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The use of anti-infective agents or pyrimethamine may invalidate diagnostic assays for folic acid and vitamin B12

Too little may be ineffective, while too much could increase side effects or reduce efficacy

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As a result, the acne bacteria could concentrate instead on using their cellular machinery to churn out more compounds to attack our face and induce inflammation in acne. Indeed, as you can see here and at 3:53 in my video , without excess B12 on the skin (with B12 shown in green), the bacteria have to make most of it on their own at the expense of porphyrins (shown in red), which can trigger acne inflammation