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Your skin needs time to heal itself and when you injure skin (which microneedling does) while it is already inflamed, there is risk of scarring and pigmentation changes

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Unfortunately, some patients have difficulty absorbing an adequate amount of vitamin 12 because they do not produce enough stomach acid due to a condition called autoimmune atrophic gastritis which can cause a deficiency of vitamin B12

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14 It recommends rapid initiation of alternate-day intramuscular hydroxocobalamin therapy, and maintenance of this treatment until all symptoms have resolved or there is no further neurological improvement, with long term B 12 therapy depending on the presence of deficiency on presentation, together with total abstinence from the use of nitrous oxide