Pernicious Anaemia Society

Spotty irritated forehead after B12 Injections

Hi all, Having never had bad skin in my life I was wracking my brains as to why, all of a sudden my forehead has become spotty (More lumpy under the skin), red and sore. Started about 2 days after my 8th injection (Has been having 2 weekly, all 10 completed since early last week). I didn't present with any issues, but apparently, my levels were deficient after being checked in a routine blood test. I was advised I would feel more energetic mid-end course, but hand on heart feel no different at all! (Maybe they got the results mixed up!) Anyway, the fact remains, I did have 10 injections and this probably does explain the skin irritation that is progressively getting worse since my last injection. I know I need to play the waiting game. Can anyone recommend a useful non-intrusive cream that would help? Or a mask? Thanks so much :)

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Hi fufu1981 it's probably best to see a pharmacist about your skin problems.

A previous respondent wrote this on the subject:

B12 Side effects

"The pimples/acne, is likely to be caused by microbes on your skin reacting to the additional B12 by producing substances that your skin is then reacting to. In theory this could be resolved by use of a good skin wash. You might have better luck talking to your pharmacist and seeing what they can recommend prior to your next maintenance shot - though there is always a chance that it was something that won't recur".

It is not uncommon for some symptoms to appear to get worse before they get better as the B12 starts repairing the damage done to your nervous system and your brain starts getting multiple messages from part of the body it had "forgotten about" or lost contact with.

I sometimes liken it to a badly tuned radio on which you have turned the volume up high trying to catch the programme you want when all of a sudden the signal comes in loud and clear and the blast nearly deafens you.

A lot will depend on the severity and longevity of your B12 deficiency as to how long before there is no further improvement or recovery.

Some symptoms will "disappear" quite quickly whereas others may take months or even years. There is no set timescale as we are all different.

If you can get to see a doctor please also ask him/her to check your Folate level as this and B12 help your iron to make red blood cells and to function properly.

I am not a medically trained person but I've had P.A. (a form of B12 deficiency) for more than 45 years.

I wish you well


Thank you!


Would suggest you speak to a pharmacist - the most likely explanation is that it is micro-organisms living on your skin reacting to the B12 by excreting a toxin that your skin is then reacting to. A wash might help.

If you were B12 deficient then that would have lowered your immune system and it may now be kicking back in - but it often seems to kick back in in overdrive so that reactions to toxins etc are much more vigorous than normal but then settle down.

If you weren't symptomatic before then it may be that you weren't deficient but have fallen prey to failure to understand how to really interpret test results - 5% of people below the normal range will actually be okay. On the other hand symptoms of B12 deficiency do creep up on you very slowly so can easily be put down to just getting older. Worth taking a look at the list of symptoms and ticking everything that applies - even if it has been around for years.

I can trace my symptoms back 40+ years before I was diagnosed as having a B12 absorption problem.



Thanks so much :)


Hi, I had an awful face - very sore - after my injections. I read it was the possible detoxing of homocysteine coming out through your skin - after all, the skin is our largest organ. Keep the face clean using water was the advice given. I used Elemis products, especially the green pearls on a night, it just seemed to help calm everything down and they are fairly natural. Be careful you don't use products that are too harsh. I think I would try calendula cream now.

Drink lots of water to flush everything through. They will improve. Honest. I can empathise, i was so embarrassed - but no one seemed to notice!

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Its the dry red soreness of it too! A constant reminder that its there! Hopefully, it will ease over time! Hope yours cleared up too!

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"my levels were deficient after being checked in a routine blood test"

Just wondered if your doctors had explained what they thought was causing your low B12 levels?

Risk factors for PA and B12 Deficiency


Symptoms of B12 Deficiency

pernicious-anaemia-society.... See Checklist PDF on right of page

B12 books I found useful

There may be something about side effects of B12 injections in these.

"What You Need to Know About Pernicious Anaemia and Vitamin B12 Deficiency" by Martyn Hooper

Martyn Hooper is the chair of PAS (Pernicious Anaemia Society). Book is up to date with UK B12 guidelines.

"Living with Pernicious Anaemia and Vitamin B12 Deficiency" by Martyn Hooper

Has several case studies.

"Could it Be B12; An Epidemic of Misdiagnoses" by Sally Pacholok and JJ. Stuart (USA authors)

Very comprehensive book about B12 deficiency with lots of case studies.

In UK, NHS uses hydroxycobalamin and sometimes cyanocobalamin forms of B12. People may respond differently to different forms of B12. There are also methylcobalamin and adenosylcobalamin forms.

UK link about hydroxycobalamin mentions rashes with IM use.

Lots more B12 info in pinned posts on this forum.

If you do a search for posts on PAS forum with acne or rash or spots in the search box (top right of page) there should be some posts from people with similar issues.

I hope you find something to help with your skin problems.


Thanks so much, they didn't explain anything, but I am back in 5 weeks to get bloods done (Will be 6 weeks since my last injection so they will be checking my levels) and at that stage I'll be asking questions! Thanks for the references too, I will look into them :)


Hi again,

"they didn't explain anything,"

Are you in UK? I'm asking because patterns of B12 treatment vary from country to country.

If you're in UK, I'd suggest reading all of the following

BMJ B12 article

BSH Cobalamin and Folate Guidelines

Flowchart from BSH Cobalamin and Folate Guidelines

BNF British National Formulary

NICE clinical knowledge summary B12 and folate deficiency

PAS (Pernicious Anaemia Society)

Have you been tested for PA? In UK, people with suspected PA are usually given an Intrinsic Factor Antibody (IFA) test. See Flowchart link above.

IFA test is not always reliable and it is still possible to have PA even if IFA result is negative or normal range.

Have you had tests for Coeliac disease? In UK, NICE guidelines for Coeliac disease recommend that anyone with unexplained B12, folate or iron deficiency is tested for Coeliac disease.

NICE guidelines Coeliac disease

Diet and B12 deficiency

Do you eat a diet that has plenty of B12 rich foods eg meat, fish, shellfish, dairy and eggs?

If yes then it becomes less likely that low b12 is due to diet and more likely that there is an absorption problem. See Risk Factors in my first post for more info.

Link about What to Do Next if B12 deficiency is suspected (mainly UK info)

Blood tests

Do you get copies of all your blood test results? In relation to B12, I look particularly at B12, folate, ferritin and full blood count.


Full Blood Count

Blood Film

Folate Deficiency

I am not medically trained.


Hi Sleepbunny, I am in the Rep. Ireland. I will read the links, thanks for sharing them. I didnt get the results but will ask for them when I ask there for my next bloods (Feb 14)



I'm not aware of any national guidelines on B12 deficiency in Rep. Ireland. I think the doctors there tend to use UK guidelines.

If you start another thread and put Rep. Ireland in title. you may attract attention of others on forum from Rep. Ireland who might know of any national guidelines.

B12 blogs

Martyn Hooper's blog about PA

B12 Deficiency Info blog


My daughter experienced the same thing when she first started her B12 injections. It was really bad and she even got them in her scalp. We tried everything and nothing really helped. I really do believe it is your bodies response to finally getting B12 in your system. About 6 months into injections it stopped happening so hopefully that will be the case for you also. We found just basic Dove soap and water was the best for her. The more we used other products the worse it got. Hope this helps!


Thank you for responding. I just steamed my face and did the original face mask from glamglow. Done and moisturised (usually my regular moisturizer, avoiding any new products for now) and it has helped alleviate the redness and discomfort. Not gone by any stretch of the imagination but it definitely helped. And avoiding makeup for a few days. Vanity taking a hit. And 4 weeks into this bad skin business I gave up smoking 5 days ago which no doubt is adding to the toxins leaving!


Hi i had serve scalp & face ache after my loading jabs they were horrendous got horrible scaring & bold patches just hope it doesn't start again now I'm having loading jabs again. I guess it's a small price to pay to feeling well & human again 😁



I think this happens a lot as I got a red rash on my forehead & bumps/spots around my chin after my loading doses. They did subside after a week or so. All I used was tea tree gel which seemed to help. Like others have said it may be toxins being released . I am not due any more shots until Feb now so remains to be even if spots & rash will appear again !!

Hope you get some relief.



My chin has since broken out too! What teatree product did you use?


Hi again in answer to your question

I used a gel by 'Witch naturally clear 'with witch hazel extract, comes in a green tube.

It is reasonably priced & I bought it from Superdrug.

Google it for a stockist in your area , it should be easy to get hold of.

It worked for me & gave relief so hopefully it will do the same for you.

Let me know how it goes !



Hi i had serve scalp & face ache after my loading jabs they were horrendous got horrible scaring & bold patches just hope it doesn't start again now I'm having loading jabs again. I guess it's a small price to pay to feeling well & human again 😁

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I completely agree, except for me, I didn't feel unwell, to begin with and feel no different now! Still, I am hoping there are hidden benefits!


Hi fufu, I didn't get spots on forehead so much from injections...probably because here they don't give so many, but I use the b12 patches and they cause itchy spots on forehead. Hope you get the help you need

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