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In physiological oral mucosal melanin hyperpigmentation there is no increase in the number of melanocytes, but there is increased melanin in melanocytes in the basal cell layer of the oral epithelium, in the melanocyte-keratinocyte units, and in the lamina propria within melanophages

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Additionally, tolerability of the regimen remains a question

While specific amounts and intervals depend on study design, most research protocols mimic the once-weekly schedule for consistency in data collection

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Sullivan DM, Wehr NB, Fergusson MM, Levine RL, Finkel T