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Mild skin irritation (redness, burning sensation) when using high concentrations

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Risk factors include structural abnormalities (kidney stones, enlarged prostate), indwelling catheters, diabetes, pregnancy, or immunocompromised states that allow bacteria to ascend and persist in the urinary tract

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And here is something most people miss: aged cells generate more reactive oxygen species, and since melatonin acts as a potent endogenous antioxidant, the body consumes more of it to neutralize oxidative stress