Wegovy Hair and Skin Changes: What the Clinical Evidence Actually Shows

What the label reports about hair loss

Wegovy's weight-management safety data come from three randomized, double-blind, placebo-controlled trials: 2,116 adults took semaglutide 2.4 mg weekly for up to 68 weeks and 1,261 took placebo. Hair loss was reported by 3% of the semaglutide group and 1% of the placebo group [1]. In the same table, dysesthesia appears at 2% versus 1% [1]. The pooled population averaged 48 years of age and was 71% female [1].

At the higher 7.2 mg dose the signal is stronger. Two 72-week trials enrolled 1,311 adults on 7.2 mg, 304 on 2.4 mg and 303 on placebo. Hair loss was reported by 6% on 7.2 mg, 3% on 2.4 mg and 1% on placebo, and 8.4% of women on 7.2 mg reported it versus 0.2% of men [1].

The daily tablet follows the same pattern. In the 64-week trial of Wegovy 25 mg tablets (204 adults with obesity or overweight, no diabetes), the label says reaction types and frequencies were similar to the injection table, with dysesthesia reported by 5% versus 0% on placebo [1].

Alopecia also appears among postmarketing reports for Ozempic; because these reports are voluntary, its frequency cannot be estimated [2].

Altered skin sensation: the skin effect that tracks with dose

The label reports dysesthesia more often at higher doses: 22% with 7.2 mg, 6% with 2.4 mg and 0% with placebo [1]. A footnote to the adverse reaction table defines it broadly: paresthesia, hyperesthesia, burning sensation, allodynia, skin burning sensation, pain of skin and sensitive skin [1]. The label states that the rate rises with dose, and that 18% of affected patients on 7.2 mg had not recovered by the end of the trial [1].

Injection-site and allergic reactions

Injection-site reactions were reported by 1.4% of adults on 2.4 mg versus 1% on placebo. Allergic reactions were reported by 16% of patients who developed anti-semaglutide antibodies versus 7% of those who did not [1].

Anaphylaxis and angioedema have been reported with Wegovy, and a prior serious hypersensitivity reaction to semaglutide or to an excipient is a contraindication [1].

Weight loss in the trials

Wegovy binds and activates GLP-1 receptors, including receptors in brain areas that regulate appetite and calorie intake, and it delays gastric emptying [1]. The weight loss it produces is substantial: in STEP 1, 1,961 adults without diabetes lost a mean 14.9% of body weight on 2.4 mg versus 2.4% on placebo over 68 weeks [3]. STEP 5 followed 304 adults for 104 weeks, with a mean change of -15.2% versus -2.6% [4]. In STEP UP, the mean change was -18.7% at 72 weeks on 7.2 mg [7].

Skin laxity and facial volume loss

Facial volume loss and skin laxity do not appear among the reactions in the label's adverse reaction table for Wegovy 2.4 mg [1].