Melanocortin
Afamelanotide
An approved melanocortin implant for a rare light-sensitivity disease — not a tanning drug, whatever the internet says.
Also known as: Scenesse, Nle4-D-Phe7-alpha-MSH
Evidence passport
Last reviewed 2026-08-23
- Evidence level
- L5Practice-changing
- Confidence
- High confidence
- Human efficacy
- 78/100
- Human safety
- 75/100
- Regulatory status
- Approved — narrow indication
- Development
- Approved
- Routes
- Implant
- Evidence base
- Includes human data
- Furthest stage
- Approved
- Source curation
- Sources fully curated
- Clinical maturity
- Approved orphan medicine with completed pivotal trials
Overview
Clinical maturity: Approved orphan medicine with completed pivotal trials
Routes & formulations
Studied / approved routes
The approved product is a subcutaneous implant administered by healthcare professionals in a certified setting. It is categorically not the same product or evidence base as research-market 'melanotan' injections.
Route availability is not evidence of efficacy, and evidence from one route does not transfer to another. The Registry never provides dosing or sourcing information.
Peptide lifecycle
Discovery
Preclinical
Phase I
Phase II
Phase III
Approved
What it is
A synthetic alpha-MSH analogue that stimulates melanin production, developed to give people with EPP more tolerance to light.
What people claim
- Increases pain-free light exposure in EPP
- Confused online with unapproved 'melanotan' tanning products
What the evidence actually says
Randomised controlled trials supported its approval for EPP — a genuine rare-disease success. The approval does not extend to cosmetic tanning, and the registry treats conflation with unapproved Melanotan products as a misinformation pattern, not a grey area.
Human evidence
- Randomised controlled trials in adults with erythropoietic protoporphyria measuring pain-free light exposure.
Preclinical evidence
- MC1R pharmacology and pigmentation biology.
Animal and cell findings are Level 1–2 evidence.
Mechanism and pathways
- MC1R agonism on melanocytes increases eumelanin production, raising light tolerance.
Safety and unknowns
- Labelled effects include implant-site reactions, nausea and headache.
- Administration is restricted to clinical settings under the approved programme.
Cancer relevance
Monitored in trials; not demonstrated in humans
Regulatory status
FDA-approved (Scenesse) for increasing pain-free light exposure in adults with erythropoietic protoporphyria (EPP), a rare genetic disorder of severe light sensitivity. Approval is specific to that orphan indication.
Evidence grade
Replicated large randomised trials, pivotal Phase 3 programmes, or a major regulatory decision.
What would change our rating?
- Long-term registry data from the approved EPP population.
References and sources
- Regulatory / labelFDA orphan drug designation record — afamelanotide
- Regulatory / labelFDA NDA review — Scenesse (afamelanotide), 2019
Source hierarchy: regulatory documents and trial registries first, peer-reviewed work next, sponsor material flagged as non-independent. We never use supplier or clinic marketing as evidence, and where a verified source has not yet been curated we say so rather than inventing one.
Evidence change history
No recorded changes yet. Baseline position set on 2026-08-23.