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.

GUEST BLOGGER:
“Acne”
by SETH ROBERTS
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.


Masa'il

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.

who, me?

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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Paul Bowers

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.

Anonymous

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.

Anonymous

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!

Masa'il

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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Paul Bowers

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.

seth roberts

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 roberts@berkeley.edu. 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

Elam Bend

Seth,
Sorry for my ignorance, but reading your paper, I could not discern what the mixture rate of the sugar and water is. For instance, is 4oz. of sugar water equal to 4 table spoons of sugar and 4oz. water? How would someone like me (with poor lab experience) mix your concoction?
ElamBend

Anonymous

It's been about 30 years ago, but my acne was cured either by regular sex or by salads with olive oil. My new bride brought both of these with her, and I didn't think to experiment and stop either of them (would you?)

nimnar

seth,
I was kind of nasty in an earlier post about your diet suggestions. I apologize. I have been trying Canola oil and after 3 days I believe it's helpful in significantly moderating appetite.
Nimnar

penxv

Bowers,
-The obstacle isn't big pharma or the medical community.
-This new diet along with the Atkins diet are helpful for losing weight, but it isn't technically healthy. There is no substitute for a balanced diet and exercise.
-I wouldn't suggest Atkins' or Roberts' plan to anyone who isn't obese.

penxv

And it makes sense that acne is an alergic type response to foods that are foreign to our immune systems, but there is definitely a hormonal aspect to it as well.

Anonymous

Seth,

Speaking of self-experimentation, have you heard of Terrence Howard? He's the star of a movie released this summer called Hustle & Flow. Anyway, I saw him interviewed on TV this summer and apparently when he was young he came down with an ear infection that left one side of his face paralyzed. Somehow he found out from the doctor that electric shock treatements might be able to reverse the paralysis but his family couldn't afford them. So he set about shocking his own face everyday with some homemade contraption and after several months - whaala! he regained sensation in his face. The interviewer was like, wow, you are persistent, some of us might have stopped after a few weeks.

http://www.cbsnews.com/stories/2005/08/05/
earlyshow/saturday/main763129_page2.shtml

Paul Bowers

penxv,
care to define what "healthy" means? also, what is a "balanced" diet? i could burn freakonomics bandwidth with just the links to the research that supports reducing CHO intake.

Anonymous

I too went and was provided the same exact treatment for my acne. The only exception was that I also was getting pimple-like bumps in my armpits of all places. He said it was blocked adenoid glands. For this he gave me a topical antibiotic in what I refer to as "the bingo dabber". Ironically enough I did almost the same thing you did. Took away one just to see if there was any improvement. I found that using the cream 3-4 times a week reduced the acne a lot. When a pimple did appear, the dabber could get rid of it in a day(face, underarm, neck). I gave up the pills. I found that taking the pills alone did nothing. I will definitely try the vitamin B though.

penxv

-I would call a healthy diet the kind that keeps people alive for the longest amount of time.
-Limiting caloric intake can make people weigh less, especially if you are fat, but that isn't necessarily going to help you to live longer.
-A balanced diet would be roughly 20% protein, 20%fat, and 60% carbohydrates. It doesn't really matter what you eat as long as your body gets all of the necessary vitamins and nutrients. Deficiencies can lead to health problems and lessen your life span.

StCheryl

I had moderately bad acne on my face and bad acne on my back as an adolescent. Under a dermatologist's supervision, I took tetracycline and used topical Retin-A. The Retin-A essentially burned off the top layer(s) of skin, and I now have stained teeth of which I am reminded whenever I see a new dentist. I gave up both pretty quickly. In my mid-20s, I moved to the Silicon Valley and began riding my bike 10+ miles a day. Dehydrated, I began drinking 100-120 ounces of water daily, gave up all sodas, and signficantly cut back on drinking fruit juice. The acne went away, never to return.

Prior to drinking a lot of water, the only thing I ever found that worked at all well on acne was rubbing apple slices on my face.

Anonymous

Seth-

I didn't run an experiment, but I have had the exact same results - and heard the exact same things from dermatologists.

I took the tetrocycline (sp?) and benezyol too. They didn't work at all. The Doc said diet had no bearing. When my acne was bad around age 16 (mostly just on my back) the most vicious outbreaks would occur a day or so after eating chocolate or pizza. School cafeteria's are loading with greasy food and those didn't help either.

Now I have much less acne on my back, but chocolate, pizza, or some other greasy food can still brink on some pimples. The sun is incredibly good for my back (acne). Everytime I've been surprised to find that my back is completely clear (somewhat rare) I think back... I haven't eaten chocolate or pizza in over 2 weeks, and I've gotten some sun. That's always the scenario.

That doesn't sound very high tech, but if you do a study of acne on kids from California and Minnesota (or some other cold weather state)... the Cali kids will probably have less acne on average (more sun). Also include the study to cover the diet of their parents or them, if you can nail that down, but it's hard since teenagers just eat whatever is put in front of them. Include diet and I'll bet the averages become even more polarized. It would be interesting to see the numbers... and yes, it would sound completely un-professional.

Lastly, stress seemed to have a very small impact, although the docs always told me that was a big factor. Isn't 'stress' always a huge factor, I'm kind of sick of that crap. Also, water quality in your home. I've always suspected that hard water equaled more pimples. A few of the very rich homes I've been in have had exceedingly soft water... just a hunch, but I think it helps. Perhaps water pressure as well. If that was included in a study, it could turn up something too.

-Andy Wink
Juneau AK

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Hopscotch

For the last few days I've been trying to think about the relation between 'set-point' and 'metabolism'. It would be interesting to see what happened with someone at a healthy weight, who began taking sugar-water or oil between mealtimes, but continued, despite a reduced appetite, with the same caloric intake as always (including the sugar/oil in the count), and if had a weight change or not. (I am sorry if that too-long sentence got grammatically fershuganah.)

I think all of the diet questions are fueled in part by a fear that in trying it out, and getting it wrong would somehow wreak havoc, and say, make it then thereafter not possible to achieve a lack of appetite from swallowing 2Tb of flavorless oil, if one had once had the oil 20minutes after, say, a snack, and had permanently made a calorie-flavor link, never to be broken. It would be interesting to hear from Seth (hint hint!) about such malfeasances, and assurance or warning about such.

*Note to Sally, Enova-taker: I'd try a nice organic cold-pressed oil instead and see if that little headache doesn't go away -- my semi-educated guess would be that it very well may be related to the laboratory-made, chemically expelled nature of the Enova.

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