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Skin reactions are reported less often than for the comparison drug

A safety analysis where these drugs come out ahead — against a comparator with a recognized blistering side effect of its own.

Neil Sanders6 min read
Skin reactions reported, vs DPP-4 drugsequal reporting0.27Fewer, not more — against a comparator with its own skin problems.Up to 8.16% of reports mentioned a skin reaction.Of reports. Not of patients.

Most safety analyses this desk covers find a signal. This one finds the reverse, and reporting it is the same discipline as reporting the others [1]. The hair and sexual-function questions from the same literature are in four questions about contraception, one answered.

Against DPP-4 inhibitors, skin reactions were reported proportionally less often for GLP-1 drugs, at a proportional reporting ratio of 0.27 (95% CI 0.257–0.284). Within the class the pattern varied: semaglutide had the highest raw rate, dulaglutide the lowest, and exenatide showed five times the odds of dulaglutide in the regression.

The 8.16% figure needs its unit stated or it misleads badly. That is a share of adverse event reports, not of patients: eight in a hundred reports mentioning a GLP-1 drug included a skin reaction. Since only a small fraction of people taking any medicine ever generate a report, the proportion of users experiencing a skin reaction is not calculable from this and is certainly far lower — the same denominator problem as in the erectile dysfunction signal.

The exenatide result also needs its reference point. An odds ratio of 5.01 sounds alarming and is measured against dulaglutide, not against taking nothing — a within-class ranking rather than a risk estimate. Exenatide is also an older drug with far fewer current users and an entirely different reporting history, which makes cross-drug comparisons in a spontaneous database unreliable in ways the confidence interval does not capture.

For someone choosing a product the practical content is modest and real: skin reactions happen, they are not the dominant adverse effect of this class, and if one occurs it is worth raising because it may affect whether treatment continues. The authors make that last point themselves, noting these reactions might influence adherence — which is the thread running through two thirds stop within a year and what patients said when asked.

Frequently asked

How common are skin reactions on these drugs?
Unknown from this data. Skin reactions appeared in up to 8.16% of adverse event reports, which is a share of reports rather than of patients, and reporting databases have no denominator of users.
Are they more common than with other diabetes drugs?
Less common, on this analysis — a proportional reporting ratio of 0.27 against DPP-4 inhibitors. That comparator has its own recognized blistering skin condition, which makes it a lower bar.
Does the drug matter?
Within the class it varied. Exenatide showed five times the odds of dulaglutide, while liraglutide and semaglutide showed lower odds — though these are within-class rankings, not risks against no treatment.

Sources

  1. [1] Fat MN, Johnson HC, Farberg AS (2026). Cutaneous Adverse Events Associated With GLP-1 Receptor Agonists: A FAERS Database Analysis From 2018-2024 Journal of Drugs in Dermatology. PMID 41493256

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