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The literature is still developing

Once opened, vials remain microbiologically stable for up to 28 days when stored appropriately

In this article, we will explore some of the various theories that are currently in circulation, which outline the cause as: Excessive production of porphyrin by skin bacteria stimulated by B12 A cobalt allergy Relative deficiency of vitamin B12 cofactors A detoxification reaction Vitamin B12 Acne The Work of Skin Bacteria

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References: Abdelwahab, O