Melanotan-induced priapism: a hard-earned tan

BMJ Case Rep. 2019 Feb 21;12(2):e227644. doi: 10.1136/bcr-2018-227644.


Melanocortin analogues, such as melanotan, are illegally used for artificial tanning. They have also been suggested as possible therapeutic agents in the treatment of erectile dysfunction. This case study presents a patient attending the accident and emergency department, in a tertiary urology centre, with acute priapism after abdominal subcutaneous injection of melanotan. The priapism was diagnosed as 'low-flow' and managed with cavernosal aspiration, irrigation and subsequent intracavernosal injection of phenylephrine. The patient avoided requiring surgical shunting but had not yet recovered erectile function at 4-week follow-up. Acute priapism is an unreported side effect of melanocortin analogue use and this case report presents a patient managed without surgical intervention. Future therapeutic application of these agents will need to take this potential life altering complication into consideration.

Keywords: skin; urology.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Humans
  • Male
  • Melanocortins / adverse effects*
  • Melanocortins / pharmacology
  • Penis / drug effects*
  • Penis / physiopathology
  • Peptides, Cyclic / adverse effects*
  • Peptides, Cyclic / pharmacology
  • Photosensitizing Agents / adverse effects*
  • Photosensitizing Agents / pharmacology
  • Priapism / chemically induced*
  • Recovery of Function / drug effects*
  • Recovery of Function / physiology
  • Suntan
  • Time Factors
  • alpha-MSH / adverse effects
  • alpha-MSH / analogs & derivatives*
  • alpha-MSH / pharmacology


  • Melanocortins
  • Peptides, Cyclic
  • Photosensitizing Agents
  • melanotan-II
  • alpha-MSH