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Treatment typically requires intramuscular hydroxocobalamin injections (1 mg three times weekly initially, then every 23 months lifelong) when malabsorption or neurological symptoms are present

Warnings and Precautions Insulin pens, needles, or syringes must never be shared between patients

However, mild effects such as temporary redness, tingling, or dryness may occur, especially after microneedling or injection procedures

Melatonin enhances antioxidative enzyme gene expression (CAT, GPx, SOD), prevents their UVR-induced depletion, and protects against the formation of DNA damage (8-hydroxy-2-deoxyguanosine) in ex vivo human skin