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Why do the lesions develop and then heal rather than persist indefinitely if high serum vitamin B 12 caused them to form? While it is interesting that one in ten healthy subjects injected with high dose vitamin B 12 developed acne, adds Eady, it is more significant that nine out of ten did not

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The British National Formulary (BNF), for example, differentiates the prescription of hydroxocobalamin according to presenting symptoms, eg, For neurological involvement, it is advised to administer hydroxocobalamin by intramuscular injection, initially 1 mg once daily on alternate days until no further improvement, then 1 mg every 2 months. In the Netherlands, pharmacotherapeutic guidelines51 recommend (for the same neurological symptoms or abnormalities) administration of 1000 mcg once or twice weekly for up to two years