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Rogan and Jacobsen examine user-reported effects: | Effect | Reported Frequency | Mechanism | |---|---|---| | Skin darkening | Universal | Stimulates melanocytes to produce melanin | | Spontaneous erections | Common in men with ED | Stimulates melanocortin receptors (MC4R) in the brain involved in sexual arousal | | Increased libido | Majority of users | Same MC4R pathway | | Hair color change (darkening) | Anecdotal (single case report) | Melanin repigmentation of hair follicles | | Nausea, yawning, flushing | Common at higher doses | Off-target receptor activation | | New or darkened moles | Reported | Potential masking of melanoma | Jacobsen notes a critical physiological nuance: melanin produced via injection may not migrate to the correct location in the skin

Cigarettes made with lighter burley tobacco became popular, especially among men who served in World War I, sapping dark-fire chaw profits

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