reactions in 156/5,066 semaglutide recipients and 114/3,483 comparators (OR: 0.86, 95% CI: 0.67-1.11; p = 0.256; very-low-certainty evidence). Active comparators and design-specific results were described separately. Semaglutide may increase reports of alopecia or hair loss; its comparative effect on injection-site reactions remains uncertain. Available-count synthesis does not resolve selective non-reporting or incomplete event ascertainment. The findings do not establish a hair-loss mechanism or injection-site safety equivalence.

PMID:
42966951
Bibliographic data and abstract were imported from PubMed on 01 Nov 2026.

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