Originally published on LA Times by Sara Kitnick on July 22, 2026. Dr. Ghiyam was featured as an expert contributor.
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If you’ve been scrolling through wellness content lately, you’ve probably seen Melanotan promoted as an easy injectable solution for a tan without sun exposure. But what most TikTok videos conveniently skip over is a critical detail: the compound never received FDA approval. And buried in the early research data was something unexpected that would ultimately transform into an FDA-approved women’s health medication.
On a recent episode of the “Live + Well” podcast, Beverly Hills physician Dr. Daniel Ghiyam breaks down the fascinating science behind Melanotan, why regulators shut it down, and how researchers repurposed one of its side effects into Vyleesi, a prescription treatment for female sexual desire disorder.
Understanding How Tanning Actually Works
Tanning isn’t cosmetic—it’s your body’s defense response. When UV radiation hits your skin at levels your body perceives as dangerous, it activates the melanocortin system, a signaling pathway that tells melanocytes (pigment-producing cells) to increase melanin production. The resulting darker skin absorbs and deflects harmful UV radiation before it penetrates deeper tissue.
Melanotan was engineered to trigger that exact same pathway without any sun exposure. “Think about when the sun hits your skin,” explains Dr. Daniel Ghiyam, who specializes in anti-aging medicine and peptide therapy at Med Pod LA. “Your brain says, ‘this is dangerous for us,’ so it releases a peptide to tan it, to protect itself. Melanotan was developed to mimic that same natural peptide, triggering the body’s tanning response without requiring UV exposure.”
The concept made scientific sense, and the compound advanced into human trials. Participants did develop darker skin. But then researchers noticed something troubling.
Why Regulators Rejected Melanotan
The clinical trials revealed a consistent pattern of serious side effects. Severe nausea and headaches were common. Some participants experienced uncontrolled darkening of existing moles and abnormal pigmentation changes. These findings raised red flags about skin cancer risk that regulators couldn’t ignore, ultimately blocking the drug’s path to FDA approval.
But researchers didn’t abandon the data. They kept digging.
From Failed Tanning Drug to Female Sexual Health Treatment
Something unexpected was showing up across trial participants—a marked, reproducible increase in sexual arousal. This finding wasn’t part of the original study design, but it was consistent enough to warrant investigation.
Scientists traced the pathway responsible and made a crucial discovery: it was completely separate from the tanning mechanism. The sexual arousal effect was rooted in melanocortin receptor activity in the hypothalamus (the brain region that regulates motivation and desire), not in the skin. Researchers then developed a new compound that targeted only this brain pathway, removing the pigmentation mechanism entirely.
“A different peptide, PT-141, got FDA approval under the brand name Vyleesi,” Ghiyam explains. “They took that one, and it received FDA approval for premenopausal women with sexual desire disorder.”
In 2019, Vyleesi became one of only two FDA-approved therapies specifically designed for hypoactive sexual desire disorder (HSDD), a condition affecting approximately 10% of women in the United States. HSDD is characterized by persistently low sexual interest that causes personal distress and isn’t simply attributed to aging, relationship issues, or other health conditions.
How Vyleesi Works
Vyleesi is self-administered as a subcutaneous injection taken 30 to 60 minutes before anticipated sexual activity. Because it works on the brain rather than reproductive tissue, it leaves hormone levels untouched—a significant advantage over some alternative treatments.
Some users still experience mild nausea, a faint remnant of its Melanotan origins, but the pigmentation risks have been engineered out. The 2019 approval marked one of the first times the FDA had formally addressed female sexual desire as a legitimate clinical target.
The Dangers of Gray-Market Melanotan
Despite Melanotan’s rejection, unregulated vials continue to circulate on gray-market websites and social media platforms. “A lot of people just Google this stuff, order it from websites they don’t know anything about, and then inject themselves,” Ghiyam warns. The quality is completely unknown.
“I know somebody who tests these batches,” he notes, “and he says one out of ten isn’t right. It’s not even close to what it’s supposed to be.” Many sellers operate without verifiable physical locations. “If you go look at the address on Google Earth, no such building exists,” Ghiyam explains. “Some even require cryptocurrency payment.” Vials often carry disclaimers stating they’re “for research use only,” a legal workaround to skirt regulations.
There’s another layer of risk: peptides are fragile compounds. Heat, sunlight, and improper shipping can degrade them, meaning what arrives at your door may bear no resemblance to the original formulation or label claims.
Why Those Safety Concerns Still Matter
The regulatory concerns that blocked Melanotan’s approval haven’t disappeared just because it’s being sold online. Researchers were particularly worried about uncontrolled mole darkening and other pigmentation changes—issues that contributed directly to the FDA’s rejection.
“Melanotan could have a future if there were more rigorous studies,” Ghiyam says. “But for now, people buying it online are essentially using a compound that researchers deliberately left behind.”
The takeaway is clear: Vyleesi represents the legitimate path forward for treating female sexual desire disorder. The gray-market Melanotan trend, by contrast, carries all the risks that led to its original rejection, with added concerns about product quality and safety that come with unregulated online sales.