1. Introduction

Melanotan II is an unlicensed synthetic peptide analog that falls within the melanocortin family of hormones. It is a cyclic lactam derivative (Ac-Nle-α-MSH-NH2) designed to mimic the effects of α-melanocyte-stimulating hormone (α-MSH). By activating the MC1-R receptors on melanocytes, it promotes the production of eumelanin, leading to a tanned appearance without exposure to sunlight [1,2,3]. Melanotan II is accessible in both injectable and nasal spray forms. Although it remains unregulated and illegal in Bulgaria, as well as in numerous other countries, its use has increased significantly in recent years. This rise in popularity is largely fueled by social media content showcasing its ability to produce quicker and more intense tanning effects [4]. Several studies in the literature have explored the potential association between Melanotan use and the development of cutaneous melanoma [3,5,6]. However, conclusive evidence confirming a direct causal relationship remains lacking. In addition to its effects on the skin, Melanotan II has also been associated with intraoral pigmentation. A recent report described a case of intraoral melanoma potentially linked to the use of a nasal spray containing Melanotan II [7].

The primary objective of the present clinical case is to monitor and document intraoral mucosal changes before, during, and up to three months after the administration of Melanotan II. To the best of the authors’ knowledge, this is the first documented follow-up case assessing oral mucosal reactions to this peptide. An additional aim of this report is to raise awareness among dental professionals, who may be the first to observe such mucosal changes and are therefore in a unique position to inform patients about the potential risks associated with Melanotan II use.