acne from anemia

[Becca2023]

hi everyone I’ve just been diagnosed with pernicious anemia, I’ve just had the first 6 injections over two weeks and ever since my last one I’ve developed acne which I’ve never had. Any help would be appreciated

Thanks

[Technoid]

Although I haven't experienced myself, it is a known side-effect that's often reported. There is some coverage of possible causes in this article : b12-vitamin.com/acne/

[Sleepybunny]

Hi,

I hope you have a doctor who understands PA.

If you have any neurological symptoms eg tingling, pins and needles, other unusual sensations, tinnitus, balance problems, brain fog etc... the BNF suggests that loading injections should be every other day for as long as symptoms continue to improve (could be weeks or even months of them) then maintenance injections every 2 months.

At the very least if you have neuro symptoms, I would expect a UK GP to give more than 6 loading injections.

If no neuro symptoms are present, BNF suggests 6 loading injections over two weeks then a maintenance injection every 2 - 3 months.

BNF hydroxocobalamin

bnf.nice.org.uk/drugs/hydro...

Point 1 in this next link is about being under treated for B12 deficiency with neuro symptoms present. Link has letter templates to help people write to their GPs.

b12deficiency.info/writing-...

If you have neuro symptoms, don't let GP fob you off with inadequate treatment.

Acne is listed as a possible side effect of B12 injections in BNF (British National Formulary).

I had more spots when I started B12 treatment but it was fairly mild and eventually they stopped.

If you're not already a PAS member, worth thinking about joining.

PAS membership is separate to membership of this forum.

pernicious-anaemia-society....

Keep asking questions and I'm sure someone will be along to help you.

I've written some very detailed replies on the forum.

[Becca2023 in reply to Sleepybunny]

Thankyou for your help, I’ve just been recently diagnosed with it so I’m learning more about it. But the acne came out of know where, I’ve never suffered with it.

[Electricblue22 in reply to Becca2023]

I know the feeling, I have exactly the same problem as you. It's horrible isn't it.It's been 4wks since my last loading dose & I still have itchy painful spots appearing out of nowhere on my face & chest 🫤 my other symptoms due to b12 deficiency have started to wain though so I shouldn't complain really, but the side effects from these Hydroxocobalamin injections are really annoying to say the least.

[Pickle500]

Acne is a very common effect of the injections. Most people will get some form of spots. I don't think anyone can say for sure why they happen.

They will go away after a short time. Don't pop them or scratch them. If you can conceal them and keep the area clean you should find they do go away soon.

[B12life]

well i had acne rosacia for 1 year. took tetracyline to get rid of it. if the acne goes onto your chin and chest, it is most likely acne rosacea and may be related or absolutely pure coincidence. If this is the case, get to a dermatologist, and get a confirmation. If they confirm it is acne rosacea, then the ONLY thing that worked for me was a long stent of tetracycline (I tried EVERYTHING else for 6 months and that was the only thing that got rid of it. I don't think my acne rosacea hand anything to do with injections. I typically never get acne before until that break out. Not everyone is the same, but for me, I don't believe my case was related. I'm just giving a heads up so you can differentiate. My bro that wasn't doing injections also got acne rosacea and it took him a year to get rid of. I'm hoping you don't have that but helping you detect if it is. Normal acne doesn't go to chin and chest like acne rosacea will, so that's one key differentiator.

If you just have mild acne which just stays on your forhead and not on chin and chest, just treat it best you can with over the counter topicals and it should go away. Overdoing the topicals can cause other irritations, so don't over do it on those either.

Don't stop or reduce the b12 injections. I've been doing daily injections for 2 years. I no longer have the issues with acne.

[Scott-rock]

it could also be the homocysteine being removed from the body. It should settle down.

I did get more spotty at the start.

[Lurcher-lady]

same happened to me and continued for a few months of regular treatment, then disappeared altogether. Seems to be the system sorting itself out. I was 69 and not had it before, so was a bit surprised but it totally disappeared.

[MoKayD]

When I started B12 shots, pimples around my nose and hairline appeared. My forehead also seemed to be more oily than before. After a year or so the pimples disappeared.

[Sleepybunny]

A few links about PA and B12 deficiency that might be of interest.

PAS (Pernicious Anaemia Society)

Based in Wales, UK.

pernicious-anaemia-society....

There is a helpline number that PAS members can ring.

PAS membership is separate to membership of this forum.

There may be a PAS support group near you.

PAS support groups in UK

pernicious-anaemia-society....

B12 Info.com (formerly known as B12 Deficiency Info)

Lots of useful info and is run by a UK B12 deficiency campaigner.

b12deficiency.info/

Two B12 books I found useful

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

Martyn Hooper founded PAS (Pernicious Anaemia Society).

UK BNF treatment info in book is out of date. See BNF hydroxocobalamin link for up to date info.

"Could it Be B12?: An Epidemic of Misdiagnoses" by Sally Pacholok and JJ. Stuart (US authors)

Very comprehensive with lots of case studies.

There may be copies of these available from your local library service.

Some UK B12 documents/articles

NHS article about B12 deficiency and folate deficiency (simply written)

nhs.uk/conditions/vitamin-b...

NICE CKS (Clinical Knowledge Summary) B12 deficiency and Folate deficiency

(aimed at health professionals but easy to read)

cks.nice.org.uk/topics/anae...

There are currently new NICE guidelines in development for Pernicious Anaemia and B12 deficiency. These should be published in 2023.

nice.org.uk/guidance/indeve...

If you click on "project documents" then on "consultation comments and responses" it gives a good insight into current issues around diagnosis and treatment.

Local B12 deficiency guidelines

I usually suggest to UK forum members that they find out what's in the local B12 deficiency guidelines that their ICB (Integrated Care Board) or Health Board uses.

List of ICBs in England

nhs.uk/nhs-services/find-yo...

If you can't find them on this forum or online, you could submit a FOI (Freedom of Information) request to ICB/Health Board asking what b12 deficiency guidelines are used locally and for a link to or copy of them.

The reason I make a point of this is that the local guidelines can vary from NICE/BNF and BSH (British Society for Haematology) guidance. There are some good local B12 deficiency guidelines in UK but there are also some that are unhelpful.

See blog post below about local guidelines in one area of England.

b12deficiency.info/gloucest...

[Beccy_123]

I had this and still have this, 12 weeks on and injections every other day. I read that taking biotin can help, and I think this does indeed help me, as I have tried reducing the days I take biotin, and this seems to make it worse. It is an unfortunate effect for some, but I would far rather suffer this than the crippling effects of PA any day. 😘

[Wwwdot]

Becca2022

What a great question! I am into month 2 of every other injections and have broken out on acne on me forehead and chin and I don’t usually have acne issues. It didn’t occur to me it could be the B12! 🙄

I am using a mud pack on the spots which helps but what is more helpful are the responses to your questions explaining firstly that it’s normal and secondly it’s the exit route for toxins!

Happy day - bring on the spots - but not in the end of my nose please! 🧙‍♀️

[Cherylclaire Forum Support]

This seems to be quite common when first having injections.

In fact, it is the only negative aspect of B12 injections that I have heard of here - apart from a few people being allergic to certain brands due to additives.

I got these acne-like red spots - around hairline, on face, ears and neck, but also up nose and in ear canal. They did not last long and are best left alone. They never seem to come to a head- the inflammation reduces and each spot will dry up after a few days. A few people unfortunately get stuck with this side-effect - but this is rare and I would imagine that a few spots compare favourably to the range and severity of symptoms that B12 is managing.

Strangely, after I've had a "blip" - a sudden inexplicable surge of B12 deficiency symptoms despite regular self injection - I find that these spots return, as if I'm starting all over again with B12 treatment . Luckily not often and never as bad as at first - the ones down my ear canal would catch me unawares as not visible, so these were the worst to me. I expect if I was much younger, the ones at the end of my nose might have been least-favourite.

I hope you find that symptoms improve. For some, this can take a while. Please take note of the difference in treatment regime if neurological symptoms experienced - see Sleepybunny 's reply above. BNF is the British National Formulary - the "Doctors' Bible".

[B12life]

update:

I know I spoke of acne rosacea; however I'm now a believer the acne I have this round is indeed due to the b12. It's on my face mainly. Not on my chest like the acne rosacea was. But this is just as bad. Huge spots all down my face. They wouldn't go away for 6 months or more.

mine started to clear up after I did. two things:

Started taking lot of b5 - Pantothenic acid

and switched from the hervert b12 to the Canadian b12.

I did. the b12 brand switch first and got some results but in the end I think the b5 is working. It takes 7-12 weeks of taking it.

I have never had acne before so it must be the b12

my acne is fortunately localized to my face.

I also boil water in a post then turn off the heat and my face for 7-10 min. Then do a hydrogen peroxide and baking soda paste. I did that once a week or whenever my fave would want to start getting oily.

Those things have helped tremendously

I really think the b5 and steaming with topical meds did the best. I may go back to the hervert b12 as it really does help with my b12 symptoms!