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If you’re into looking at research to figure out more natural ways to support your skin condition (eczema, psoriasis, rosacea, hives, seborrheic dermatitis), this episode is for you.
Like you, I love digging through research to see what’s being ignored or overlooked with the hopes of helping listeners as well as my clients.
But there’s a sneaky truth that I think needs to be stated clearly…
Research isn’t always right.
What do I mean by that?
Sometimes the outcome of a study looks so promising, but when you use the same exact intervention in a clinical setting, the results aren’t nearly as incredible.
Not knowing these issues with translating research to your case could leave you feeling like you’re somehow broken beyond repair because what appears to work for others just will not work for you.
I want to dive into these problems with research as well as how research + studies may be presented to you (the patient or caregiver or interested party) so you can take a much more balanced + pragmatic approach to research!
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In this episode:
- Ways that research may be presented that’s misleading
- Why testing out data in clinical practice matters so much
- Problems with small studies (even when the results look so promising)
- Types of content that may often misrepresent data
- Why you should ALWAYS look at the references!
- Tips on how to assess study citations for educational content + products
Quotes:
Many blog posts are littered with references that don’t actually back up any of the claims the author is trying to make.
Beware of authors + expert who know that their audience doesn’t know how to read research + unfortunately won’t question the conclusions they’ve drawn nor look at the research they’ve cited.
300: Why Research Isn’t Always Right (FULL TRANSCRIPT)
Welcome back to episode #300 of the Healthy Skin Show!
I have to take a moment to acknowledge that we finally hit the 300-episode milestone after hitting over 1 million total downloads of the show a few months ago.
While it’s certainly been a ton of work, I couldn’t have done it without my amazing team that helps keep things rolling as well as YOU.
So thank you for being on this crazy journey with me!
Now if you saw the title of this episode + were a bit taken aback thinking “Wait, research isn’t always right?,” we’re going to dive into this today.
Because the truth is that research that looks promising in a research setting doesn’t always work in the body.
So if you’ve ever stumbled across some amazing study about some supplement or nutrient or diet that yielded what looks like great results…
And you’re left feeling like you’ve found some secret key thinking to yourself “Why is no one talking about this?”…
Then you know exactly what I’m talking about – amazing research that maybe even makes you consider if this could rival the power of a medication!
While I think these types of research outcomes are certainly interesting, I’ve learned over the years to practice restraint with my enthusiasm.
Clinical experience working directly with clients has taught me that what might work in a controlled setting, may not work so well in a much larger + diverse population.
And on the flipside, I’ve also seen where certain combinations of products or alternative interventions work well together, but no studies yet exist (and probably never will) to demonstrate efficacy on a grander scale so that it would be accepted by the conventional model.
Research Problems No One Talks About
Research isn’t perfect.
And if we’re going to be honest, it should be stated that what we know + understand about the human body (as with so many other things in life) is probably a drop in the proverbial bucket.
This was impressed upon me over the years by my father – an MD, PhD, surgeon + avid researcher who was constantly inventing crazy technologies for which he held many patents before his death in 2020.
I used to get so excited about studies that show that a certain nutrient at a specific dose, for example, could help with some specific health issue.
But with time + then implementing research in clients (who are all in their own right very different), I discovered that “the research” doesn’t always work the way the studies suggest.
This explains why there is no ONE protocol for fixing specific issues.
And it underscores why research paired with clinical experience is probably a more valuable combo when it comes to solving health struggles.
I’m not saying that research isn’t true or not to be trusted, but that it continues to evolve + must be taken with a grain of salt.
That’s why I get frustrated seeing research outcomes OVERSTATED by both practitioners and those online sharing about their latest research find in patient support forums.
It’s worth highlighting both sides of the coin here since it will directly impact the information you might end up consuming.
I see this happen at conferences that I have attended, where practitioners (including physicians (MDs)) who are definitely open-minded present research on topics that seem incredibly promising.
Recently I sat in on a talk at a medical conference about different probiotic strains used to treat eczema.
All the research sounded great, except for a few issues –
- The studies were small – most of them having under 50 or even 20 participants.
- The presenting physician likely doesn’t practice in a fully integrative manner so I’m rather skeptical if this research has actually been tested out in his patient population. At no point was it ever mentioned that they had experience putting this promising research to the test on actual eczema patients.
- What adds to my concern is that as someone who has actively used many different probiotic strains + probiotic combination formulas, I haven’t really seen this type of substantial improvement IN PRACTICE that’s being shared in this promising data.
Now it doesn’t mean that I don’t believe in the power of probiotics (because I certainly do), but there’s so many more factors that could prevent them from working as well as was being presented in the research.
This is where the clinical application of research is important – I only know this because of my experience trying these types of interventions out with clients.
And that can get lost when a practitioner doesn’t try out these interventions, is retired (and never had a chance to try them) or is no longer seeing patients or clients because their career has changed away from a clinical setting.
I’ll share a behind-the-scenes story with you that underscores exactly what I’m talking about…
A few months ago, I interviewed Dr. Shawn Kwatra for an upcoming episode about Prurigo Nodularis (which will be released in the next two or three weeks). This is a hellish, itchy condition that hasn’t had many great options for treatment.
Before the interview, my associate and I pulled a bunch of interesting small studies using different topical skin preparations from natural ingredients that showed positive outcomes to reduce itchiness.
Before we started recording, I asked Dr. Kwatra if we could dive into these studies and talk about some of these alternative options.
He chuckled + very kindly told me that he’s clinically never seen much improvement or relief in patients trying these more natural preparations. While I was bummed to hear this, it underscores what I’m talking about here – that research may not pan out the way we’d hope in a clinical setting.
This is all beside many other issues with studies + how they are conducted which also can make the outcomes rather questionable.
About l-Histidine Research To Help Eczema…
Some of you might recall episode 95 of the Healthy Skin Show podcast where I detailed a study about the use of a single amino acid – l-Histidine – to improve eczema.
I’ve seen this paper presented at several conferences pointing to how incredible this simple intervention had a similar impact on eczema rashes compared to a “mid-potency steroid”.
While it’s certainly neat, I did offer a dose of reality in the podcast episode that I often don’t hear in these presentations.
First, the study only included 24 people.
And probably more importantly, I’ve not witnessed this magical improvement in someone’s eczema to the level shown in this study.
I’m not saying the research is wrong or not to be trusted, but when someone asks me if l-histidine will fix their skin, the answer they get is likely not what they want to hear.
A small number of clients have seen some possible improvement as well as a small number of those in my Skin Rash Rebuild group program, but most don’t notice anything.
I have had a few listeners of the podcast write in to say that they believe it’s helped.
And why it helps some, but not many others is incredibly unclear to me so it’s hard to know exactly who to recommend this to that would likely benefit the most.
It *might* be helpful along with other interventions that we have implemented for clients, but I can’t say how helpful it is on its own. It’s possible that there could be a synergistic effect.
So this is where testing out the research + working with it in practice can make a big difference.
AND it can help you know who might not tolerate it well (as those with a serious histamine overload problem often can’t because its converted directly to histamine in your body).
As well as how to troubleshoot issues that may arise from a certain type of case presentation.
Why Research Might Not Work…
Back in Episode 290, I explained why what works for one person won’t necessarily work for you (and could even make you feel worse). If you missed that episode, definitely check it out because the feedback I got from listeners was really great + helped them to see why knowing your root causes is actually VERY important.
I explained a bit in that episode about the importance of the sample size – basically the number of people the particular intervention was tested on.
And another piece to this would be if the research was conducted on the right population.
Just today I was reading a neat study using a topical probiotic solution for reducing hyperpigmentation.(1)
The headline caught my attention since I’m often asked about options to address hyperpigmentation (and we do have a couple of episodes here on this topic).
By all looks of the conclusion, this sounds like a winning solution…
The researchers shared that “the color intensity of the tanned skin was decreased by 47.647%, and skin brightness was increased by 8.098% after the treatment period. PMC48 also significantly decreased the melanin index by 11.818%…[while it] improved skin moisture content level by 20.943%.”(1)
Sounds good, right?
The problem is that, the study was only run with 22 participants – so a small sample size.
And when I dug deeper, I found that the participants were healthy having been subjected to artificially UV-induced tanned skin which was thus considered to be hyperpigmented.
In fact, the researchers explicitly EXCLUDED the following people “without acute or chronic physical disease including skin disease; pregnant or lactating women and women who were planning to become pregnant during the trial period; those who had a history of photoallergy or photosensitivity; those who had used external skin preparations containing steroids for more than 1 month for the treatment of skin diseases; those who consumed a drug or food with a skin-whitening effect; and those who were judged to be unsuitable for this study by the investigator” whatever that means.(1)
So if someone didn’t read the details and just presented the conclusion, they might be led to believe that this topical probiotic solution could be helpful for hyperpigmentation due to melasma or topical steroid use.
To be worth anything in my book, they’d need to do a larger study on those with actual hyperpigmentation (not just from having UV-tanned skin).
For now, it’s an idea… a future possibility, but it could also be complete junk.
We just don’t know.
What Should You Do To Watch Out For Misrepresented Research?
I share this because I want you to make smarter, wiser, more measured decisions about what you try – as well as helping you to manage your expectations.
Research is shared all over the internet in ways that may not be appropriate.
So many blog posts are littered with references that don’t actually back up any of the claims the author was trying to make.
This might be because the author doesn’t know how to read research and drew inappropriate conclusions from it. I often see this with citations that are animal or test tube studies which are a red flag unless explicitly explained that their conclusions *might* or *might not* pan out inside a human body.
Or they might know that their audience doesn’t know how to read research + unfortunately figures that you won’t question the conclusions they’ve drawn.
(THIS happens way more often than you realize online.)
It also happens in the supplement + product industry as well.
If a company is offering references for their claims, it’s worth seeing if the references are…
- Printed + available in your own language (ie. using a study only available in Chinese can’t be used as a legit reference since the majority population its being marketed to is probably not able to read Chinese)
- Citing data specific to YOUR condition that you’re being marketed for (or are the benefits demonstrated in other unrelated conditions – ie. cardiovascular disease or lung disease but making the claim for a skin or liver detox issue)
- Animal or test tube (aka. in vitro) study
- Sharing outcomes from research with healthy individuals
- Conducted by anyone with a financial bias (ie. being paid by the company – it doesn’t mean it’s automatically bad, but it’s worth noting this)
Educational webinars + social media content is another place where you should verify citations rather than just take it at face value.
And lastly, presentations at conferences.
I honestly wish that presenters would be required to disclose if they have any clinical experience with the data they’re presenting especially if they’re just sharing research on a topic.
That would be helpful to know if they’ve actually tested out these interesting studies on actual people to see if it’s really worth caring about.
Does this add a layer of complexity for you?
Possibly.
But this is the complexity that I + my fellow practitioners are faced with when looking at research.
And explains why I have so much measured enthusiasm mixed with a healthy dose of skepticism.
I talked a couple years ago on the podcast about managing your expectations along your healing journey, and this topic certainly goes hand-in-hand with that.
Rather than get overly excited assuming that you’ve found the next silver bullet, you can better manage the emotional ups + downs of this journey to make smarter choices along the way.
If you’ve got any questions or thoughts to share about this, leave a comment below so I can address them.
Thank you so much for tuning in and I look forward to digging deeper with you in the next episode!
REFERENCES
Jennifer Fugo, MS, CNS
Jennifer Fugo, MS, CNS is an integrative Clinical Nutritionist and the founder of Skinterrupt. She works with adults who are ready to stop chronic gut and skin rash issues by discovering their unique root cause combo and take custom actions with Jennifer's support to get clear skin (and their life) back.