I believe the cream is used mostly on children, in the autism community.

We had quite a bit of spamming by the distributors of the patch, so I am not much of a fan of them. The patches are very expensive compared to the oral form.

People sort of gravitate to technical advertising. So they fill a niche of sorts.

Since medical papers have shown in studies that oral works as well as injectable, I don't see the need for other forms.
For children, the cream is a definite solution. The autism community also uses magnesium creams. It can be very difficult to medicate an autistic child.

Oral should be taken on an empty stomach for best results.

If you want to pay $1.00 a day instead of .09 to .30 cents a day..that is your choice. That is the price difference with the patches. Their website did a "study" using TWELVE people.

Some sophisticated additives are used in the patches, including selenium. (at least one brand).
The patches use synthetic cyanocobalamin. The cream is methylcobalamin.

Patch technology was developed originally by NASA for motion sickness. I will tell you that over the years, patches made for RX drugs... PD--example Neupro (http://parkinsons.hopedigest.com/blo...sease_patients), fentanyl, scopalamine, have all had manufacturing failures and have been recalled here and there.
If experienced drug manufacturers cannot get it right, I don't really trust an OTC company to be better than this either.
So I don't have much faith in the B12 patch. B12 is a huge chemical molecule and very difficult to get to cross the skin barrier.