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B12 supplementation may alter gene expression in Cutibacterium acnes bacteria, increasing porphyrin production that promotes follicular inflammation High-dose B12 (especially intramuscular injections of 1,000 micrograms) appears more likely to trigger acne than dietary intake The effect is relatively uncommon and does not affect most people taking B12 supplements Topical acne treatments (benzoyl peroxide, adapalene combinations) can manage breakouts without discontinuing necessary B12 therapy Never stop prescribed B12 treatment without medical supervision, as untreated deficiency causes serious neurological damage and anaemia Suspected adverse reactions to B12 should be reported through the MHRA Yellow Card scheme Table of Contents Can B12 Vitamins Cause Acne
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(2019) 73:354–63.e3
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