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It lowers melanin activity, but the effect is not permanent

In the UK, hydroxocobalamin 1 mg intramuscular injection is used: Without neurological involvement : 1 mg three times weekly for two weeks, then maintenance of 1 mg every two to three months With neurological involvement : 1 mg on alternate days until no further improvement in symptoms, then maintenance of 1 mg every two months Lifelong maintenance is required for pernicious anaemia or other irreversible causes of deficiency Oral B12 supplementation may be appropriate for diet-related deficiency in patients without neurological symptoms and with adequate absorption capacity

Environmental Conditions: Dry weather, hot showers, and harsh soaps can contribute to dry and itchy skin by stripping away the skin's natural oils

Theoretical and route-specific risks FDA's 2024 review specifically flagged that no published human exposure data exists for the subcutaneous, transdermal, or intranasal routes that compounding pharmacies have offered

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