You mentioned your skin has always been fairly resilient, but recently it’s been reacting more than usual. The forehead texture and closed comedones show your skin is producing extra skin cells and oil, likely triggered by the B12 injections and supplements. The barrier is slightly compromised, so it’s craving balance and hydration, but it also needs gentle exfoliation to help the comedones come to the surface without causing more irritation. Retinol and BHA have been used inconsistently, which can create more inflammation when the skin is already sensitised. Your perioral area has also shown signs of perioral dermatitis, so strong actives should be avoided there for now. The goal is to restore your barrier, calm inflammation, and bring the skin back to a balanced state using a consistent, simple routine.