The 'Barbie drug' is back in the spotlight—along with its life-threatening health risks
Industry Buzz
The safety and effectiveness of [this drug] as a skin tanning agent have not been extensively studied in healthy individuals, and it should not be used for cosmetic purposes. [It's] an illicit drug that has no proven medical benefits in humans and is associated with significant risks.
—Kelly Johnson-Arbor, MD, FACEP, FUHM, FACMT
The so-called "Barbie drug" (aka melanotan, named for its purported ability to give users tan, glowing skin) continues to attract attention from health authorities because of ongoing concerns about safety, quality, and adverse effects.[]
These risks are extending beyond skin cancer—with patients reporting nausea, vomiting, and high blood pressure, in addition to new changes in mole size and shape. The Skin Cancer Foundation published guidance on these drugs back in 2022, noting they are dangerous and shouldn’t be used to tan the skin.[][]
With so many Americans tanning outdoors intentionally (and millions going to tanning salons—increasing melanoma risk by 75% after just one session before age 35), it’s no surprise people are looking for an easy, quick-fix tanning drug—especially among people seeking a faster alternative to traditional tanning methods.
What is melanotan?
There are two types of melanotan—melanotan 1 and melanotan 2—synthetic peptide analogs of alpha-melanocyte-stimulating hormone, a naturally occurring hormone involved in skin pigmentation.
“Melanotan 2 is a shorter cyclic variant of melanotan 1 that was developed in the 1990s,” according to researchers writing in Dermatology Practical & Conceptual.[] “Melanotan 2 was found to increase skin pigmentation at lower cumulative doses than melanotan 1."
Because of these effects (which also include weight reduction due to suppressed appetite and prolonged penile erections), melanotan 2 became known as the ‘Barbie drug.’
In 2019, the FDA approved melanotan 1 (marketed as Scenesse), for adults with a history of phototoxic reactions from erythropoietic protoporphyria (EPP), a rare disorder characterized by painful reactions to sunlight. The drug works by increasing “pain-free light exposure,” says the FDA.[]
EPP is a type of porphyria. Porphyrias are rare disorders affecting the skin or nervous system that lead to an accumulation of protoporphyrins in a patient’s red blood cells.
Normally, protoporphyrins change into heme, but this fails to occur in patients with porphyria. This failure leads to photosensitivity and can lead to other conditions, like liver disease.[][]
Melanotan 2 is not approved for tanning nor regulated by the FDA. “Melanotan 2 is an illicit drug,” says Kelly Johnson-Arbor, MD, FACEP, FUHM, FACMT, medical toxicologist, co-medical director, and interim executive director at the National Capital Poison Center. “Melanotan 2 is often marketed online as a tanning agent, but it also carries side effects, including painful and prolonged erections.”[]
Today, people are buying the drug online—and searching for “melanotan 1,” “melanotan 2,” “afemelanotide,” “tanning peptides,” “tanning injections,” “Barbie drug,” and “tanning jab” in order to find it.
Social media platforms have helped popularize tanning nasal sprays and injectable products that claim to be made from melanotan 1 or melanotan 2. The FDA has tried to crack down on illegal sales of these types of drugs, but the issue continues.[][]
Healthcare professionals have raised broader concerns about the growing online market for unregulated peptides. Unlike FDA-approved medications, products sold through some websites, social media channels, and wellness marketplaces may not undergo rigorous testing for purity, potency, sterility, or manufacturing quality.[] As a result, patients may be exposed to contaminants, inaccurate dosing, or ingredients that differ from what is on the label.[]
For example, in Australia, people peddling the drugs—claiming they can offer a tan without the risk of melanoma—are finding loopholes around legislation banning advertising of melanotan 2.
Related: Everything doctors need to know about the ‘peptide Wild West’The risk of tanning peptides
According to Journal Of Case Reports: Clinical & Medical, “Numerous case reports of melanoma, eruptive nevi, and atypical nevi appearing after initiation of melanotropic peptides therapy have been reported."[]
“Melanotan 2 is associated with significant concerning side effects,” Dr. Johnson-Arbor says. “These include painful erections, drowsiness, and compulsive yawning. Melanotan 1 (afamelanotide) is not associated with sexual side effects, but people who use the medication may experience nausea, vomiting, headaches, and facial flushing in addition to increased skin pigmentation.”
Additionally, melanotan is reported to cause cancer, brain swelling, and even rhabdomyolysis.[]
Patients may not volunteer information about melanotan use, particularly if the products were purchased online or recommended through social media. Clinicians evaluating unexplained hyperpigmentation, changing nevi, gastrointestinal symptoms, or adverse reactions associated with injectable or intranasal products may consider asking specifically about tanning peptides and other non-prescription peptide products.
In the end, Dr. Johnson-Arbor urges healthcare providers to warn their patients about the Barbie drug.
“The safety and effectiveness of melanotan 1 as a skin tanning agent have not been extensively studied in healthy individuals, and it should not be used for cosmetic purposes,” she says. “And while melanotan 1 may be useful for people with certain medical conditions, it should only be used as prescribed."