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For one, hyperhomocysteinemia has been known to be associated with insufficient stimulation of CBS activity (Selhub et al., 12 deficiency, methionine block implies that SAM (driven by Met) is lowered as well and hence it is plausible CBS is less effective

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Our protocol adjustments for Fitzpatrick IV-V patients using the GHK-Cu stack include more conservative SkinPen depth settings, lower needle density on the first session, an extended recovery window between sessions compared to lighter skin types, consistent mineral sunscreen guidance beginning two weeks before the first session, and careful timing to avoid treating recently tanned skin

PubMed Kannengiesser, K., Maaser, C., Heidemann, J., Luegering, A., Ross, M., Brzoska, T., Bohm, M., Luger, T.A., Domschke, W., Kucharzik, T