How common are rashes (not at the injection site) from Wegovy and are there any reports of a forearm rash presenting 3 days following the dose and then resolving?

How common are rashes (not at the injection site) from Wegovy and are there any reports of a forearm rash presenting 3 days following the dose and then resolving?

Comment by InpharmD Researcher

Limited anecdotal evidence from published case reports suggests that semaglutide-associated cutaneous reactions may occur but appear to be rare. However, reports describing a brief, isolated rash occurring a few days after semaglutide administration with spontaneous resolution were not identified. One case report described a patient who developed granuloma annulare after semaglutide initiation, with annular plaques involving the abdomen, waist, thighs, wrist, arms, and legs after dose escalation; the patient elected to continue semaglutide therapy and received treatment for granuloma annulare (see Table 1). Other reports have described semaglutide-associated hypersensitivity reactions and drug eruptions that improved after discontinuation of therapy. Of note, these cases either did not specify the semaglutide product or involved Ozempic rather than Wegovy.

Relevant Prescribing Information

Adverse Reactions [1]
Adverse Reactions (≥3% and Greater than Placebo) in WEGOVY 2.4 mg Injection-treated Pediatric Patients Aged 12 Years and Older with Obesity for Weight Reduction
Rash: Placebo 0% vs. Wegovy 3%

Postmarketing Experience [1]
Hypersensitivity: anaphylaxis, angioedema, rash, urticaria

Literature Review

A search of the published medical literature revealed 3 studies investigating the researchable question:

How common are rashes (not at the injection site) from Wegovy and are there any reports of a forearm rash presenting 3 days following the dose and then resolving?

Level of evidence

D - Case reports or unreliable data Read more→

Please see Tables 1-3 for your response.

Granuloma annulare after starting semaglutide
Design	Case report
Case presentation	A 73-year-old woman with a medical history of type 2 diabetes mellitus, obesity, hyperlipidemia, lichen planus, and atopic dermatitis developed a new cutaneous eruption after initiating semaglutide therapy. She was started on semaglutide 0.25 mg weekly and titrated to 1 mg weekly per the manufacturer-recommended dose escalation schedule. Approximately 2 weeks after increasing to the 1 mg weekly dose, she developed an asymptomatic rash and was evaluated by her primary care provider. Physical examination revealed numerous small, erythematous, annular plaques involving the hips, lower abdomen, medial thighs, and left wrist. The eruption initially developed around the waist near the area of semaglutide injections, raising concern for a possible medication-related reaction. The patient was treated with a 16-day prednisone taper, which resulted in partial improvement; however, the rash did not completely resolve. Despite the persistent eruption, the patient wished to continue semaglutide therapy, and the dose was further increased to 2 mg weekly. After approximately 2 months on the higher dose, the rash progressed, with new involvement of the arms and legs, prompting referral to dermatology. Dermatologic evaluation revealed annular, erythematous patches and plaques involving the groin, abdomen, arms, and legs. The patient denied associated symptoms, including pain or pruritus, and reported no prior history of a similar eruption. A punch biopsy obtained from the right medial leg demonstrated a palisading infiltrate of histiocytes and lymphocytes within the dermis surrounding areas of altered collagen fibers and increased mucin deposition. Based on the clinical presentation, temporal relationship with semaglutide initiation and dose escalation, and histopathologic findings, the patient was diagnosed with granuloma annulare associated with semaglutide therapy. The patient elected to continue semaglutide treatment and was started on tirzepatide for management of granuloma annulare.
Study Author Conclusions	That we know of, we are the first to report a case of disseminated granuloma annulare in response to semaglutide therapy. Physicians should be cognizant of new cutaneous reactions developing after starting semaglutide and continue to report these cases to better understand the risks of the medication and what treatments are effective.

Table 1 References:
[2] Jones T, Myers B, Konia T, Tartar DM, Rick J. Granuloma annulare after starting semaglutide. JAAD Case Rep. 2025;62:9-11. Published 2025 May 30. doi:10.1016/j.jdcr.2025.05.005

Dermal Hypersensitivity Reaction to Semaglutide: Two Case Reports
Design	Case reports; abstract only
Case presentation 1	A 75-year-old woman receiving semaglutide for 10 months developed a 3-month history of a rash involving the legs, back, and chest. Skin biopsy revealed a subepidermal blister with eosinophilic infiltration, consistent with a drug-related hypersensitivity reaction.
Case presentation 2	A 74-year-old White man receiving semaglutide for 1 month developed a 3-week history of an eruption involving the bilateral flanks and lower abdomen. Skin biopsy demonstrated a perivascular inflammatory infiltrate with eosinophils, consistent with a drug-related hypersensitivity reaction.
Study Author Conclusions	Cases of hypersensitivity reactions have been previously reported in patients taking GLP-1 receptor agonists dulaglutide and liraglutide. However, to our knowledge, there have been no reports of hypersensitivity reactions to semaglutide. Here, we present two cases of dermal hypersensitivity reactions in patients taking semaglutide for type II diabetes. Both patients began experiencing resolution of their symptoms within 1 month of discontinuing semaglutide.

Table 2 References:
[3] Ouellette S, Frias G, Shah R, Alamgir M, Wassef C. Dermal Hypersensitivity Reaction to Semaglutide: Two Case Reports. J Drugs Dermatol. 2023;22(4):413-416. doi:10.36849/JDD.6550

Semaglutide-Induced Atypical Pustular Drug Eruption: A Case Report
Design	Case report
Case presentation	A 43-year-old woman with type 2 diabetes mellitus, hypertension, hyperlipidemia, and recurrent genital herpes developed a diffuse, pruritic, burning rash after a recent dose increase of semaglutide (Ozempic®) from 0.5 mg to 1 mg approximately 30 days prior. She initially presented with a rash on her right arm and torso that progressed to involve the flexures, chest, trunk, and legs, with vesiculopustular lesions on the face and postauricular areas. Infectious evaluation, including cultures and herpes simplex virus PCR, was negative. Skin biopsies demonstrated intraepidermal and subcorneal neutrophils with spongiosis and dermal perivascular infiltrates containing eosinophils, consistent with an atypical acute generalized exanthematous pustulosis (AGEP)-like drug eruption. Semaglutide (Ozempic®) was discontinued, and treatment with topical corticosteroids, tacrolimus, and antihistamines resulted in resolution of the eruption within one month. An excipient comparison identified propylene glycol in semaglutide (Ozempic®) but not her previously tolerated insulin aspart, supporting semaglutide as the likely trigger. The patient was advised to avoid future semaglutide (Ozempic®) use due to recurrence risk, and tirzepatide was recommended as an alternative.
Study Author Conclusions	As semaglutide and similar agents become more widely used, clinicians must remain vigilant for cutaneous side effects. Our case emphasizes that these pharmaceuticals are capable of producing reactions that are quite rare, and providers should continue to report them in the literature as they occur. This practice will assist in the continuous development of evidence-based guidelines for prescribing these medications. Additionally, our case underscores the importance of collaboration with pharmacists as a part of the multidisciplinary care team. Eliciting their expertise led to the prompt identification of the likely causative agent of our patient's reaction and the introduction of a safer alternative. In conclusion, early recognition, clinicopathologic correlation, and attention to both active ingredients and excipients are essential for diagnosis and safe patient care.

Table 3 References:
[4] Elliott DC, Veon FL, McBride JD, Levin J. Semaglutide-Induced Atypical Pustular Drug Eruption: A Case Report. Cureus. 2026;18(1):e101016. Published 2026 Jan 7. doi:10.7759/cureus.101016