“If you have a medical problem, it’s because you’re not on a particular drug.”
“Acne is caused by inflammation.”
Neither is a real explanation!
Is this really the best modern medicine can do?:
“You have a health problem? OK, regularly ingest quantities of this exogenous chemical from now until forever. It won’t fix the actual problem, but it will help the symptoms. If this chemical doesn’t work, we’ll try a different chemical of course. (And you may have one of these side effects…)”
Was your medical problem caused by a lack of exogenous chemical #1,432?
Evolution produces organisms that are adapted to their environment. Evolution produces organisms that are, by default, healthy in the environment in which they evolved.
If this many people are sick, something in the environment—how we live, how we eat, how we exercise, what we’re exposed to—is the cause. Thus the true solution lies in a change to the environment.
I’m not saying that drugs and other non-root-cause interventions can’t be helpful—they can be, no doubt—but I think our culture is obsessed with treatments that, one, don’t make much sense and, two, have limited potential. Isn’t fixing the root cause usually the best solution?
And, at the very least, simple lifestyle interventions should be explored before prescribing drugs indefinitely!
In three years of acne, I was prescribed five different prescription medications by my dermatologist.
One was a topical antibiotic. I asked why it should help and was told ‘acne may, though not always, have to do with bacteria. This kills the bacteria.’
Another prescription was an oral antibiotic. This also had a similarly poor mechanistic explanation.
Two other prescriptions consisted of a blend of several dozen nonhuman, non-typically-environmental chemicals. Stuff that no human before the 20th century has been exposed to in regular or large quantities.
The last prescription (which I essentially self-prescribed) was a multivitamin with anti-inflammatory effects. ‘Fix nutrient deficiency’ seemed to me like a marginally better mechanistic explanation than ‘continually ingest exogenous chemical #1,432, we’re not sure why’ and ‘use antibiotics, we’re not sure why’. This fifth prescription was the last I used until I eventually rejected all prescriptions here.
But here’s a wild idea!, what if my acne were caused by something? Because it’s definitely not caused by ‘the lack of this particular exogenous chemical on my skin or in my stomach’!
Acne isn’t caused by inflammation and bacteria— because what caused the inflammation and the bacteria? And, even then, why isn’t that a problem for everyone else?
In this way, none of what I had been prescribed made sense. Evolution does not produce organisms whose skin naturally bursts with inflammation. However, evolution can only provoke adaptation to long-lasting environments, so acne could easily be caused, or inclined, by something novel or omitted in our modern environment. In the 200,000+ years of human history, essentially none of it has been spent living in civilization as we do today— but evolution takes tens of thousands of years. Old genes, new world; the world is broken, not my body.
Because the treatments prescribed to me did not affect the factor in my environment likely causing my acne, they could not cure my acne. At best, they intercepted part of the mechanism.
After all, if these treatments were actually treating the root cause, their effects wouldn’t be so fickle! And, there wouldn’t be a market for hundreds, if not thousands, of different acne drugs.
Soon I explored changing my diet to fix my acne. What if my diet was what was too new for my old genes? I could be failing to eat enough of something I should—and presumably something my genetic ancestors ate rarely, or mistakenly eating something I shouldn’t—and presumably something of my genetic ancestors ate often.
It has now been five months since I changed my diet deliberately and radically, and also stopped taking my acne prescriptions. For the last two months at the time of writing (with one hiccup), my acne has been nearly completely resolved.
I pursued the root cause, and so far the problem seems to have been remedied. After all, fixing the root cause is usually the most effective solution.
Even if a prescription improves acne, it probably doesn’t improve one’s health overall. If X causes acne for an individual (X may be different for different people), and acne just happens to be unusually visible, then it is likely that there are other subtle and long-term consequences caused by X—however, these effects are simply harder to see. Rubbing a topical antibiotic on one’s skin isn’t going to affect those other problems because the root cause hasn’t been addressed.
This realization—that my health problem was probably more than just acne—generated newfound motivation to fix the root cause, whatever it was. I had acne for three years before this but had given up two years ago in my earlier attempt to fix it.
A natural avenue to explore here is diet. What if I had a nutrient deficiency? What if something in my diet spiked my immune system and inflamed my skin? These would stand to be real explanations.
Now, I had been already been deliberate about my diet. [Link at end of essay.] My diet for the prior two years consisted of meat, fish, green vegetables, occasional nuts and berries, and the very rare fruit, and this diet was specifically devoid of added sugar, all grains, 20th-century processed vegetables oils, and most carbohydrates.
I proceeded to experiment with a ‘carnivore’ diet consisting of exclusively beef, butter, seafood, and salt. Soon I added a daily serving of ruminant (beef/lamb) liver, too. Within two to three months the acne on my back was nearly gone. Acne had also also nearly resolved on one side of my face but not the other, so I hypothesized that my remaining acne was related to not replacing my pillowcase often enough. I began to change my pillowcase daily and the acne on the other side of my face improved, too.
My current hypotheses for what caused my acne:
This could also explain why I didn’t notice much change until two months in, because only after the first month did I begin consuming a few ounces of liver daily.
For whatever reason I had the hunch that vitamin A was related to skin health. Particularly, vitamin A is extremely concentrated in liver, but hard to find in essentially all other foods.
Furthermore, while my acne was first nearly-completely clear by about 2020 December 1, it seemed to come back when I stopped eating liver. I was eating liver often until mid January when I ran out, and within just a few days my acne came back. A week later I started eating liver again and it cleared up. This is merely observational of course, and the reason I stopped eating liver had to do with travel, so that could also be related.
So my strongest suspicion is that my acne was caused by a nutrient deficiency, cured by something in liver.
Alternatively, it could’ve been cured not by eating liver, but by eating more, or higher quality, red meat in general. In my previous diet I ate a pound of ground beef every few days, but now I eat about a pound a day of any number of different cuts of steak, in addition to more salmon and seafood.
The main group removed from my diet was green vegetables. I could have been having a relatively mild immune reaction to vegetables. [See Mikhaila Peterson’s story if this possibility is unfamiliar to you.]
And maybe my acne just happened to settle around the same time.
I will update this page as I learn more.
As I’ve noted in a previous essay, I dislike explanations that fail to explain the intuition that helped generate the solution.
I was lucky to have heard about the carnivore diet recently. Without looking for it, I had already heard references to the diet improving skin health.
Looking back, it probably would have helped to have done a nutrient test via blood profile though. If this was vitamin A deficiency, I could have known for certain and focused my efforts thereafter.
Also due to luck. I was lucky to perhaps predominantly sleep on one side of my face, I suppose.
According to Mayo Clinic, acne is caused by “Excess oil (sebum) production; Hair follicles clogged by oil and dead skin cells; Bacteria; Inflammation.”
Do you see the problem?
Also, Wikipedia (2021 February 4):
Genetics is the primary cause of acne in 80% of cases.[2]
And also,
Acne commonly occurs in adolescence and affects an estimated 80–90% of teenagers in the Western world.[19][20][21] Some rural societies report lower rates of acne than industrialized ones.[21][22]
But genetics isn’t a cause. It’s an inclination. It could just as well be for example that, genetically, some people require more vitamin A or else their skin breaks out in acne. In which case I would call vitamin A the cause, not genetics. Which is like saying starvation is caused by “genetics”, because our genetics require that we eat food.
How can you profit from the explanation “to reduce acne, eat more red meat and/or liver”?
How can you profit from “to drastically reduce the chances of all modern diseases, eat less sugar and junk”?
How can you profit from a problem that can often be fixed with simple interventions?
I know, I know, this doesn’t apply to all cases, but at the very least, simple lifestyle interventions, simple environment-changing interventions, should be explored before prescribing drugs indefinitely!
Well, here’s one way to profit from problems that can be solved simply: trick everyone into believing the problem can’t be fixed, obfuscate the research into its causes, and indefinitely sell its sufferers proprietary medication to treat the symptoms.
But that would be crazy…
The sleep problems we see today seem to be related to the environment. Specifically: the presence of artificial light at night seems to be harmful to sleep quality.
I believe that the sleep problems we see today are majorly caused by the presence of blue and green light at night.
But I don’t know anyone that’s going to trade light after sunset for better sleep. That’s the root cause, but maybe we can intercept the effects of these frequencies of light. Maybe we won’t get the full benefit of having sleep hygiene completely in-line with the environment, but perhaps we can get most of it. This is how wearing orange glasses works, and there’s empirical evidence to back this up for real-life use.
Thus, unlike acne for example, this is a case where it makes sense to attack a problem without remedying its root cause.
Posted 2021 February 5, last updated 2021 February 7.
2021 May 2 update: Of all of the days I’m aware in the past few months where my face has developed a new nontrivial amount of acne, all of these days seem to have been after a day where I did not eat liver. On the days after I eat liver, this does not seem to occur. This is just observation, though, and has not been controlled.