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Your main struggle is with pigmentation , and you've tried many topical bleaches/serums with limited success

Practical note on titration: tirzepatide titration schedules described in trial and community sources typically step up from 2.5 mg 5 mg 7.5 mg 10 mg 15 mg every 4 weeks

Regarding the form of vitamin B12 used, cyanocobalamin was the most common (n = 14), followed by methylcobalamin (n = 6), hydroxocobalamin (n = 4), and combinations including adenosylcobalamin in isolated cases

Some of the treatments available include: At Evenly Clinic, we offer Q-switched Nd: YAG laser technology for effective skin whitening treatments