B12 injection & Acne - Please don't a... - Pernicious Anaemi...

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B12 injection & Acne - Please don't answer unless you've had acne as a reaction


Hi! So follow up to my last post, after 3 weeks of horrific acne my skin started to calm down slightly. It's still fairly calm, but my left cheek still has the ugly scarring and leftovers of the breakout.

In the past 2 days, the acne seems to be coming back? I don't understand. I was just wondering if anyone has had a similar reaction? My left cheek is kind of resuming the hideous pink blotchiness that I suffered in the beginning of the reaction. My forehead is also kind of getting the small bumps that I had earlier on.

The last injection I had was January 28th. I stopped taking them and I wish on my life that I never took them to begin with - I haven't noticed anything different except for the awful skin. I still get up at 5 am, run around everywhere, get my work done and and am home to fix dinner after a busy day in London.

I've completely stopped any intake of b12 because A) my doctor was freaked out by my reaction and B) I want my body to flush out whatever I'm reacting to. I have read that a mega dose of b12 apparently changes the 'friendly' skin bacteria to bad bacteria which causes the acne eruptions.

I just don't get though why I've had 3 injections, completely stopped a month ago and this stupid acne is still hanging around? I want my clear skin back! Has anyone had a prolonged reaction like this?


59 Replies




Thanks! I've read both of those already...I just wanted to see if someone could provide a timeline for their reaction.

I had very severe spots on my face and had quite a lot on my scalp too, when I started taking oral methylcobalamin in high doses. I also got very severe mouth ulcers and severe eczema on my hands that made it painful to bend my fingers.

I had all these problems before starting methyl-B12 so they weren't new, but they got many times worse than usual once I started the B12.

I persisted despite the pain and the problems I was having, and over 2 - 3 months each problem gradually started to improve and then disappear. I still have some small mouth ulcers but the other problems have 98% disappeared and my skin is the best its been for as long as I can remember.

I also take methylfolate and other B vitamins with the Methyl-B12.

Thanks! Glad to read something from someone's who's had this reaction. It's been a month now so I'm seriously hoping this will go away by the end of March..I feel so hideous and make up can only do so much.

I don't understand why you had injections if you didn't have any symptoms before. It suggests to me that you were given it when you didn't need it and if this is the case I'm not surprised at your skin's reaction. I am dead without huge amounts of B12 but come out in acne if I manage to get more than I need.

The more recent reaction may be due to the rate at which your cells are metabolising the B12 that is in your system. If so, in time it will get better.

Have you eaten things rich in B12 that may have boosted your levels? Or supporting vitamins and minerals that may have increased its metabolism?

I suggest you look up what factors increase and decrease B12 and see if you can manage your levels with those things.

I was prescribed injections because I was suffering from increasing tinnitus and muscle pain, and both reached a peak around December 2015. I had a blood test done and my b12 levels were 150. Besides those two symptoms I wasn't tired or tingly or anything. Both symptoms are still around, although the muscle pain far less because I've been taking magnesium sprays and as for the ear popping and tinnitus, this still hangs around. My doctor never mentioned side effects from the b12 injections.

I guess that's because usually there aren't any - even the acne only affects a very few people.

The increasing magnesium levels in your body would explain the increasing B12 metabolism. Don't stop that - you'll feel terrible!

I'm not suggesting getting drunk but alcohol uses up B12! ? :-)

There's side effects to everything. I will probably take vitamin C to lower the b12 and go vegetarian for a while. I'm really sick of looking like this.

Laura5 in reply to minniemouse89

Why do you think vitamin C lowers B12? Do you have a reference?

minniemouse89 in reply to Laura5


Laura5 in reply to minniemouse89

From the first reference on that page: "Previous reports that megadoses of vitamin C destroy vitamin B12 have not been supported (92) and may have been an artifact of the assay used to measure vitamin B12 levels (17)."

minniemouse89 in reply to Laura5

That's fine...but I'm pretty keen to try whatever to lower my b12 so I look more like a human being again.

I have eaten beef in the past 3 days, which is when the acne has flared up again after I thought about it.

By the way, have you suffered from acne? I'd like to know your experience.

Metformin can lower B12

With b12 levels your low I wouldn't advise stopping the injections. Yes, I had the same as you, I erupted in terrible acne/rashes/spots on my face/scalp/ears. I've heard of others who get it on chest too. I've also read that it is a form of detox. I can empathise as it was incredibly painful and ugly. My nurse was shocked, the Dr dismissive. I carried on and indeed self inject 2x a week roughly. After the first outbreak they eventually cleared up - at that time my surgery stopped my injections. On starting them again, they didn't come bk. I've had small outbreaks of odd spots but that's all. I use an aloe Vera facial scrub most days and at time of outbreak used elemis skin capsules which were lovely.

So my advice, hang in there, take injections with folate etc too.

I get buzzing in my ears and sudden bouts of tinnitus too, less now.

My homocysteine level halved- all good.

My chin is the same I feel like a teenager, seriously don't know what to do. my face has scarred deep also aghhhh help

Cut out dairy/meat/b12 heavy foods and drinks lots of water and green tea to flush out the toxins faster. I'm also using an acne cream (which barely helps) but it at least gets rid of the redness.

I made the mistake, just as my skin was getting better and settling, of eating 2 hamburgers over 2 days and having an omelette...basically resuming my old diet. On the third day, here comes the small bumps, itchy uncomfortable feeling and the redness on my chest.

I've stopped eating meat since last Monday (29/2) and it's beginning to calm down again.

I think it just takes a while for different people - like I've been fighting this going on over a month now and I'm thinking it's going to take roughly 2 full months for this to go away which is really frustrating.

Hey MInniemouse!

Just keen to hear an update on your skin?

I had a low-ish result when i had a test with my GP (138).  I live a pretty healthy lifestyle and wasn't showing any signs of low b12 however my GP still gave me the shot.  I had my first shot on a monday, second shot the following monday and by that Friday i was starting to get a reaction in my skin- shoulders, neck, scalp and face.  It died down after a week but then flared up again.  My GP decided not to give me the final shot and to wait to see what happens.  It has been about 3 and a half weeks since i first saw a reaction and spots are still there.  I am pretty much eating vegan and gluten free and have cut out coffee and booze.  This was not suggested to me i guess i figure the less crap i'm putting in the better for me.

My GP has put me on a short course of prednisolone and i am also taking zinc and vitamin c.  The pred seems to have helped take the severity out of it (not sure what will happen when i finish that up though).

Anyway.. i was reading this thread and it sounds like you are a few weeks ahead of me so keen to hear how you are doing and if there is in fact light at the end of the tunnel  :-/



Well - it's been a very strange journey. I began to take note of when I was having flare ups (yes, I'm still having them after 2 months) and it comes every two weeks and last about 2 weeks. So to put that into perspective:

• Beginning of Feb (immediately after injections) : Very red, itchy bumpy skin, small bumps turned into whiteheads or cystic acne. Awful, raged on until about the 8th or 9th of Feb. Reached a plateau by the 13th. Began to calm down somewhat.

• Last two weeks of Feb, relatively calmed down, I thought I was on my way...only for it to come back

• First two weeks of March, acne begins to come back, by the 6th it was returning to being very bumpy and hideous. Around the 9th or 10th I think it started to calm down again.

• Last two weeks of March, my forehead was actually completely clear! my cheeks still had bumps but I was hoping for the best and then

• March 29th, the bumps start coming back all over my forehead. By the 31st, my temples, forehead, cheeks and jawline were covered again...

So that's where I'm at now. Right now it's a uniform looking type of acne - but still very very frustrating. I've been a big crybaby about this and get so upset when I see my reflection. It has calmed down though, and I will say that after each 'attack' or outbreak, it slowly seems to get a bit better each time. 

However - I've been reading a lot of comments of this lasting for months and months, and since I'm going to the beach in August (!!!!!!!!) I'm going to the doctor this Thursday, and then trying to get referred to a dermatologist. Fingers crossed! 

Regarding your diet - yes, I have also cut out red meat, seafood, coffee, anything too sugary, although I must admit I'm still eating chicken (in smaller portions). I've been trying to limit any intake of foods that are high in b12, I believe chicken and turkey are on the lower end but I should probably also go completely vegan.

My doctor only prescribed me anti-histamines, which had no effect. I've continued take my acne medication as prescribed over a year ago (and was very effective - until this b12 fiasco, so not very effective at all anymore :(

Ugh! It really sounds like you've had it rough.  What a nightmare.

I have been trying to get in to see a specialist but the wait list is horrendous. 

I don't have a current plan other than to just wait it out and to get my b12 tested every couple of weeks to see if/how much its decreasing.  Being this healthy is soooo boring ha.

I'm sure you've exhausted all forums and tried all remedies however I will say that zinc tablets seem to help me as does anti inflammatory foods.

I hope you get some help from the dermatologist - please keep me posted and I'll do the same!

Yeah, I've been getting so...to put it bluntly, pissed off with this. I feel like I went in for one problem only to deal with another and this time I have no idea how to handle it whatsoever. Plus, I'm in my late 20s - I don't want to feel like a teenager again with acne ruining my confidence. I've actually been getting ID'd again for alcohol, how ridiculous is that? All I need is my braces back on and here I go. 

I might try the zinc tablets - but yeah, I agree, I miss eating omelettes, burgers, fish & chips...it feels like a double punishment. I think this clean of a diet would make a celebrity weep. 

Anyway, yes will let you know how it goes...although I'm expecting my doctor to be just as flustered and confused as last time. Hopefully the dermatologist I see will have some familiarity or understanding of this...!!!

My GP is exactly the same. Every time I go and see him he just does this \_(ツ)_/¯ 

Clutching at straws and getting more more down about it. Certainly gives the old confidane a boot in the guts!

Anyway, focus on the positives I guess. Saving money on junk food. 



Haha :-/

Ha ;). Yeah, well I'm not sure if you're prone to acne, but I am, and I'm very sensitive to many different things. I think that my body type was just too sensitive overall for the b12 megadose and so I'm having this ongoing reaction. 

I hope that you're not as sensitive as I am and that it goes away faster! It is horrible, I feel like I just want to be a vampire and only be in public when it's dark and then hide away when it's light. 

Let me know how you get on :)

Hey Minniemouse!

Hope you're well :)

The course of prednisolone really helped out my symptoms. In fact by the end of the 2 weeks I had my skin almost back to 100%.  I have been off it for a week now there has been a slight return but only honestly was minimal.  Pretty happy so far although I am still going to see the allergen and immunity specialist in a few weeks just so they can get to the bottom of what happened.

What's your update after going back to see the doc...?

I take it you haven't had any more B12 then?  I'm still getting spots in my scalp and the odd one on my face but I've been fortunate not to erupt fully again.  I do keep my face throughly, healthily scrubbed mind - much better than i used to lol.  I'd never had acne as a teen, just random spots so it all had been a shock to me - urgh.

just think how much your body needs detoxing though!

Have you had a homocysteine blood test and a methylmalonic acid - MMA - that would show whether you were low at cellular level.

Are you taking a good B complex such at Thorne.  What is your vitamin D level like?

Hang in there.....

Hey both. No, I've completely stopped b12 @bluedragon - my acne has actually not broken out in over 3 weeks. But I am going to the dermatologist in mid May. I think that I will take the b complex like Thorne, or the sublingual spray - but I'm really scared of going back to the injection since I had bad scarring.

Hey team!

Minniemouse, good to hear you haven't had a breakout recently! I'm the same as you, quite nervous about what to do next.

I have completely cut out all b12 in my diet. No meat, fish, eggs in over 4 weeks. Once I have a bit more time under my belt I'll start to introduce them. 

My test results went from 138 (pre shot) to 850 (after two shots) down to 360 (two weeks after no b12 in my diet). Next test will be b12 and homocysteine. 

Pretty fortunate to get have got an appointment with the specialtist (apparently the top dr in the country for this sort of stuff). It's in 2 weeks.

I'll keep you posted. 

Hope you're having a good weekend!

Bluedragon- how long did you have your skin issues for?

Hello all - so I have been to the dermatologist. I gave her the backstory, my b12 history and what not. She felt that my GP had been overzealous especially as I was told to take the Holland & Barrett tablets for a month, followed by 3 injections AND I'm acne prone. So, I have been prescribed a skin regime of oral antibiotics, skin wash, a gel for my skin, and a gel for my chest and back. I was also told to stop taking my prior acne medication, Skinoren. So...here I go! I'm supposed to do this for 2.5 months and then report back. I really am hoping that this will help!!! I did ask about the scarring, apparently not much can be done. 

I have sand paper like skin feeling along my chin and my forehead. A little on my nose as well. I'm also having itchy skin and small break outs of pimples from b12 injections. But the injections do help so i will deal with the acne for now lol.

Spots from B12 is common. It's supposedly the homocysteine coming out of the system. No idea if that's actually the cause. I wouldn't stop just because of the spots. Low B12 can cause a lot of harm if not treated.

I understand that spots are common, but severe acne for months and months? It was so aggressive the first two months that I now have scarring the dermatologist deemed irreversible. All I can say is that I'm basically a case of a doctor being indifferent by recommending a patient take vitamin b12 tablets in addition to b12 injections...which allowed a severe reaction to take place that is ongoing.

Bless, I know how you feel, I'm going through the same thing, I'm 39 and finished my B12 loading doses over a month ago, I had acne on face, scalp, back, neck and chest, I've never felt so ugly. It is getting better with just a few here and there, I still have a sandpaper feel on my chest and back but not massive lumps everywhere. I hope it improves for you soon...xx

Hey Minniemouse,

How is your skin now? Are the new meds you're on helping?

I am coming up to 10 weeks since my first lot of symptoms from the shot. My face has pretty much cleared up now (about 90%). I still have spots showing up on my shoulders and chest though.

i cut out all b12 from my diet for about 6 weeks (pretty much vegan) - this certainly helped. I am now slowly starting to introduce it back in. Plan is to take it slowly though as the last thing I want is to go backwards!!

Hey :) I haven't started the new meds because I work in London so I keep running out of time to get my prescription picked up, but I will have to adopt a new skin regime recommended to me by the dermatologist for 2 months. My skin has almost come to a halt for the bumps, but the scarring is still there which is frustrating. I've started to eat seafood again (like prawns) but I'm avoiding salmon & too much beef, cause those are the b12 heavy foods. The derm said not much can be done about the scarring, only time will tell (again, frustrating!!!!). Glad to hear that you're feeling better, drink lots of water and keep your diet fairly clean and you should be okay soon.

Hey Minninemouse!

Hope you're well!

I was just wanting to touch base to see how you are progressing.

Is your skin regime helping? Have you had any new breakouts? Are you eating normally agin?

I have been up and down but the downs are not as bad as what they once were. I'm hoping that means it's fading out ha. It has now been 4 months since my last shot- crazy how long it affects you!?

Anyway let me know 😊

Yeah it's insane how long it stays in your body. So I had the awful reaction from the beginning of February basically until end of May, which is when I went to the dermatologist. I was put on anti biotics for skin infections and heavy duty acne medication (Epiduo?). I was told to do this for 2.5 months, so far my skin has been normal and I haven't had any outrageous bullshit to deal with.

I will be finishing up with my course of medication early/mid August but holy heck I wish I was never involved with this awful injection to begin with. It really impacted my life in a very negative way for a long time, and I didn't notice any improvement with the bloody symptoms I went in with, in the first place! Ugh.

All I have as a reminder for the incompetence of my doctor and my oversensitivity to this injection are brown marks on my face from where the acne breakouts kept happening repeatedly at a very severe level. Thanks, doc.

But, I am extremely grateful that the dermatologist had half of a brain and helped me with this. Honestly, I feel like everyone that gets severe acne as a reaction should go to the derm as fast as possible because it seems like it can go on or get out of control for an indefinite amount of time. Awful.

Hi I know I'm late to this thread but I have been reading it and found it very helpful to my current situation. It sounds like I am going through exactly what you went through last year. I had x6 b12 injections in 2 weeks 3 months ago. As soon as I had these I immediately came up with small bumps all over my forehead, chin and chest. This felt more like a rash. This lasted a few weeks and calmed down for a month or so but I have now just broken out with acne all over my chin and jawline. I have been a previous acne sufferer but have had clear skin since I had treatment 10 years ago. I just want to know if you are now out the other side of this nightmare? And if you have any tips you can share for me? It is really getting me down :(

Hi I am going through the same thing it is awful I am so depressed !! It's now been 3 1/2 months since my last 6 injections in two weeks which I didn't think I needed !! And I took oral b12 tablets for two months not being told not to or knowing the side effects !! My skin has been like this now for about 6 weeks and it is driving me insane !! Doctor put me on Yasmin pill and I'm on tetracycline now but I can't go in the sun which is so annoying cause I'm living in Spain at the moment. I just want this nightmare to be over !! I have doubled up my antibiotic dose so I'm hoping they start to work soon and I have bought a BH+ mask / exfoliant that I have tried for the first time today hooding that works xx will update you in a couple weeks fingers crossed it starts to get better and doesn't scar because it looks like it is scaring :( I have always had great skin so this is really heartbreaking I wish I never had anything to do with b12 :@ doctor should worn you about skin conditions after !!!

Hiya, I'm so sorry you're going through this. I feel like although the earlier commenters made it out like it's so 'uncommon', it's not at all.

What worked for me was seeing an amazing dermatologist in Kent, who put me on skin antibiotics for 3 months. After that time, I no longer have any acne whatsoever. It's now been a year since that whole skin circus I went through and my skin is very healthy. Also, I'm not tired or twitchy muscles. I still have ear problems however but I think it's more to do with allergies.

I definitely advise possibly going to a dermatologist if possible. I think if I had left it any longer I would have developed scarring from how bad it was going on.

Also I'm not taking B12 injections anymore. The best decision for my own health, ever.

Hi not sure if this is still relevant to you. I recently had 5 days worth of the b12 injections and have been prescribed to have them every 3 months alongside folic acid. I suffer from acne anyway (id say moderate). However since taking them, I've had a severe breakout on my face, neck, back and chest. A lot of whiteheads and very sore and itchy.

Just came back from the gp who prescribed me epiduo gel. I've tried a lot of the topical lotions so this was the next best bet. What did you find helped? Hope your well x

I know this post is 3 years old at this time but I need to answer it for the many people that are suffering with acne after B vitamin injections. I went through the same thing. I stopped my injections in October, it is now mid February of the following year and I'm still breaking out although not as severely. Same type of acne you're describing ...bunch of bumps all over my forehead temples inflammatory acne on my cheeks and Chin. What I have discovered is that the liver can store vitamin B for years! But what I also found is that in five or six months the acne should resolve. Doctors don't seem to know about this though unfortunately. I finally started using Thayer's witch-hazel toner and Ole Henriksen African red tea foaming cleanser both available on Amazon. I read about these on an acne blog and they definitely helped my skin. The more of us that post about B12 and acne the better so that our suffers don't fall prey to this for whatever reasons we were told we needed B vitamin injections! Good luck to all my fellow sufferers.

Yogijo in reply to Ni_na

I’ve also suffered an outbreak of acne following a course of 6 injections of B12 over 2 weeks. It has affected my face, neck, back and chest!!!! Totally fed up with it, I’m 48 and now have worse skin than I did as a teenager! It started after injection number 4 and when I mentioned it to the nurse administering the injections she was dismissive and didn’t appear to know (or believe) it was a possible side-effect. I downloaded a patient information leaflet for hydroxocobalamin from the internet and took it with me to my next appointment. I’ve been told I’ll need an injection every 3 months but haven’t actually confirmed whether there is an issue with my levels of intrinsic factor. I was told the treatment was the same regardless but that isn’t what the NHS website says so I if my skin doesn’t settle soon (it’s 6 weeks since the last injection) I’m going to ask if I can try oral supplements if there isn’t an issue with intrinsic factor.

On the plus side, I feel far less tired since having the injections.

Hopeful11346 in reply to Yogijo

How are you going now ? Is it clearing up? I'm experiencing the same ... is there any hope does it go away?

Bibbys in reply to Ni_na

Hello. Hope things have improved for you. My daughter is in the same position having bad acne after injections. Two months since last injection and no improvement in face it’s worse. Did the acne resolve after 6 months as you had read? I do hope so. Best wishes

Daftpunk262 in reply to Bibbys

Hi, I’m going through the same thing now and completely at a loss about what to do, it’s been 3 months since I stopped the tablets and I’m still breaking out with inflammatory acne on my cheeks which is getting me really down. Did it resolve after a few more months? Any tips on how to clear things up?

How are you going now ? Is it clearing up? I'm experiencing the same ... is there any hope does it go away?

Hey I wanted to ask you, how long did it end up lasting for you that acne???

Really hope you reply, I had 4 a couple weeks ago and my face is still rough and bumpy!

Hi guys!

I had 3 b12 injections (one every week for 3 weeks) and have acne on my back and neck. On my chest is a rash. So disappointed!

It’s been 7.5 weeks since my last injections, really hope it doesn’t take months and months to go away.

ElleTed in reply to Jayda88

I have also got the same. I had 2 weeks of the loading dose, which I finished about 2 weeks ago and now I am going down to every two months. I managed to get rid of the chest rash though, with salcura bioskin, went in 2 days. I also used the piritize cetrizine hydrochloride antihistamines to help with the itching. For my face and neck, I am using la Roche posay effaclar as it has always worked for me in the past, it is just very drying and not a quick fix unfortunately, so we will see. I haven't tried anything for the back yet. Hope yours is clearing up.

Hopeful11346 in reply to Jayda88

I have the same thing... how are you going? Is it clearing is there any hope?

Jayda88 in reply to Hopeful11346

My doctor put me on doxycycline antibiotics for 2 months, which actually makes the acne worse before it gets better. But after the 2 months it was good. It’s now been almost 5 months since I stopped taking it and in the last week I have had a couple pimples on my neck. I really hope it’s not coming back!

Iv attached a photo of when I was using the antibiotics.

Hopeful11346 in reply to Jayda88

I hope it stays clear for you! Stay positive! Keep me updated! I might go visit my gp see what he recommends.

Nish12 in reply to Jayda88

how is your skin feeling now? I am dealing with a similar situation

I’m so glad to have found this thread! I am going through the same thing. I started taking oral supplements in August 2020 and still am. My doctor prescribed a super super high dose as I am now aware (was on the 5000 mcg Methylcobalamin (Methyl B-12) and was advised to take one every day. So then I read that that is an incredibly high dose and have lowered it myself to one per week. I have been dealing with extreme breakouts on my cheeks (a distinct patch that gets cystic bumps over and over) and jaw area for months and cut out dairy/gluten a month ago. It improved a tiny bit but was still persistent. I’m hoping my new lower dose of b12 will help. I will get labs done again next month (Dec) to see if the intrinsic factor is there/if it is indeed PA.

I just want to add that my skin was bad with both methylcobalamin and hydroxocobalamin. And with the hydroxocobalamin I really did push through, with no luck. In the end I was too vain to keep hoping and went back to cyanocobalamin, which has never affected my skin.

Obviously, no two people react the same. Just putting it out there just in case.

Hi, I know this post is old but i just had 3 injection of b12 in 1 month.... now I have acne- spots in my cheeks jaw chin n ear. how long does it last!? Does it ever go away because it's really takin a toll on me

Nish12 in reply to Hopeful11346

I have had the same reaction but I took oral supplements of B12. It takes time to go away . May be 6 months. Traditional acne medications like antibiotics is not recommended because it has to go away by itself. It's been almost 3 months I stopped taking them . My skin is still very oily but the acne is decreasing. It might flare up again. I have seen this acne going and coming back like a cycle. Almost everyone has had this reaction. It will take a few months to go away. Be patient

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