What it is
Melanotan II (MT-II) is a synthetic cyclic alpha-MSH analogue and non-selective melanocortin receptor agonist, originally developed at the University of Arizona in the 1990s as a tanning and libido research compound. It is the parent molecule both Melanotan 1 (afamelanotide, FDA-approved as Scenesse) and PT-141 (bremelanotide, FDA-approved as Vyleesi) were derived from, each by a chemical modification made specifically to reduce a side effect associated with MT-II itself.
MT-II has never been approved for any use, in any country, and has never completed a registered human clinical trial for tanning, libido, appetite or any other indication. One Phase 2 trial (NCT07437560) was recruiting as of this entry, testing MT-II as an adjunct to phototherapy for vitiligo, a use unrelated to why it circulates.
The documented harms
Because MT-II circulates as an unregulated injectable, its adverse effects are documented mainly through case reports rather than trials. A published case report describes acute low-flow priapism after subcutaneous MT-II injection, managed with cavernosal aspiration and phenylephrine, with erectile function not yet recovered at four-week follow-up; the authors describe this as a previously unreported complication.
A separate case report describes a 16-year-old with a family history of atypical mole and melanoma syndrome (FAMMM) who developed darkening of multiple melanocytic nevi and an enlarging nevus after self-injecting Melanotan II and using UV tanning beds, prompting concern for malignant change. MT-II’s mechanism is direct stimulation of melanocyte activity; darkening or changing of existing moles is a mechanistically expected risk, not a coincidental one, and is the reason dermatology bodies have specifically warned against its use.
Nausea, flushing, and spontaneous erections are common and expected at typical doses, consistent with non-selective melanocortin receptor activation; MT-II’s persistent erection effect, more pronounced and longer-lasting than PT-141’s, is exactly what PT-141 was chemically modified to reduce.
What is not known
Any dose, purity or safety standard for MT-II as sold, since it has never been manufactured or studied as a regulated pharmaceutical product.
Long-term melanoma risk from repeated melanocyte stimulation. No long-term surveillance study of MT-II users was located; the concerning findings that exist are individual case reports.