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I am 14 years old and I’m getting a lot of pimples.

Q:I am 14 years old and I’m getting a lot of pimples. My mom says I should just wash my face a lot with strong soap. But that doesn’t seem to be helping at all. So I did a Google search and came up with Metazene on your website. How good is Metazene, and how does it work?

A:Your mother’s approach to treating acne is the one used in the 19th Century. While soap and water can help the skin in some ways, it is useless for preventing acne. Soap and water do not reach the places in the skin where the problem arises.

Acne is caused by the following process:1

  • Androgenic hormones (which increase during adolescence) cause oil glands in the skin to become enlarged and overactive.
  • The channels that bring this oil to the skin surface become clogged with proteins that are produced in the skin.
  • Bacteria that normally live and multiply in the skin and oil can no longer escape to the surface. They produce inflammatory substances that irritate and damage the skin.

There are 7 basic approaches to treating acne:2

  • Retinoid drugs (like tretinoin)
  • Antibiotics (like tetracycline)
  • Bactericides (like benzoyl peroxide)
  • Steroidal hormones or hormone inhibitors (like estrogens or cyproterone)
  • Heat
  • Light (intense blue/violet light or laser light)
  • Anti-inflammatories

Most of these approaches have a downside:

  • Retinoids make the skin dry, red, flakey, cracked, and painful, and they cause severe birth defects.
  • Antibiotics work poorly, and have distressing side effects if used systemically.
  • Bactericides also work poorly, are inconvenient, and can damage clothing.
  • Steroids and inhibitors often have undesirable side effects, and sometimes even damage the body permanently.
  • Heat is not very effective.
  • Light therapy is very expensive and can cause burns.

That leaves the last approach: anti-inflammatories. This approach has minimal or no bad side effects, is inexpensive, and is available without hassle and without having to get ‘permission’ from a high-priced physician or a government bureaucrat.

There are a variety of anti-inflammatory therapies available, and they vary in effectiveness. These include: zinc, azelaic acid, tea tree oil; ibuprofen and other anti-inflammatory drugs; turmeric, witch hazel and other herbal anti-inflammatories; and niacinamide.

Of these anti-inflammatories, none can beat niacinamide and Hamamelis virginiana extract for effectiveness against acne and lack of undesirable side effects.

Once an acne lesion (pimple) is gone, the damaged skin needs to be repaired. While the skin does have repair mechanisms, they do not work well — if they did, we would not be seeing adults with faces scarred from acne episodes earlier in life. Aloe is a substance that can improve the skin’s repair process.

Let’s look at what is known about these substances as acne treatments.


Niacinamide (aka ‘nicotinamide’) is a member of the vitamin B3 family. In the body niacinamide is converted to NAD, which plays an essential role in many biochemical reactions.

Niacinamide’s ability to suppress acne results from several different actions it has in the skin:

  • It suppresses inflammation by decreasing the production of pro-inflammatory cytokines (signalling molecules)3, reducing free radical levels,4 and blocking the inflammatory actions of iodides.5
  • It reduces sebum production by hair follicles.6
  • It improves the skin’s water barrier function7, which is impaired in acne-prone skin.8

Niacinamide’s powerful anti-acne activity has been clearly demonstrated clinically.9

Hamamelis extract

Hamamelis virginiana (aka ‘witch hazel’) is a plant with a long history of medicinal use. In pre-Columbian times it was used by native Americans who steamed witch hazel twigs in a sweat lodge to treat many ailments. Today the twigs are chipped and extracted by steam distillation to produce an oil containing flavonoids, tannins, and other physiologically active components.10

Hamamelis extract has significant anti-inflammatory action, particularly when used on the skin.11 The mechanism for this activity is thought to involve the inhibition of signalling molecules that mediate inflammation — different signalling molecules than those that account for niacinamide’s anti-inflammatory action.10

Because this mechanism of action involves a different part of the inflammatory process than the part manipulated by niacinamide, Hamamelis extracts can have a synergistic effect when combined with niacinamide. This would explain why Metazene, which uses the two substances in combination, has such a remarkable impact on acne in many people.

Aloe leaf extract

Aloe, a gelatinous substance from the plant Aloe barbadensis (aka ‘Aloe vera’), is a traditional herbal remedy used mainly for skin ailments.12 In recent years scientific studies have shown its value in healing wounded skin.13 This activity seems to depend upon certain polysaccharides (chains of sugar-like molecules) that regulate cytokines involved in skin regeneration.12

Aloe is included as an ingredient in Metazene in order to stimulate the growth and repair of the skin where acne lesions (pimples) have occurred. Furthermore, aloe has anti-inflammatory properties that add to those of niacinamide and Hamamelis.14

No hidden ingredients

LifeLink reports that it has had queries from amazed users asking whether Metazene contains any ‘hidden’ active ingredients, such as prescription drugs, that are not listed on the label. Well, it doesn’t. Just niacinamide, Hamamelis extract, and aloe — a surprisingly powerful anti-acne combination.


Disclaimer: The information provided in this “Ask Dr. Zarkov” article contains no medical advice whatsoever — it contains biological information. Nothing in the article constitutes an effort to persuade readers to use, or not to use, this biological information as a basis for action.

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