#1Proposed tier UnassignedsynthesisAwaiting human appraisal
A Review of Randomized Controlled Trials for Vitiligo Therapies Published Between 2013 and 2023.
Europe PMC · 2026 · PMID 42569625 · DOI 10.7759/cureus.112280
synthesis
Scientific intelligence record
Experience 2.0
Melanocortin peptide analog
Afamelanotide is a melanocortin peptide analog. The research record considers pigmentation biology and clinical outcomes in erythropoietic protoporphyria, alongside distinct exploratory questions such as UV responses and vitiligo. These settings should be kept separate.
Record status
Traceability partial
Last meaningful update: 9/23/2026
Ranked research corpus
151
Categorized publications with transparent machine-proposed ranking; human appraisal pending.
global evidence atlas
This is a deduplicated literature screening registry—not a claim that every mention directly proves efficacy or safety. Machine proposals remain visibly separate from governed human appraisal.
151 matching records · ranked 2026-09-18
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Europe PMC · 2026 · PMID 42569625 · DOI 10.7759/cureus.112280
synthesis
Europe PMC · 2026 · PMID 42678656 · DOI 10.1007/s43630-026-00986-x
preclinical-animal
Europe PMC · 2026 · PMID 41766687 · DOI 10.1111/php.70081
human-observational
OpenAlex · 2026 · Source ID doi:10.1007/s40278-026-93209-0 · DOI 10.1007/s40278-026-93209-0
contextual-unclassified
Europe PMC · 2026 · PMID 41793078 · DOI 10.1111/ddg.15996
human-observational
Europe PMC · 2026 · PMID 41718315 · DOI 10.3390/reports9010065
human-observational
Europe PMC · 2026 · PMID 41542313 · DOI 10.1016/j.jdcr.2025.11.022
human-observational
Europe PMC · 2026 · PMID 41999898 · DOI 10.1016/j.jconrel.2026.114932
preclinical-animal
Europe PMC · 2026 · PMID 41547183 · DOI 10.1016/j.jpba.2026.117362
preclinical-animal
Europe PMC · 2026 · PMID 41885813 · DOI 10.1080/14656566.2026.2651281
preclinical-animal
Europe PMC · 2026 · PMID 41489668 · DOI 10.1007/s00105-025-05636-4
preclinical-animal
Europe PMC · 2025 · PMID 40692281 · DOI 10.1093/ced/llaf306
contextual-unclassified
Europe PMC · 2025 · PMID 41118158 · DOI 10.18553/jmcp.2025.25132
human-observational
Europe PMC · 2025 · Source ID doi:10.20944/preprints202512.2837.v1 · DOI 10.20944/preprints202512.2837.v1
human-observational
OpenAlex · 2025 · Source ID doi:10.1111/phpp.70039 · DOI 10.1111/phpp.70039
contextual-unclassified
Europe PMC · 2025 · PMID 40858983 · DOI 10.1007/s00431-025-06418-9
human-observational
Europe PMC · 2025 · PMID 39011756 · DOI 10.1111/liv.16027
synthesis
Europe PMC · 2025 · PMID 40082741 · DOI 10.1111/phpp.13012
human-interventional
Europe PMC · 2025 · PMID 41466311 · DOI 10.1186/s13023-025-04170-9
human-interventional
Europe PMC · 2025 · PMID 41002740 · DOI 10.3390/diseases13090305
preclinical-animal
Europe PMC · 2025 · PMID 40817749 · DOI 10.1002/psc.70052
preclinical-animal
Europe PMC · 2025 · PMID 39401412 · DOI 10.1210/clinem/dgae729
human-observational
WPF seed · 2025 · PMID 40117616 · DOI 10.5826/dpc.1501a4600
laboratory-mechanistic
OpenAlex · 2024 · Source ID doi:10.1136/bmjgast-2024-icpp.15 · DOI 10.1136/bmjgast-2024-icpp.15
contextual-unclassified
OpenAlex · 2024 · Source ID doi:10.1136/bmjgast-2024-icpp.33 · DOI 10.1136/bmjgast-2024-icpp.33
contextual-unclassified
governance and regulatory context
No new outcome conclusion is inferred from discovery metadata. Named accountable approval is required for governed scientific conclusions.
1 FDA structured product label record(s) were identified for this compound name in openFDA. Label presence reflects an approved product exists under that name; it is not a claim about the specific formulation, dose, or use being discussed anywhere else on this page.
No machine-proposed evidence-strength grades exist yet for this compound; all screening records are unassigned pending further review.
Afamelanotide evidence · ranking key
A tier describes the evidentiary role and design strength of a source. It is not a popularity score, proof that every conclusion is correct, or a substitute for claim-level review.
Large, well-conducted randomized trials; prespecified major outcomes; rigorous systematic reviews or meta-analyses; and major regulatory assessments.
Smaller randomized trials, strong prospective cohorts, prespecified secondary analyses, and high-quality comparative-effectiveness studies.
Retrospective cohorts, claims-database studies, pharmacovigilance analyses, mechanistic human research, and well-documented case series.
Case reports, conference abstracts, preclinical research, hypothesis-generating analyses, and expert commentary.
APA
World Peptide Foundation. (n.d.). Afamelanotide — Peptide Scientific Intelligence. World Peptide Foundation. (Updated September 23, 2026.) https://www.worldpeptidefoundation.org/directory/afamelanotide
AMA / Vancouver
World Peptide Foundation. Afamelanotide — Peptide Scientific Intelligence. World Peptide Foundation website. Updated September 23, 2026. https://www.worldpeptidefoundation.org/directory/afamelanotide
Featured tiered studies
0
Cornerstone publications with study-level interpretation, limitations, and tier disclosure.
Research domains
6
Clinical and scientific questions synthesized independently across the evidence atlas.
Governed reviewed evidence
33
Database records promoted through the governed publication workflow—not the corpus total.
Corpus generated 2026-09-18. Counts remain separately labeled to prevent automated screening from being represented as completed human review.
Human experience · separate evidence stream
Eligible observations remain below the privacy and reliability threshold. WPF will not convert a handful of reports into a percentage, trend, or clinical claim.
Observation is valuable human context. It is not evidence of causation, efficacy, or safety.
Public display gate
n ≥ 20 eligible observations
Exact progress remains private before the threshold.
Intelligence snapshot
A compact view of what is represented, what remains unresolved, and how completely the record can be traced.
Ranked research corpus
151
Categorized screening records; proposed rankings remain pending human appraisal.
Featured tiered studies
0
Cornerstone studies with published study-level interpretation and tier disclosure.
Research domains
6
Independent evidence dossiers covering the major research questions.
Governed reviewed evidence
33
Reviewed database records promoted through the governed publication workflow.
Contradictions
0
Conflicting evidence relationships that remain visible.
Research gaps
1
Questions the current record identifies as unresolved.
Connected media
0
Media records explicitly linked to this scientific record.
What we know
The project separates represented evidence from qualification, contradiction, uncertainty, and what the evidence does not establish.
Reconciled domain conclusions
Afamelanotide no longer relies on the legacy “no public claim” state. Each research domain publishes a bounded conclusion, confidence level, evidence synthesis, limitations, geographic applicability, regulatory interpretation, and research gaps.
Inspect the reconciled evidence atlasContent-verified record concerning Afamelanotide: "Afamelanotide and narrowband UV-B phototherapy for the treatment of vitiligo: a randomized multicenter trial." Abstract excerpt: Narrowband UV-B (NB-UV-B) phototherapy is used extensively to treat vitiligo. Afamelanotide, an analogue of α-melanocyte-stimulating hormone, is known to induce tanning of the skin. To evaluate the efficacy and safety of combination therapy for generalized vitiligo consisting of afamelanotide implant and NB-UV-B phototherapy. This study was performed in 2 academic outpatient dermatology cent
Scientific context
Existing reviewed chemistry is preserved as scientific context. Chemistry and mechanism information do not establish clinical efficacy or safety.
Chemical identity describes the recorded molecular information. It does not establish biological activity, clinical efficacy, safety, or therapeutic suitability.
Explore further
Move from this peptide record into the project's broader evidence, research, comparison, and methodology systems.
Research
Chronology, unresolved research questions, opportunities, and researcher activity remain descriptive rather than evaluative.
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2026 · regulatory · Temporal status not established
European Union — EMA
2026 · regulatory · Temporal status not established
United States — FDA
The represented chronology reflects records currently included in the governed dataset and does not claim to represent the entire scientific literature.
No institutional claim record is currently represented for this peptide.
Evidence is missing or not represented as studied; this is not a conclusion that the intervention does not work.
Connections
Connections appear only when they are represented by the project’s underlying records.
institution
institution
institution
Traceability
The experience makes incomplete links visible instead of presenting a false impression of perfect provenance.
Source publication state
A governed source may be verified and approved for publication while its claim-to-evidence link is still incomplete.
Reviewer provenance state
“Human scientist reviewed: no” means that specific source-path attribution is not recorded. It does not silently negate the separate publication-review state.
Domain conclusion → Evidence
Connected
Evidence → Source
Connected
Source → Original record
Connected
Traceability documents how the project connects statements to records. It does not establish that a source is scientifically valid or that a claim is clinically true.
Reconciled for 6 domain conclusions and 0 featured studies.
Detailed study-to-domain mappings and original-source paths appear in the Afamelanotide evidence-governance section.
Inspect the ranked source recordsObservational archive
Observational archive data is intentionally separated from published scientific evidence.
Observational boundary
Insufficient eligible observations are available for display under the current filters.
Insufficient eligible observations are currently represented to display aggregated findings for this peptide.
Regulatory context
Regulatory status is jurisdiction-specific and time-dependent. It is presented as context, not as a recommendation for use or a substitute for scientific evidence evaluation.
European Union — EMA
Regulator: EMA
As of: 9/23/2026 · Temporal status not established
United States — FDA
Regulator: FDA
As of: 9/23/2026 · Temporal status not established
FDA Orphan Drug Designations and Approvals: afamelanotide / SCENESSE
Research + media
Only media explicitly linked through the project’s relationship system appears here.
No scientifically connected media is currently represented for this peptide.
Sources + provenance
Generated: 9/24/2026, 4:00:56 AM
Tier classifies source design and evidentiary role. Confidence reflects risk of bias, sample size, comparator quality, outcome relevance, follow-up, missing data, directness, replication, reporting quality, and whether conclusions stay within the measured results.
Funding and conflicts are disclosed and considered, but sponsorship never automatically changes a tier. Corrections, retractions, and expressions of concern override the original rating.
Content-verified record concerning Afamelanotide: "Afamelanotide, an agonistic analog of α-melanocyte-stimulating hormone, in dermal phototoxicity of erythropoietic protoporphyria." Abstract excerpt: Afamelanotide, an α-melanocyte stimulating hormone (MSH) agonistic analog is a first-in-class therapeutic. Its application to protoporphyria (PP), a disease associated with absolute sunlight-intolerance is discussed. The genetics and existing therapy of the inherited disease PP comprising both erythropoietic protoporphyria and X-linked dominant protoporphyria. The physiological and pharmacol
Content-verified record concerning Afamelanotide: "Afamelanotide for Treatment of the Protoporphyrias: Impact on Quality of Life and Laboratory Parameters in a US Cohort." Abstract excerpt: Erythropoietic protoporphyria (EPP) and X-linked protoporphyria (XLP) are rare disorders of heme biosynthesis characterized by severe cutaneous phototoxicity. Afamelanotide, an α-melanocyte-stimulating hormone analogue, is the only approved treatment for protoporphyria and leads to increased light tolerance and improved quality of life (QoL). However, published experience with afamelanotide
Content-verified record concerning Afamelanotide: "The efficacy of afamelanotide and narrowband UV-B phototherapy for repigmentation of vitiligo." Abstract excerpt: Vitiligo is characterized by depigmented patches of skin due to loss of cutaneous melanocytes. Many recent studies have demonstrated defects in the melanocortin system in patients with vitiligo, including decreased circulating and lesional skin levels of α-melanocyte-stimulating hormone (α-MSH). Afamelanotide is a potent and longer-lasting synthetic analogue of naturally occurring 
Content-verified record concerning Afamelanotide: "Afamelanotide improves quality of life and light tolerance in Austrian erythropoietic protoporphyria patients." Abstract excerpt: Erythropoietic protoporphyria (EPP) is a rare genetic disorder characterized by severe phototoxic reactions that occur within minutes of light exposure. In clinical studies, afamelanotide has been shown to prolong pain-free sun exposure, improve quality of life, and reduce the frequency and severity of phototoxic reactions. To present the real-world data of the Austrian EPP cohort treated with afa
Content-verified record concerning Afamelanotide: "Pseudoleucoderma after injections of afamelanotide in a patient with atopic dermatitis." (identity confirmed; no abstract text available to excerpt.)
Content-verified record concerning Afamelanotide: "Association of quality of life measures with afamelanotide treatment in patients with erythropoietic protoporphyria and x-linked protoporphyria: A retrospective cohort study." (identity confirmed; no abstract text available to excerpt.)
Content-verified record concerning Afamelanotide: "Long-term observational study of afamelanotide in 115 patients with erythropoietic protoporphyria." Abstract excerpt: In erythropoietic protoporphyria (EPP), an inherited disease of porphyrin-biosynthesis, the accumulation of protoporphyrin in the skin causes severely painful phototoxic reactions. Symptom prevention was impossible until recently when afamelanotide became available. Afamelanotide-induced skin pigmentation has statistically significantly improved light-tolerance, although the clinical significance
Content-verified record concerning Afamelanotide: "The effects of cholecalciferol and afamelanotide on vitamin D levels in erythropoietic protoporphyria: a multicentre cohort study." Abstract excerpt: Patients with erythropoietic protoporphyria experience lifelong painful photosensitivity resulting in a lack of sunlight exposure. Previous studies have shown that 47-63% of patients with EPP suffer from vitamin D deficiency and a high prevalence of osteoporosis. An effective treatment for EPP has been available since 2016: the α-melanocyte stimulating hormone analogue afamelanotide. So far,
Content-verified record concerning Afamelanotide: "Erythropoietic protoporphyria in the Netherlands: Clinical features, psychosocial impact and the effect of afamelanotide." Abstract excerpt: Erythropoietic protoporphyria (EPP) patients experience severe burning pain after light exposure, which results in a markedly reduced quality of life. However, there is limited information on the psychosocial aspects of EPP. To investigate the clinical features and social aspects of living with EPP, before and during afamelanotide treatment in the Netherlands. A single-center prospective longitudi
Content-verified record concerning Afamelanotide: "Association of Afamelanotide With Improved Outcomes in Patients With Erythropoietic Protoporphyria in Clinical Practice." Abstract excerpt: The effectiveness of afamelanotide treatment in patients with erythropoietic protoporphyria (EPP) in clinical practice who experience pain after light exposure that substantially impairs quality of life is unknown. To evaluate the association of afamelanotide treatment with outcomes in patients with EPP in regular practice during longer-term follow-up. This single-center, prospective postauthoriza
Content-verified record concerning Afamelanotide: "[Medicaments and oral healthcare. Hyperpigmentation of oral soft tissues due to afamelanotide]." Abstract excerpt: The medicament afamelanotide is an analogue of endogenous ?-melanocyte-stimulating hormone. It promotes cutaneous pigmentation, providing protection from sunlight. In dermatology, afamelanotide seems to establish therapeutic results for polymorphic light eruption, solar urticaria, erythropoietic protoporphyria, Hailey-Hailey disease, vitiligo and acne vulgaris. Afamelanotide is available for non-m
Content-verified record concerning Afamelanotide: "Afamelanotide" Abstract excerpt: Afamelanotide is a melanocortin-1 receptor agonist that stimulates melanin production in the skin and is used to decrease pain and itching from light exposure in patients with erythropoietic protoporphyria and X-linked protoporphyria. Afamelanotide has not been linked to serum aminotransferase elevations during therapy nor to instances of idiosyncratic acute liver injury with symptoms and jaundice
Content-verified record concerning Afamelanotide: "Investigation of the stability profile of therapeutic α-MSH analogue: Insights from liquid chromatography-high resolution mass spectrometry analysis of afamelanotide." Abstract excerpt: Afamelanotide, also known as melanotan-1, is a synthetic 13-amino acid peptidomimetic of α-melanocyte stimulating hormone (α-MSH), and is a critical peptide orphan drug used for the management of erythropoietic protoporphyria. It contains norleucine and D-phenylalanine at positions 4 and 7, in place of methionine and L-phenylalanine, respectively as found in endogenous peptide. Therape
Content-verified record concerning Afamelanotide: "A bioassay for the detection of neutralizing antibodies against the α-melanocyte stimulating hormone analog afamelanotide in patients with erythropoietic protoporphyria." Abstract excerpt: The tridecapeptide afamelanotide (Scenesse®) is a congener of α-melanocyte stimulating hormone (α-MSH). Upon binding to the melanocortin 1 receptor (MC1R) on the surface of pigment cells of the skin, the melanocytes, α-MSH or afamelanotide trigger the synthesis of cAMP, which stimulates the synthesis of melanin and therefore induces skin tanning. In a recent trial, afamelano
Content-verified record concerning Afamelanotide: "Pharmacokinetics and Pharmacodynamics of Afamelanotide and its Clinical Use in Treating Dermatologic Disorders." Abstract excerpt: Afamelanotide, the first α-melanocyte-stimulating hormone (MSH) analogue, synthesized in 1980, was broadly investigated in all aspects of pigmentation because its activity and stability were higher than the natural hormone. Afamelanotide binds to the melanocortin-1 receptor (MC1R), and MC1R signaling increases melanin synthesis, induces antioxidant activities, enhances DNA repair processes a
Exploratory human study of acute UV response; not evidence of benefit across other conditions.
Content-verified record concerning Afamelanotide: "Clinical and dermoscopic changes of acquired melanocytic nevi of patients treated with afamelanotide." Abstract excerpt: Afamelanotide (AFA) is a synthetic analogue of α-melanocyte-stimulating hormone that is approved for the treatment of patients affected by erythropoietic protoporphyria (EPP). AFA induces a "sun free" tanning and changes of acquired melanocytic nevi (AMN) that are generically described as "darkening". To assess clinical and dermoscopic AMN changes during AFA treatment. Adult EPP patients tre
Content-verified record concerning Afamelanotide: "Afamelanotide: An Orphan Drug with Potential for Broad Dermatologic Applications." Abstract excerpt: Afamelanotide (SCENESSE®) is a synthetic analogue of α-melanocyte-stimulating hormone that is FDA-approved to increase pain-free sunlight exposure in adult patients with erythropoietic protoporphyria. Its dual photoprotective and anti-inflammatory effects also make it a promising therapy for other photosensitive dermatologic diseases that are resistant to treatment. The PubMed/MEDLINE an
Content-verified record concerning Afamelanotide: "Afamelanotide: A Review in Erythropoietic Protoporphyria." Abstract excerpt: Afamelanotide (SCENESSE(®)) is a synthetic α-melanocyte stimulating hormone analogue and first-in-class melanocortin-1 receptor agonist that is approved in the EU for the prevention of phototoxicity in adults with erythropoietic protoporphyria (EPP). It is administered subcutaneously as a biodegradable, controlled-release implant containing 16 mg of afamelanotide. This article revi
Content-verified record concerning Afamelanotide: "Vitamin D status in patients with erythropoietic protoporphyria taking the systemic photoprotective agent afamelanotide." (identity confirmed; no abstract text available to excerpt.)
Content-verified record concerning Afamelanotide: "Afamelanotide for Erythropoietic Protoporphyria." Abstract excerpt: Erythropoietic protoporphyria is a severe photodermatosis that is associated with acute phototoxicity. Patients with this condition have excruciating pain and a markedly reduced quality of life. We evaluated the safety and efficacy of an α-melanocyte-stimulating hormone analogue, afamelanotide, to decrease pain and improve quality of life. We conducted two multicenter, randomized, double-bli
Content-verified record concerning Afamelanotide: "Afamelanotide (CUV1647) in dermal phototoxicity of erythropoietic protoporphyria." Abstract excerpt: The application of afamelanotide, an α-melanocyte stimulating hormone agonistic analogue to protoporphyria, a disease with absolute sunlight-intolerance is discussed. The clinics, genetics and existing therapies of protoporphyria are described. The physiological receptor-mediated intracellular signaling of α-melanocyte stimulating hormone and effects of receptor variants are outlined.
Content-verified record concerning Afamelanotide: "Afamelanotide in protoporphyria and other skin diseases: a review." Abstract excerpt: Afamelanotide is a synthetic alpha melanocyte stimulating hormone presenting a higher activity than natural hormones. Its main properties are related to the enhanced production of eumelanin by agonistically binding to the melanocortin-1 receptor. Since 2016 afamelanotide has been especially applied to treat cases of erythropoietic porphyria (EPP), where painful photosensitivity has been observed s
Content-verified record concerning Afamelanotide: "Into the Light: Afamelanotide and the Treatment of Erythropoietic Protoporphyria in the United States." Abstract excerpt: Erythropoietic protoporphyria (EPP) is a rare disease that causes disabling cutaneous photosensitivity with pain and burning sensations. In 2019, afamelanotide, an α-melanocyte-stimulating hormone analogue, was approved in the United States for treatment of EPP. In this study, patients receiving afamelanotide filled out questionnaires assessing the benefit of treatment. Outcomes measured inc
Content-verified record concerning Afamelanotide: "A feasibility and safety study of afamelanotide in acute stroke patients - an open label, proof of concept, phase iia clinical trial." Abstract excerpt: Neuroprotective agents have the potential to improve the outcomes of revascularisation therapies in acute ischemic stroke patients (AIS) and in those unable to receive revascularisation. Afamelanotide, a synthetic α-melanocyte stimulating hormone analogue, is a potential novel neuroprotective agent. We set out to assess the feasibility and safety of afamelanotide for the first time in AIS pa
Content-verified record concerning Afamelanotide: "A review and update on melanocyte stimulating hormone therapy: afamelanotide." Abstract excerpt: Afamelanotide ([Nle4-D-Phe7]-alpha-MSH) is an analog of alpha-melanocyte stimulating hormone given as a subcutaneous injection. Afamelanotide is currently undergoing phase II and III trials in Europe and the US for skin diseases including vitiligo, erythropoietic protoporphyria, polymorphic light eruption and prevention of actinic keratoses in organ transplant recipients. Unregulated analogs and c
Content-verified record concerning Afamelanotide: "Evaluation of the immunogenicity of the synthetic α-melanocyte-stimulating hormone (α-MSH) analogue afamelanotide ([Nle4-D-Phe7]-α-MSH, Scenesse®) in erythropoietic protoporphyria patients by ELISA detecting both anti-afamelanotide and anti-α-MSH antibodies." Abstract excerpt: Afamelanotide is an α-melanocyte-stimulating hormone (α-MSH) agonist with proven efficacy in photodermatoses such as erythropoietic protoporphyria (EPP). This peptide drug, repeatedly administered over prolonged time, may induce anti-drug antibodies (ADA). Here, we describe a new ELISA method developed to monitor the occurrence of ADA against afamelanotide as well as against α-MS
Content-verified record concerning Afamelanotide: "German Cohort Observational Study to Investigate the Short- and Long-Term Safety and Clinical Effectiveness of Afamelanotide 16 mg (SCENESSE) in Patients With Erythropoietic Protoporphyria (EPP)." Abstract excerpt: Afamelanotide 16 mg (SCENESSE) is the first approved treatment for erythropoietic protoporphyria (EPP). EPP is a rare autosomal recessive inherited disorder of the haem biosynthesis pathway, where patients experience severe and debilitating acute phototoxicity. It affects at least one in 140,000 of the European population. A postauthorisation safety study (PASS) and a disease registry were imposed
Content-verified record concerning Afamelanotide: "Increased phototoxic burn tolerance time and quality of life in patients with erythropoietic protoporphyria treated with afamelanotide - a three years observational study." Abstract excerpt: Erythropoietic protoporphyria (EPP) is an ultra-rare genetic disorder (prevalence 1:150`000) characterized by instant painful phototoxic burn reactions in skin exposed to visible light. Afamelanotide is the first clinically tested therapy effectively increasing the time EPP patients can spend in direct sunlight without developing symptoms and reducing the number and severity of phototoxic reaction
Content-verified record concerning Afamelanotide: "Afamelanotide implants and narrow-band ultraviolet B phototherapy for the treatment of nonsegmental vitiligo in Asians." (identity confirmed; no abstract text available to excerpt.)
Content-verified record concerning Afamelanotide: "Erythropoietic protoporphyria and afamelanotide: a patient's perspective." (identity confirmed; no abstract text available to excerpt.)
Content-verified record concerning Afamelanotide: "Afamelanotide for prevention of phototoxicity in erythropoietic protoporphyria." Abstract excerpt: Introduction : In erythropoietic protoporphyria (EPP), an inherited disorder of heme biosynthesis, accumulation of protoporphyrin IX results in acute phototoxicity. EPP patients experience severe burning pain after light exposure, which results in a markedly reduced quality of life. Afamelanotide is the first effective approved medical treatment for EPP, acting on melanocortin-1 receptors. This ar