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This can be particularly appealing to patients who have struggled with low levels in the past and want something more reliable than oral supplements

Some studies suggest that vitamin B12 may influence bacterial activity on the skin, which can play a role in the development of acne

Chronic or low-grade conditions often respond to oral dosing

Options for B12 treatment include injections, patches and pills

In rare cases where B12 is essential but acne remains intractable, dermatologists may consider oral isotretinoin, which in the UK can only be initiated by consultant dermatologists and requires strict monitoring, including a pregnancy prevention programme for women of childbearing potential

Hospira (now a Pfizer company) produces pharmaceutical-grade bacteriostatic water that meets USP standards