Seth’s blog

This article reports that there was no acne whatsoever among the Kitava Islanders in Papua New Guinea and the Ache hunter-gatherers in Paraguay. Here is the abstract:

BACKGROUND: In westernized societies, acne vulgaris is a nearly universal skin disease afflicting 79% to 95% of the adolescent population. In men and women older than 25 years, 40% to 54% have some degree of facial acne, and clinical facial acne persists into middle age in 12% of women and 3% of men. Epidemiological evidence suggests that acne incidence rates are considerably lower in nonwesternized societies. Herein we report the prevalence of acne in 2 nonwesternized populations: the Kitavan Islanders of Papua New Guinea and the Aché hunter-gatherers of Paraguay. Additionally, we analyze how elements in nonwesternized environments may influence the development of acne. OBSERVATIONS: Of 1200 Kitavan subjects examined (including 300 aged 15-25 years), no case of acne (grade 1 with multiple comedones or grades 2-4) was observed. Of 115 Aché subjects examined (including 15 aged 15-25 years) over 843 days, no case of active acne (grades 1-4) was observed. CONCLUSIONS: The astonishing difference in acne incidence rates between nonwesternized and fully modernized societies cannot be solely attributed to genetic differences among populations but likely results from differing environmental factors. Identification of these factors may be useful in the treatment of acne in Western populations.

This implies that acne isn’t inevitable. It’s almost surely caused by something environmental — perhaps diet, perhaps something else (such as washing your face with soap). That’s why self-experimentation about acne is promising: By changing your environment in various ways, you may be able to figure out what’s causing your acne.

In this post Andrew Gelman comments on my recent post about acne self-experimentation. He makes an excellent point about drug-company studies:

How would you want to evaluate the risks and effectiveness of a new drug that was developed by a pharmaceutical company at the cost of millions of dollars? I’d be suspicious of an observational study: even if conducted by professionals, there just seem to be too many ways for things to be biased.

Right. And it’s not just observational studies. The data from any big study can be analyzed many ways. The more at stake, the greater the chance of what Andrew calls bias and I call making choices that favor the result you prefer. Independently of Andrew, Hal Pashler and I came up with what I call the Pashler-Roberts Law: The more expensive the research, the less likely the researchers will be honest about it.

You may remember that Robert Gallo, the AIDS researcher, did very expensive research. The deception (possibly self-deception) that accompanied very expensive fusion research is described in Charles Seife’s Sun in a Bottle: The Strange History of Fusion and the Science of Wishful Thinking (2008).

As Andrew says, this is a big virtue of self-experimentation. Because it’s free, it’s easy to be honest, especially about failure. The cheaper the better is a broad truth about science that’s hard to learn from books or classes or even talking to scientists.

A year ago I told students at my friend’s Mohamed Ibrahim’s school that a student of Allen Neuringer’s had gone on a camping trip and found that her acne went away. At first she thought it was the sunshine; but then, by self-experimentation, she discovered that the crucial change was that she had stopped using soap to wash her face.

Now Mohamed writes:

I told my classes about your friend who went camping without her face products only to discover that the face products were contributing to her acne, and that from that point on she only washed her face with water. It turns out that two of my students wash their faces with water! And their skin looks great! I started “washing” my face with water about a month ago, and [now] my face is acne free and soft as a pair of brand new UGG boots. [He had had acne for years.] The only additional thing I do is wipe my face with a napkin throughout the day to remove any excess oil.

So one cause of acne is using soap to wash your face.

Acne really matters. And it’s common. It now turns out that it has a pathetically easy solution, in at least some cases. Dermatologists don’t know this. Apparently hardly anyone knows it. Somehow the entire healthcare establishment, to whom we entrust our health in many ways, missed this. Dennis Mangan’s discovery that niacin can cure restless-leg syndrome is another example of a pathetically easy solution missed by experts. Likewise, the Shangri-La Diet is very different than anything an obesity expert has ever proposed.

What else has been missed?

More Imagine a med student in a dermatology class. The student raises his hand and asks a question. “I read in a blog that acne goes away if you stop using soap. What do you think about that?” What would the instructor say — after telling the student not to believe everything he reads on the Web?

There is nothing new about large industry leaders, such as General Motors, going bankrupt; in The Innovator’s Dilemma, Clayton Christensen gives many examples and an explanation: complacency, also called smugness. We’re doing well, why shouldn’t we continue to do things our way? They fail to innovate enough and less-complacent companies overtake them, often driving them out of business. Complacency is human nature, true, but it’s the oldest mistake in the economic world. (I’ve studied a similar effect in rats and pigeons.) In the 1950s, complacency was surely why the big American car companies rejected the advice of quality expert Edward Deming. In less-complacent Japan, however, his ideas were embraced. This doomed the US car industry. Much later, Ford was the first American car company to take Deming seriously, which may be why Ford is now doing better than GM or Chrysler.

The further away you are I suspect the more clearly you see complacency for what it is — a failure to grasp basic economics (innovate or die):

“Chinese financial assets [in America[ are very safe,” [Treasury Secretary Tim] Geithner said. His response drew laughter from the [Peking University] audience.

In this post Jasper Lawrence describes a trip to Cameroon to infect himself with hookworms. Here’s how it begins:

As my asthma got worse I became increasingly reliant on inhalers, pills and antihistamines as well as upon the oral steroid prednisone to stay out of hospital. I tried all the drugs and therapies available. As it was by the time I was in my late 30s I was a frequent visitor to the emergency room. As anyone who has experienced a severe asthma attack can tell you they are terrifying.

My use of prednisone increased, and as you may know the side affects of prednisone are quite horrible, particularly with long-term use. I started to suffer from some of these side affects, particularly obesity, and despite all this these drugs were only marginally effective in controlling my asthma.

Soon I was denied health insurance and so now I had the added burden of paying for all my medical care.

On a trip in the summer of 2004 to visit relatives in England I learned of a BBC documentary about the connection between a variety of intestinal parasites and various autoimmune diseases.

In Cameroon:

Cameroon has no tourism infrastructure, its people being so poor (your pocket change represents two or three months wages) and the insane corruption make for a very challenging environment for a western traveler, particularly a conspicuous white one. You are a walking pile of cash, a visitor from another, much wealthier, planet. One feels very vulnerable and exposed. It can be very wearing and the danger of being robbed is constant. . . . With the driver’s help (I told everyone of my quest) I was able to visit a variety of villages and with practice learned to identify where the locals would defecate.

Worm therapy.