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Using a fresh, sterile needle for each injection and never reusing or resharpening needles eliminates the risk of bent or blunt needles that might slip into vessels rather than pierce cleanly through tissue

The primary limitations identified included the absence of a list of excluded studies and justification, as well as a written or registered protocol for the included studies, a lack of detailed funding sources, an assessment of risk of bias, and a discussion regarding the heterogeneity observed

Excessive side effects at any dose requires reduction by 50-100mcg or temporary pause allowing tolerance development before resuming at lower dose

In addition to acne, vitamin C is important for skin structure