Melanin Injections Are the Dangerous Way Some People Are Trying to Tan

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A quick Googling of "melanin injections" brings up some interesting stories. At the time of this publication, top headlines include: “My Addiction to Tanning Injections Nearly Cost Me My Life” and “[White] Woman Who ‘Turned Black’ from Melanin Injections Wants to Move to Africa.” Other articles label fans of this controversial treatment “users” of the “drug,” and point to several people who have become “addicted,” undergoing dramatic transformations in skin pigmentation in a matter of months. 

And it's not just tabloid-esque tales that you'll find. You'll also discover sites that sell the tanning treatment, which is illegal worldwide, right on their homepages (even if it's from a site based in another country, it's still against the law for someone in the U.S. to order a non-FDA-approved drug for stateside shipment).

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Where Did Melanin Injections Come From?
Created by faculty at the University of Arizona Cancer Center in the 1980s, synthetic melanotan, also known as the molecule afamelanotide, is not actually melanin at all; it's an artificial peptide (it mimics the naturally-occurring alpha-melanocyte stimulating hormone, or alpha-MSH) that signals our melanocytes (pigment-producing cells) to make more melanin, giving skin a richer, darker color. 

The initial goal of this compound—which included two iterations called melanotan types I and II—was the treatment of skin pigmentation disorders like vitiligo, and of sun-sensitivity disorders like erythropoietic protoporphyria (EPP). Boosting melanin levels was thought to protect against that photosensitivity, since melanin absorbs light and can dissipate UV radiation.

Melanotan-I was licensed to an Australian company in 2000 as a potential EPP treatment (that firm developed it into a drug called Scenesse that's now under FDA review for approval). A New Jersey-based pharmaceutical company bought Melanotan-II for its promise in relieving sexual dysfunction; a variation (swap a hydroxyl group for an amide and you’re there) eventually became Vylessi, which the FDA approved in June 2019 to treat abnormally low sex drive in premenopausal women (that’s right, a relative of melanotan can ignite libido and sexual response).

But even though melanotan is not approved anywhere as a cosmetic tan enhancer, so-called melatotan products for skin darkening—you probably know them collectively as “Barbie drugs” or just melanotan-II—have been sold illegally in salons, gyms, and online for more than a decade, prompting government warnings in the late 2000s.

What Makes Injectable Melanotan Dangerous?
Often, when people buy illicit melanotan, the drug is intended to be self-injected using a provided syringe (which might just be a repurposed insulin needle). The concept of non-prescribed DIY injections should automatically trigger warning bells, since it's pretty unlikely that an untrained Jane has enough knowledge of the human vascular system and anatomy to avoid any injection mishaps (or deal with those that might occur).

In these injection kits, the drug typically comes as a powder, which means that it's on the buyer to reconstitute it by mixing the correct proportions (is it two parts melanotan? Three?) with water (don’t forget to use sterilized H2O to avoid any foreign floaters in the bloodstream!). 

Then, the buyer needs to jab the needle (beware of blood-borne diseases like HIV and hepatitis if you share) into the appropriate depth of skin (subcutaneous to intramuscular is preferred, according to one oddly educational seller’s site), while adhering to a rigid time schedule (a shot a day for five days, just to begin the process) before baking in the sun for a minimum of 20 minutes daily (injections don’t work without the very thing many are trying to avoid—UV exposure) to deliver a tantalizing tan (for a few months, max). 

If the whole injection process isn't enough to scare you off, we’ll just leave the potential drug side effects here: nausea, vomiting, cramps, loss of appetite, fatigue and, just maybe, skin cancer (more on that below).

Another big reason you should run from any non-prescribed injectables? The lack of regulated formulas. As Franklin, TN dermatologist Jill C. Fichtel, MD, says: “These injections are not legal, so you can't be sure that what is supposed to be in them is actually in them - the needle could be filled with poison for all we know!” 

Can Melanotan Trigger Skin Cancer?
Because there's been so little research, we don't know if injecting melanotan could have negative heath impact down the road. “Even if the shot has what it is supposed to have, we have no idea what the long-term effects are,” Dr. Fichtel explains. “You can’t even claim that because the injections are just stimulating your body to do more of something it already does naturally, they are safe. We know that isn't true for other things. If you take shots to stimulate muscle cells (i.e. anabolic steroids), it has lots of other major side effects.” 

And there's one particularly troubling potential risk: skin cancer. “Injections definitely can cause moles to darken and look bad," Dr. Fichtel notes. "I haven’t found any proof that they increase the risk of melanoma, but there aren't any long-term studies and I could totally imagine there being a significant lag between the shots and any increase in melanoma risk.”

In fact, Dr. Fichtel’s husband, dermatologist Matthew Zirwas, MD, is currently studying how moles can darken after starting melanotan injections, which happened to one of his own patients. “I had a patient who noticed all moles get darker after beginning the injections, and on exam, the two moles looked particularly worrisome and dark to me,” he says. “They both were moderately abnormal moles that needed to be completely removed to prevent the risk of turning into severely abnormal moles or even melanoma. I did not do an exam prior to him starting the injections, so it’s hard to tell if they were abnormal prior to that, but it is definitely possible that the melanocyte-stimulating hormone could have led to the abnormal change in his moles.”

Moral of the story: Any cosmetic enhancement or treatment that’s illegal has the potential of being harmful, especially when worrisome effects like mole changes have been noted. Always talk to your doctor before deciding on a procedure, especially those that are done at home.