Skip to main content
Drug Info

Semaglutide injection burning: Causes, prevention, and solutions

A burning sensation after injecting semaglutide is common for some, but it can be managed. Here’s what you need to know.
Taneia Surles, MPH
By | Apr. 2, 2025 Medically reviewed by Madeline Remelius, Pharm.D., BCPS
Injection pen representing semaglutide burning at injection site

Key takeaways

  • A common side effect of semaglutide is injection site reactions, which can cause a burning sensation, itching, redness, and minor bruising or swelling.

  • Injection site reactions may occur if the medication is stored at the incorrect temperature, improper injection technique is used, if alcohol residue from the swab is present, or if the person experiences body sensitivity.

  • To prevent or treat semaglutide injection site reactions, ensure proper injection technique, allow skin to completely dry from an alcohol swab, rotate injection sites, use a cold compress, and take over-the-counter pain relievers and anti-itch medications if needed.

In this article:

Semaglutide, brand names Ozempic, Rybelsus, and Wegovy, is a GLP-1 receptor agonist approved by the U.S. Food and Drug Administration (FDA) to treat type 2 diabetes mellitus and lower the risk of heart attack or stroke in people with type 2 diabetes and cardiovascular disease. Most recently in 2021, Wegovy was approved by the FDA for weight loss management. Semaglutide has many proven health benefits however it is not naive to side effects. According to medical experts, some people who use injectable semaglutide may experience burning and other symptoms at the injection site. Burning at the injection site can be prevented with the proper precautions.

Is burning at semaglutide injection site normal?

Andrew J. Shapiro, MD, a board-certified general surgery specialist and the Medical Director of the Comprehensive Breast Center at Wellington Regional Medical Center in Wellington, Florida, explains that semaglutide injections can cause a burning sensation at the injection site. “Not everyone experiences this side effect, but some people do report a mild to moderate burning or stinging sensation or discomfort after their injection,” he says. 

A research review of clinical trials found that out of 407 patients, 0.2% reported a skin-burning sensation when taking 2.4 milligrams (mg) of semaglutide injections every week.

However, Dr. Shapiro adds that burning at the injection site is a normal side effect of this injectable medicine. “It is usually temporary and goes away after a few minutes,” he says.

Injection site burn is one of many common side effects of semaglutide, which include the following:

  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
  • Eructation (burping or belching) 
  • Abdominal pain
  • Stomach pain
  • Decreased appetite
  • Dyspepsia (indigestion)
  • Abdominal distension 
  • Gastroesophageal reflux disease (GERD)
  • Flatulence (gas)
  • Gastritis (inflammation of the stomach lining)
  • Diabetic retinopathy
  • Hypoglycemia (low blood sugar)
  • Increased amylase
  • Increased lipase

Causes of semaglutide injection site reactions

Below are the leading causes of injection site reactions:

Composition of the medication

According to Dr. Shapiro, the chemical composition of semaglutide could cause an injection site reaction. “Since it is not completely neutral in pH, it can cause irritation,” he says.

Injection technique

How you administer the medication could increase your chances of experiencing burning. “Technique matters immensely when it comes to injection—too deep, too shallow or at the wrong angle, as well as injecting too quickly or moving the needle while it’s in the skin can also cause discomfort,” Dr. Shapiro says.

Temperature of medication

Unused semaglutide must be refrigerated between 36 and 46 degrees Fahrenheit and then can be stored at room temperature after its first use. Improper storage can significantly reduce the drug’s effectiveness and potentially pose a safety risk. The injectable medication could degrade, leading to adverse reactions like burning.

Alcohol residue

Alcohol swabs are used to prepare the skin for a semaglutide injection. However, according to Dr. Shapiro, if the skin is not completely dry, the preservatives in the alcohol swab can cause burning and irritation. Residue from alcohol swabs can also affect the absorption and effectiveness of the medication.

Body sensitivity

Your body could react negatively to the subcutaneous injection. “Some people also have much more sensitive skin than others, so they might experience irritation due to the medication,” Dr. Shapiro says.

Common side effects of semaglutide at injection site

According to John La Puma, MD, a board-certified internist, weight management expert, best-selling author of REFUEL, and founder of The Ozempic Blueprint: A Simple Guide to Boost GLP-1 Naturally of Santa Barbara, California, common side effects of semaglutide at the injection site include the following:

  • Temporary burning
  • Itching
  • Redness 
  • Minor bruising or swelling (if a blood vessel is nicked during injection)

Rare semaglutide injection site reactions

In rare instances, Dr. La Puma says semaglutide injection site reactions can cause the following serious side effects:

  • Blistering hives or skin ulcers
  • Infections (pus, warmth, or fever)
  • Allergic reactions causing widespread rash

“These come about as either hypersensitivity reactions or from direct mast cell activation, leading to the release of histamine and other mediators,” Dr. La Puma explains. [They can also result from] the direct toxicity of semaglutide, resulting in local skin necrosis or lobular panniculitis. Immunomodulation, which is the immune system’s response to the drug, can also result in inflammatory changes at the injection site.”

According to Dr. La Puma, the rarest injection site reactions linked to semaglutide are leukocytoclastic vasculitis and allodynia (skin tenderness). Leukocytoclastic vasculitis, or hypersensitivity vasculitis, is the inflammation of small blood vessels. This condition can lead to skin rashes, fevers, malaise (general feeling of discomfort), weight loss, muscle pain or soreness, and joint pain. Allodynia is a type of nerve pain that causes hypersensitivity to touch and other contact with skin that doesn’t typically cause pain. 

If you’re experiencing severe side effects from injecting semaglutide, please seek immediate medical attention.

How to treat semaglutide injection site reactions

If you notice a reaction from the semaglutide at the injection site, here are some ways you can treat it and how you can prevent it in the future:

Ensure proper injection technique 

Incorrect angle or depth could cause injection site reactions, so make sure you administer the medication properly. Dr. La Puma recommends injecting at a 90-degree angle (perpendicular to your skin). You also want to ensure you’re not going too deep and injecting into your muscles or veins.

Allow skin to dry completely 

To avoid burning and ensure that you’re receiving an adequate dose of semaglutide, ensure your skin is dry after using an alcohol swab before injecting the medicine.

Rotate injection sites

You can reduce your risk of adverse reactions by rotating injection sites with each injection. “If you’re experiencing burning or irritation, try rotating the injection site to prevent irritation, switching between the abdomen, thighs, and upper arms,” Dr. Shapiro says. If you do decide to inject in the same area, always use a different spot in that area.

Use cold compress and topical treatments

If you’ve experienced an injection site reaction, you should contact your healthcare provider. However, if immediate relief is needed, Dr. La Puma recommends applying a cold compress, such as an ice pack, or a topical treatment like hydrocortisone cream to reduce pain, redness, swelling, and itching.

Take over-the-counter medications to relieve pain and itchiness 

If the injection has caused some pain, you can take over-the-counter (OTC) pain relievers, such as acetaminophen (Tylenol) or ibuprofen (Advil and Motrin) for relief. OTC antihistamine medications, such as diphenhydramine (Benadryl), can also help if you’re experiencing a lot of itching from your injection site reaction.