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NACS brief supports Reynolds position in the case

International Journal of Emergency Medicine

Rogan and Jacobsen examine user-reported effects: | Effect | Reported Frequency | Mechanism | |---|---|---| | Skin darkening | Universal | Stimulates melanocytes to produce melanin | | Spontaneous erections | Common in men with ED | Stimulates melanocortin receptors (MC4R) in the brain involved in sexual arousal | | Increased libido | Majority of users | Same MC4R pathway | | Hair color change (darkening) | Anecdotal (single case report) | Melanin repigmentation of hair follicles | | Nausea, yawning, flushing | Common at higher doses | Off-target receptor activation | | New or darkened moles | Reported | Potential masking of melanoma | Jacobsen notes a critical physiological nuance: melanin produced via injection may not migrate to the correct location in the skin

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