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Stopping rules: Discontinue GHK-Cu if free copper exceeds 25 mcg/dL, 24-hour urine copper exceeds 100 mcg/day, ALT or AST rises to more than 3 times the patient's baseline value, or clinical signs of copper toxicity appear

The primary molecular actions relevant to skin are: modulation of TGF- signaling (upregulating TGF-1 for collagen I/III synthesis while suppressing TGF-2 to prevent scarring), decorin upregulation for orderly collagen fibril assembly, MMP suppression paired with TIMP upregulation to preserve ECM integrity, and copper-dependent lysyl oxidase activation for collagen crosslinking

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