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8 Where results are unclear, serum MMA and homocysteine levels (both of which accumulate with B12 deficiency as discussed above) can also be used to confirm a diagnosis, although homocysteine is not specific to B12 deficiency, as it may also be caused by deficiencies in other B vitamins

Safia Pirani MD provide a specialized B12 service that prioritizes diagnostic accuracy

10.1007/s10059-013-0044-7 116 XuX.ZhuY.LiangZ.LiS.XuX.WangX.et al

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F., Grodzinsky, A

However, the AAD says that cleaning your skin properly and keeping your hands off your face can help