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You should use it in the areas with hyperpigmentation. If you tend to be sensitive, he suggests using it on alternating days

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Weight loss during this period is typically 2 to 4 pounds, primarily from reduced caloric intake and initial fluid shifts

Curr J Neurol 22(1):3034 Hauschild TC, Guerreiro G, Mescka CP, Coelho DM, Steffens L, Moura DJ, Manfredini V, Vargas CR (2019) DNA damage induced by alloisoleucine and other metabolites in maple syrup urine disease and protective effect of l-carnitine