When to Stop

• Melanoma — theoretical risk, unresolved. No documented case reports in MTI users specifically (vs. 4+ for MTII), and the EPP registry's 12-year follow-up has not flagged a signal — but: (a) the EPP population is small and likely fair-skinned with elevated baseline melanoma risk for any reason, (b) cosmetic-injectable use is at higher peak plasma exposure than implant use, (c) mechanistic concern (you're stimulating melanogenesis, so stimulating melanocyte proliferation/activity, which in pre-malignant or DNA-damaged melanocytes is theoretically risk-amplifying) applies regardless. Treat as "lower risk than MTII, not zero, fundamentally unstudied at peptide-community doses."
• Implant site reactions (Scenesse only) — local fibrosis, granuloma at suprailiac implant site. Resolves spontaneously usually.
• Hypersensitivity reactions — rare, both implant and injectable.
• No priapism case reports — meaningful absence given how prominent priapism is in MTII case literature.
• No PRES, no rhabdomyolysis, no renal infarction — case-report literature for MTII does not extend to MTI. Sample size much smaller, but mechanistic plausibility is also lower (MC1R-preferential vs. non-selective).
• Pre-treatment baseline (mandatory if using): full-body skin examination by dermatologist, total-body photography, dermoscopy of any nevus >2 mm or with prior atypia.
• First 4 weeks: assess any GI/flushing tolerance, BP changes (occasional reports), any unusual nevus change.
• 3 months and ongoing every 6 months: full-body re-exam comparing to baseline photos. Any nevus change → biopsy threshold.
• Stop immediately: any painful nevus change, severe headache, or systemic symptoms.
• Same gray-peptide-market quality variability as MTII (Gerstman 2024 substack analysis). Most "research peptide" vendors source from Chinese contract manufacturing, repackage in EU or US "labs," and sell with widely variable purity, sterility, and actual peptide content. Independent third-party COA is rare. Some vials contain <50% labeled peptide; others contain endotoxin contamination.
• No GMP, no cold-chain guarantee, no recall mechanism. Same baseline reality as MTII gray market.
• The Scenesse implant is GMP-manufactured by Clinuvel — vastly higher quality control — but is restricted-distribution and inaccessible for cosmetic use.