Let me start this post by making a bold claim. Critical thinking is by far the most important skill you can learn, as far as getting over acne is concerned. I believe that critical thinking is more important than understanding diet and nutrition. And lack of critical thinking adds years to your misery.

Let’s start with an apology – and why this post is needed

I lived with acne 8 years longer than I needed. It’s all because I was stupid, ignorant and lacked critical thinking skill. By writing this post I hope to spare you from that agony – we both know that it’s not fun to live with acne. In this post I use rather strong and loaded words, like ignorance and stupidity. I want you to know that my use of these words has no bearing on intelligence or any other personal characteristics.

The ignorance I’m talking about is actually the ‘default mode’ of the human brain. Evolution hardwired the human brain to jump to conclusions and recognize patterns where none exists, called patternicity. What we didn’t evolve were critical thinking skills. Brain-power is expensive, and critical thinking just wasn’t important for the survival of our ancestors (I’m assuming). Hence evolution resulted in believing, rather than critical thinking, being the default response to new information.

The problem is that today we are bombarded with an endless torrent of information, much of which is pure hokum. And this is where the default mode of the brain gets you into trouble.

In the about me page I told the story of how I spent 8 years trying all sorts of alternative and natural treatments. While I learned, sort of, a lot during this time, most of the 8 years was wasted on trying highly implausible treatments that, in retrospect, had no chance of working. All because the critical thinking faculties in my brain were in massive #FAIL mode.

The point of this post is not to attack your personal beliefs or anything like that. I hope that you can learn from my mistakes and cut the time it takes you to get over acne. I hope that this post prompts you to question what you believe about health. Because being able to set aside things that don’t work greatly reduce the time it takes for you to get clear.

I also hope to point out that skepticism is not a dirty word – as it’s often portrayed in the alternative and natural health circles. Being skeptical means looking at evidence with an open mind, as much as humanely possible, and being willing to change your beliefs when they are shown wrong.

I got the inspiration for this post while reading a comment on a recent post, Debating Homeopathy Part II, at the Neurological blog. The commenter recounted how his earlier ignorance led him to believe in homeopathy. This got me to thinking how ignorance and lack of critical thinking about acne just prolongs suffering and ends up wasting tons of time and money. In this post I want to offer some remedies and to cover a few common ways we ‘get it wrong’.

It worked for me

This is the mother of all fallacies. Because when you ‘see something with your own eyes’ it’s hard to dismiss it. This stems from the fact as humans we fancy ourselves as unbiased and impartial observers. We like to think that we see reality as it is, without any distortions or biases. Furthermore, many people like to think their brains as infallible supercomputers.

The reality, unfortunately, is not so kind to our collective delusions. The human brain, on its default mode, is extremely bad at coming to impartial conclusions. We tend to see patterns in meaningless noise and then come up with explanations to those patterns. The face on Mars is a good example of this. Looked from a certain angle, it really looks like there’s a face on Mars, but in reality it’s just a coincidence of how light and shadows plays on the terrain. And when you look at it from a different angle there’s really nothing there. Many people take this just as an amusing curiosity, but conspiracy theorists take this as ‘evidence’ that there’s life on Mars and that the government conspires to hide The Truth (I sometimes wonder if we are talking about the same government that couldn’t hide president’s blow job??).

Sure, the face on Mars is an extreme example, but the same principle applies to more everyday moments. Acne tends to be somewhat cyclical, meaning it waxes and wanes of time. Let’s say that you count your pimples every day for a month and find that on average you have 5 pimples, so this is your baseline acne severity. But you also have good times and bad times. Let’s say that during good times you only have 1 or 2 pimples, but on bad times you can have as many as 10 to 15. This natural variation happens without you doing anything.

Regression to mean

During one of the bad times you freak out and decide ‘you gotta do something about this’. So you go online and find Pimple Vanish 2000 cream and Detox Vacuum 5000 supplement. The seller claims they are clinically-proven, and the website features tens and tens of happy testimonials. Thinking this must be legit you decide to order a few month’s supply.

Two weeks goes by and behold your acne is going away. “It’s a miracle!”, you write to the manufacturer (who promptly adds your email as another ‘testimonial’). Most people would conclude that Pimple Vanish 2000 and Detox Vacuum 5000 combination really works.

Not so fast.

It’s possible that the remedies worked, but you can’t conclude it from your experience. It’s at least as likely, if not even more so, that your acne just reverted to the ‘baseline’. It’s called regression to mean and it’s one of the reasons anecdotal observations (testimonials, user reports, etc) are inherently unreliable.

After your acne goes through a good phase it eventually cycles to another bad phase. That’s when people post to forums that the treatment ‘stopped working’ or that acne somehow became resistant to the treatment.

In short-term observations it’s impossible to tell regression to mean apart from real improvement. They both look real, but regression to mean is just an illusion caused by small sample size.

The study effect

One of the problems in clinical studies is the fact that when people enroll into a study they tend to, often subconsciously, change their behavior in a way that improves the measured parameters. So people in heart disease studies often improve their diet and exercise more – even if the study is looking at a supplement or drug. Being in the study helps you to become more aware of heart problems and hence you may also change your behavior.

Let’s say that as you were online searching for solutions you also read some articles regarding diet. As you ordered the Pimple Vanish 2000 and Detox Vacuum 5000 you also decided to reduce dairy intake and make other small changes to your diet.

Let’s say that your acne really got better, it was more than just a regression to mean. In this case people would be more likely to attribute the improvement to the creams and supplements than on the small diet changes. I guess that’s our desire for magic bullet solutions at work.

It’s possible that the creams and supplements worked, but it’s equally possible that the improvement was due to diet change and you could just ditch the cream and supplement. Again, it’s very difficult to tell what caused the improvement.

These are just two ways the ‘it worked for me’ fallacy can fool you. The point is not to dismiss your experiences, but to take them with a grain of salt and to always keep in mind the words of Richard Feynman: “The first principle is that you must not fool yourself, and you are the easiest person to fool.”

It has been used for thousands of years

The promoters of alternative medicine use this argument to justify their chosen woo. This statement contains the implied assumption that since something has been used for thousands of years it must be correct, because if it wouldn’t work then people wouldn’t have used it for so long.

After reading about the ‘it worked for me’ fallacy, you can probably guess what’s wrong with this assumption. The tendency to fool ourselves with faulty observations is not limited to humans living today. Humans have always done it. In fact, they’ve probably done it much more in the past as critical thinking, the scientific method, and more widespread education are relatively recent developments.

Blood letting has also been used for hundreds, if not thousands, of years. It doesn’t make it any less dangerous.

Some ancient treatments, like some herbs, do have positive effects, but the fact that something has been used for ages has no bearing on whether it’s effective or not. Never underestimate humans’ capacity to fool ourselves.

Testimonials: So many people say it works, therefore it must be legit

The capacity to fool yourself is not limited to you. We are all blessed with this ‘gift’. User testimonials may mean that a treatment does work, but they can also be evidence of lots of people just fooling themselves. Can you tell those two cases apart? No, hence you should remain skeptical.

And this is assuming the seller just didn’t outright make up the testimonials. Did you know that you can buy video testimonials from Fiverr? At $5 each, I can have 10 compelling testimonials for mere $50.

Despite these flaws testimonials are extremely persuasive – that’s why marketers (including me) use them. We immediately make an emotional connection with the person giving the testimonial and imagine ourselves getting the same results. And once that emotional connection is made and you’ve experienced the results in your own mind, no amount of boring studies or statistics is able to persuade you otherwise. Massive, massive critical thinking #FAIL.

This treatment is clinically-proven

The term clinically-proven is abused to the point where it has lost all meaning. It’s pure marketing term and nothing else. This claim takes advantage of our inherent belief in science and studies. When we believe something is clinically-proven (or scientifically-proven) we assume it’s been studied and found effective.

Science, and especially medical science, is extremely complicated. Most of us don’t have the time or inclination to acquire the background knowledge needed to understand medical studied. Only a few years back I thought a study is a study is a study. I had no understanding about the hierarchy and quality of scientific evidence. If something had been studied, then I took it to mean the claim is true. I had no idea how unreliable many studies are – especially when they’ve been paid by companies.

The sad fact is that many companies simply fund studies for marketing purposes. They hire scientists to legitimize their marketing claims. There are ways to design a study to give back any answer you want – even without fudging numbers.

There are also known biases in the scientific publishing process, for example positive studies are more likely to get published than negative studies (studies that show that the treatment doesn’t work). These known biases ensure that small and uncontrolled studies often give false positive results. Many alternative medicine promoters abuse this. They point to small and unreliable studies as ‘evidence’ that their woo of choice works and completely ignore higher quality evidence that says it doesn’t work. They use science like a drunk uses a light post, for support rather than illumination.

Can you trust anything?

I’m sure you already knew that just because someone put it online doesn’t mean it’s true. For sure there’s a lot of nonsense online, but it doesn’t mean you couldn’t trust anything. With little bit of practice you can develop a nose for sniffing out nonsense and sorting out reliable information from not so reliable. Lot of pseudoscience and nonsensical claims follow certain patterns, and once you learn to spot those, it’s relatively simple to figure out what you can trust and what you should take with a grain of salt.

Critical thinking takes some effort. You have to stop your brain from jumping into conclusions and step back to really look at what’s being said. But, at least in my opinion, it’s a small price to pay for not falling pray to endless nonsense. In my case I could have gotten clear years earlier (and thus saved lot of misery and suffering) had I only learned critical thinking at the same time I learned about alternative and natural health.

Of course you shouldn’t limit critical thinking to just alternative medicine. You should apply the same methods to Western medicine and perhaps discover that diet does affect acne and that it’s ridiculous to take antibiotics for acne – despite dermatologists protesting otherwise.

A good place to start is the Baloney Detection Kit by The Richard Dawkins Foundation For Science And Reason.

If you like to listen, I recommend subscribing to Skeptics’ Guide to the Universe (SGU) and Skeptoid podcasts. SGU is more science-focused and discusses general scientific topics in addition to skeptical ideas. Whereas Skeptoid is more about skeptical and critical thinking. In each episode Brian Dunning takes a skeptical look at some popculture belief. He discusses alternative medicine, conspiracy theories and anything in between. Skepticality is another good podcast to subscribe to.

Here are some blogs worth checking out:

• Science-based medicine – In-depth discussions on various medical topics.
• Respectful Insolence at ScienceBlogs – Similar to Science-based medicine, but more focused on criticizing alternative medicine. Despite somewhat militant tone, Orac does a good job of presenting scientific evidence on the topics he discusses.
• Skeptic Blog – Posts about general skeptical and critical thinking topics.

I’m by no means saying all the above resources are always correct. I occasionally find myself disagreeing with some of the medical topics discussed. Still, it’s a good idea to listen to the both sides of the story and decide for yourself.

I want to end this post with the words of Stephen Hawkins:

“The greatest enemy of knowledge is not ignorance, it is the illusion of knowledge.”

Don’t make your beliefs and ‘what you know’ too precious. Be skeptical and keep an open mind.