Saturday, 2 September 2017

Beauty, Pseudoscience, and Finding the Answers

I've been working on figuring out the wording for this post for months now, since it's such a big topic that I have many, many thoughts about. And one of the things I realized I should address for those old and new to my blog is what my qualifications are when it comes to discussing science before I launch into why I have come to these conclusions and frustrations. For those unaware, I am a health sciences librarian, based in a teaching hospital. I've mentioned it here in passing, but what do I actually do? That's a question that I get a lot, and the answer is happily relevant to discussing science and beauty. 

My job is to support patient care. I do this through several avenues (providing a print collection of core books, facilitating access to reputable journals and databases, teaching people how to find reputable sources, finding patient education info, doing research for policy development) but the one I spend most of my time on is literature searching. If a clinician has a question and needs the latest relevant articles, they come to me. I design a search based on their question, run it through the databases I feel are most relevant (and/or Google), and screen the results for the most relevant material. I send it to them, and they hopefully use it to provide evidence-based healthcare. This means I spend most of my work time reading about all kinds of interesting health things. I am not a physician, nurse, occupational therapist, pharmacist, or qualified in any way to give you medical advice (so please stop asking, certain family members). What I am qualified to do is to find the information to back up claims and hopefully cast some light on the efficacy of ingredients for myself. I have a lot of fun tools to play with because of my affiliations, and I have been known to do a quick search or two to explore questions I have about what I might be interested in buying, and whether or not oakmoss is a dangerous irritant. But there are a lot of free tools out there that you too can use to find evidence! And I'm going to reference a few for you.

I don't often take advantage of is my access and skill in searching the literature to debunk some of the beauty pseudoscience I see floating about the interwebs. Frankly, most of it is a time/benefit thing: arguing with people on the internet is fruitless and frustrating, and I'm not going to waste an half hour on PubMed creating a search and screening the results for someone who won't appreciate it. No, I get paid to create searches and screen results and then give them to people who do appreciate it and send me chocolates at Christmas. Another aspect is I can't usually link to stuff that I've read, since I used my affiliations to access full text, and I'm not going to write an essay explaining my search and my screening criteria and the content of the full text that I read - again, because I get paid for that for people who appreciate my work and I'm not usually interested in wasting that on strangers to prove an internet point for some upvotes. And finally, because I like to use my free time to do other things and try to stave off my looming workaholic tendencies.

But there is a depressing tendency in the communities I frequent to peddle pseudoscience. This is part of the reason why I've taken several huge steps back from indies in the last year or so - I can't deal with the greenwashing and the naturalistic fallacy that so often is bandied about. There's a very strong connection between people who are into clean living and all-natural everything and good for you, but everything is made of chemicals, so please stop saying you're looking for an eyeshadow without chemicals. I like to support small businesses and am guilty of being a special snowflake when it comes to having things that other people don't have. I like cool labels and nifty oils and unusual things. But stop trying to sell me things based on their superior all-natural label. They aren't better for me or better quality or will restore my positive energies or anything else I've seen.

1. Stop asking/giving health advice on the internet.

Seriously, stop it. It's never people who know exactly how dangerous that is (usually), but people who know just enough to get themselves into trouble. I actually don't participate in groups related to my own chronic health issues for this reason alone - I tried and kept getting asked for my medical opinion, and I kept seeing people giving out advice that they were in no way qualified to do. Nah, I don't need to commiserate that badly. Skincare communities are particularly bad for this. No one here can diagnose your rash, go to a doctor. I suspect that because most English-language sites are heavily American, this has more to do with the state of that healthcare system, where people literally can't afford to go see a doctor for minor health ailments. That breaks my heart. But it doesn't change the fact that unless you're using the internet to video chat with a health care professional, you probably shouldn't be using it as a substitute diagnostician. At least we can refer people to reputable consumer health sites, like Medline Plus. But using Wikipedia to help diagnose a stranger...no. Please stop.

2. Natural doesn't equal good.

I don't know that this bears repeating on my end, but the naturalistic fallacy is alive and well, as I alluded to above. So here it is again: just because something is natural doesn't make it good for you or better or purer or anything. It's merely natural. Like bears or arsenic or thorns or crabs pinching your toe in the water. If you want to buy all-natural stuff, go to town. But remember that all it means is that you're buying stuff labelled as natural. It simply is. 

3. You probably don't know how to search, so ask someone who does.

This is a sticky point that I debated on including, mostly because it's pretty harsh, for all that it's the one I can talk endlessly about. But with the proliferation of fake news, predatory publishers, people asking questions all over Reddit that could have been Googled (I answered one the other day about if there were any Sephora locations in New Brunswick), and our elderly relatives posting memes with blatant falsities on Facebook, I'd say many people are cluing in that we're not always great at handling the massive amount of information out there on the internet. There is this pervasive belief that because we have Google/Bing/DuckDuckGo/whatever your chosen search engine is, we don't need anything else. When I said I was going to library school, multiple people asked me why I'd bother, since libraries are obsolete because we have Google. Some of you are still probably sitting here thinking that. I won't take it personally, but no candy for you when you come visit me at my reference desk. 

Just because we have Google doesn't mean you know how to search. In fact, it's entirely possible that you were never taught how to, aside from maybe one session with a librarian in university. I started kindergarten the year before Google came online, and I wasn't ever really taught how to use it in grade school, probably because the educators in my life were learning to use it at the same time I was. It's not your fault. But it's still a fact. Google has made searching almost absurdly easy - it lets you type in sentences and all that stuff. It's great when you want to find a bread machine recipe or a store selling mermaid earrings. But to dig into more advanced topics, to find the right answer? Ehhhh. I have my doubts, and I know I wasn't very good at searching till I became a formally trained finder of stuff. 

If you aren't familiar with where to go to look for evidence, then you probably aren't going to find good evidence. I was on the vegan subreddit on Reddit, and came across a poster who was looking for evidence for something and posted some blogs and YouTube videos that were of pretty questionable quality. Someone linked the poster to some PubMed Central articles to read up, and the poster claimed he was suspicious of a .gov site. Understandable, but since the president probably has no clue what the National Library of Medicine is, let alone their services, I'm still pretty confident in recommending PubMed as a good place to start looking for evidence. Not sure how to start searching in PubMed? Start with the NLM Guide. Or feel free to shoot me an email, and depending on my time, I can give you a few tips. I recommend PubMed mainly because it's free, fairly comprehensive, and also has Cochrane systematic reviews, which are noted for their quality and evidence.

Always check author information and any conflict of interest statements. Is there a retraction notice? Publishers have gotten better at that, but you can still check out Retraction Watch. PubMed has gotten better at tagging retracted article in a more obvious way, thankfully. Check out the journal's reputation. On the evidence pyramid, you'll be wanting the stuff that's higher up. A case report, while interesting and you're mostly likely to find heaps of these for whatever you're interested in, is not great evidence to support your claim. Sometimes there won't be any evidence. That doesn't mean your experience is wrong, but it does mean that there isn't an answer one way or another yet. The plural of anecdote is not data.

4. Just because it worked for you doesn't mean it'll work for someone else. 


Even if something has lots of evidence, it doesn't mean something is going to work. On Reddit, Skincare Addiction has a basic routine which is touted as the Holy Grail and we should all be using Cerave in the tub and Stridex in the red box. And sure, it's easy to access stuff filled with good ingredients that works for a lot of people. But not everyone, and the fact that it's held up as a one-size-fits-all approach (and before anyone sends me nasty messages about how SCA doesn't actually push it, I've been reading there since its inception, and people really do push it as the One True Way) is troublesome. Which again brings me back to one of my earlier points: skincare blurs the line between medicine and beauty. Often, it's both. And you have to be very careful when framing recommendations about skincare because you can very easily fall on the side of being prescriptive about skincare and cross over into giving something that looks a lot like medical advice. I'm almost positive I have done this too. I really try very hard not to do so, but occasionally it slips that way, and I'm always regretful. What if I told someone to do something based on my very tiny sample size of me and it caused them damage? Recommendations are one of the ways we learn about things, but I think we could all stand to be pickier about where we get our recommendations, myself included. And we definitely need to be incredibly mindful of recommendations versus providing medical advice. 

I've really only barely scratched the surface of this wide-ranging topic, and all of the things that I see and read on a daily basis. I could open up a thread somewhere and pull examples upon examples of pseudoscience peddled in the beauty community. I know I'm not always diligent about researching everything, but I read with a critical eye and do check the claims that trip my bullshit radar or directly reference something that I may use in my own life, on my skin. I read ingredients lists (sometimes forgetting what I'm looking for - I recently found out I am sensitive to lanolin but apparently forgot that when purchasing Glossier Balm Dot Com...) and evaluate brand claims with a healthy dose of salt. I'm not immune to marketing, but I also view beauty through a bluntly realistic lens. Nothing is going to give me a miracle overnight. Nor should it. 

Next up: tackling my thoughts on cruelty-free. Stay tuned.

6 comments:

  1. Thanks for writing this! It's great and good reminders for all of us.

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  2. I can't deal with "natural" bs at all. I'm friends with another blogger who's super sweet but very into natural products, and she's always talking about "nasty chemicals" even though everything in cosmetics is tested rigourously. The word "chemical" doesn't mean bad and "natural" doesn't mean good! Water is a chemical and deadly nightshade is natural!!! "Natural" and "organic" aren't even regulated labels in the cosmetics industry, anyway, so it's just a marketing term at this point.

    Totally agree with your first point as well. Medical advice solicited and offered via the internet pretty much never works out. I find this even happens in real life, too - I've had a lot of customers ask me complicated dermatological questions, including "Do you think this is cancer?" Like... I work in retail, I have a degree in film, I DON'T KNOW!!!! Especially here where you can get that mole checked out for free, I do not understand it.

    What you said re: skincare straddling the line between beauty and medicine is really true. When I go to brand trainings they're very careful to let us know what claims we can and cannot make, because some are considered clinical/medical (a no-no) and some are merely cosmetic. StriVectin told us not to say that their hair products will make hair grow, for example, because that's a medical claim. We could only say that it would thicken hair or repair damage.

    Skincare recommendations are very hard to give because experiences vary so widely. When I recommend products to customers I try to describe the product as empirically as possible (texture, what skin concerns the active ingredients target, if it's oil-free...) rather than making big claims. Even when I recommend something in completely good faith, it may not work out, because it's so personal. I always tell customers that a product can only have 7 ingredients but they may be allergic to one of them, even if it's not a common irritant - that's just how allergies work. I like browsing SCA but I use very few of the sub's HG products, not because they're bad but because I have a routine that works for me and there's no point in prescribing to something else entirely. It may come as a shock to some of those people, but there are lots of good skincare products out there and CeraVe in the tub isn't the only moisturizer that works!

    Anyway, very good post!

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    Replies
    1. There is a ton of really good consumer health information out there for free, but people need to stop acting like the one time they went to the hospital or dermatologist gives them authority. I consider myself decently intelligent but my undergrad is in polisci, and I've spent three years reading and searching in the health sciences, which in no way gives me enough knowledge to give advice, but is probably more understanding of medicine than the average person.

      I'm really glad that brands are making that clear in their training - like I get La Roche Posay ads attached to some of the periodicals I get from physicians, so that level so it's easy for me to see the crossover but I think a lot of people forget.

      When I first stumbled upon SCA, CeraVe in the tub wasn't available in the tiny hamlet I was living in, which I think would have killed SCA had I mentioned it. Out of necessity I used other, just as good stuff.

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  3. I'm very interested to hear your thought on cruelty-free! This was a very good post, and an important topic.

    ReplyDelete

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