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It can be categorised as primary or secondary: Primary carnitine deficiency: Caused by a genetic defect that impairs the bodys ability to produce, retain, or use carnitine normally

Its illegal to advertise melanotan to the public or supply it without a prescription

Pieter Cohen, an associate professor of medicine at Harvard Medical School who studies dietary supplements

[PubMed: 22085343] 733

Patients with oral malignant melanoma often recall having an existing oral pigmentation months to years before diagnosis, and the condition may even have elicited prior comment from physicians or dentists

For those with an exogenous source of cortisol causing the issue, tapering down or completely off the causative glucocorticoid will return cortisol to normal limits