Seth Roberts on Acne: Guest Blog, Pt. IV

Here is the latest post from our guest blogger, Seth Roberts. If you need to get up to speed on Seth’s unorthodox research with weight-loss, mood, and sleep, click here (our N.Y. Times article about him), here (research extras and pix), here (the first round of reader comments), and here, here, and here for his earlier blog postings.

Thu., Sept. 15

I told Dubner my students laugh when I say “pimple.”

“They laugh when Levitt says ‘crack cocaine,'” Dubner replied.

My acne began as a teenager. These things go away with time, a dermatologist told me. When, I asked. Everyone is different, she said. I wondered: Doesn’t she know the concept of average? Whatever she prescribed, it didn’t work very well. When I was a graduate student, I saw a different dermatologist. He prescribed both pills (tetracycline, a wide-spectrum antibiotic) and a cream containing benzoyl peroxide. I used them. They too didn’t seem to work very well.

Around that time, I began to do little self-experiments simply to learn how to do experiments. I was following the advice of Paul Halmos, a mathematics professor: The best way to learn is to do, he had written — words that slowly changed my life. The first way they changed my life was when my little experiments expanded to include my acne. It is hard to measure acne, I thought, so I am probably wasting my time. But it was worth a try. I did my best to count the number of new pimples each day. I varied the number of pills I took: Week 1 a certain number per day, Week 2 a different number, Week 3 the first number. The results implied that the pills had no effect. I told my dermatologist this result. “Why did you do that?” he asked, truly puzzled and slightly irritated.

I did more little experiments varying the number of pills per day. The results kept indicating the pills were useless. One day I ran low on pills, so I started to be more careful about using the cream, which I considered useless. My acne suddenly improved two or three days later. It was cause and effect (speaking of delayed causality). You could just look at the time series — one number per day, the count of new pimples — and see this. Just once, if I remember correctly, I stopped using the cream. Two or three days later, my acne got worse. I resumed the cream. Two or three days later, my acne got better. :-)!

That was even better than learning that something was useless. Consistent use of the cream helped a lot. Over the next several years, I only made two further advances. First, I found that a Vitamin B pill helped, probably a multi-B pill. Second, based on the idea of a two- or three-day latency, I discovered that certain foods caused pimples. If my acne suddenly got worse, I tried to remember what I had eaten two or three days earlier. Diet Pepsi and pizza were the main culprits. Taking all this together, I reduced my acne about 90%. Then, as predicted, it faded away.

A few months ago I saw a dermatologist about a different problem. I couldn’t resist: What causes acne? I asked. Well, not diet, he said. I knew this was false. And, really, how could you say such a thing without testing hundreds of different diets — at least? Which no one had. Several years ago I asked my friend Katharine Milton, a Berkeley anthropologist, whether the indigenous people she studies have acne. No, she said, unless they eat foreign food. The anthropologist was right, the doctor was wrong. The situation reminded me of something in an NIH-sponsored online medical encyclopedia: dental malocculsion, it said, “is most often hereditary.” Whereas the work of Robert Corruccini, a professor of anthropology at Southern Illinois University, such as this, had convinced me that dental malocculsion is due to soft food.

It does seem to boil down to laughter, or rather fear of laughter — fear of loss of status. Dermatologists have a fancy word for pimple but they don’t have a fancy word for small. To slowly vary the diet of one patient at a time, year after year, to figure out what dietary elements cause acne is not even close to being sufficiently high-status. It is too risky, not to mention too grubby and too low-tech. It isn’t the sort of thing that produces several publications a year, or a large grant. So a whole class of promising solutions — dietary changes — goes unexplored.

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  1. Masa'il says:

    Sorry to post off-“acne” topic, but…

    Seth, would you be so kind as to address the queries on your state of health following your “diet”? Or any caveats?

    Many of us fear this is simply too good to be true, and wonder if you indeed have anemia, hypertension, hypotension, torsotension–something!

    If this thing does work (and having studied your papers, it makes far more sense than anything else I’ve heard), this will be the best thing for the health and well-being of humanity since vaccines. A BIG DEAL!!

    So, Seth, please speak up, and scientists out there, get cracking studying his methods! If true, this would change everything for billions. And change the whole world! Meanwhile, I’ll replicate with another n=1: myself.

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  2. who, me? says:

    The physicians’ response you’re describing suggests they’re highly trained not in order primarily to observe or cure. They function
    –as consumers of technical reports;
    –with the cultivated and attributed air of authority to obtain some compliance with the grossly-stated and applied conclusions of those purchased reports.

    Your approach, OTOH, is setting up experiments (which may derive from the physician-promulgated information) in the universe over which you have control, and to which you have access. The results are highly relevant to that universe. At that point, the information is released so we “other universes” can experiment toward replication to test not the validity of your experiments, but the size and nature of the universe to which such results apply.

    Now that’s science, in a new democratic variation of the paradigm. And the re-fragmentation of investigation sounds rather like MSM and blogs, especially given the channels of the reports.

    Very cool.

    One can sit for 20 minutes in a public place and see not just obesity, but the social sorrow associated with it. No one could estimate the grief lifted from the world, if your weight loss is safe and generalizable.

    Distributed, and intelligent, all this.

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  3. Paul Bowers says:

    acne is absolutely diet-related. as the anthropologist noted, indigenous people seldom suffer from acne unless they drop their traditional diets.

    weston price d.d.s also found that people eating traditional diets were alomst completely immune to dental carries (as well as all diseases of “civilization”), until the “modernized” and changed their diets.

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  4. Anonymous says:

    I’m not sure I agree that you are better than the dermatologist. You still have a sample size of one. Do you try reintroducing diet Pepsi and pizza to see if the zits returned? I’m sure there could have been other factors which changed during your experiment. My zits went way eventually and I don’t perceive that my diet changed much. I’m not saying you are wrong but you certainly haven’t convinced me.

    Not only that but you talked to a total of 2 dermatologists and make a broad statement about dermatologists. My dermatologist said there was a link between diet and zits.

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  5. Anonymous says:

    from the simpsons:

    Hibbert-Why the only cure is bed-rest. Anything else I could prescribe would merely be a placebo.
    [General hysteria]
    Woman-Where do we get these placeboes?
    Man-Maybe theres some in this truck!
    [Said truck is duly broken into, unleashing a horde of killer bees.]
    Man-Wow, I’m cured!…I mean, ow!

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  6. Masa'il says:

    I must again post, to add to Paul Bower’s post:

    I’ve been living and teaching in Singapore and Malaysia for the past 4 years (married a Malaysian).

    One of the most striking things to see, here, is the incredible amount of deeply acne-scarred faces. This is accompanied by horrible teeth. My husband has them; almost everyone has them. The problems are very severe especially among the local Chinese populations–and is far worse than in America (where I grew up, poor white). However, the problem is noticeably less in the mainland Chinese students who emigrate here for school.

    Certainly holds up the diet theory: they’re richer here and eat far more convenience and fast foods, quite different from simple Chinese village food, as I can personally testify. Obesity is also emerging, although nowhere near the extent as in the US, yet. (I feel like I’m walking with dinosaurs when I go home.)

    Great discussion…

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  7. Paul Bowers says:

    actually, there is already a wealth of research, as well as anecdotal evidence, that supports health-promoting, satiating, low-carbohydrate diets. the science behind this is verifiable and has been reproduced by both controlled studies and millions of people.

    the obstacles these diets face are the same ones dr. roberts will most likely encounter once his diet is launched; they aren’t dependent on “health experts”, and big pharma can’t cash in on them. in fact, the medical community and drug companies stand to lose big time if these diets become, and stay, mainstream.

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  8. seth roberts says:

    yep, great discussion!

    Chris (who posted at 9:23 am) could you get in touch with me? I’d like to hear more about what you did. My email is my phone is 510.418.7753.

    my health is fine. my blood pressure is slightly better than 120/80. My cholesterol levels are so-so. They were the best they’ve ever been right after I lost 40 pounds. When I cut back on the fructose, they got worse. My paper “Self-experimentation as a source of new ideas” discussed how I stopped getting colds (at least, obvious ones) when I started to sleep much better. This has continued.

    Seth Roberts

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