Do Pimples Pay? Acne, Human Capital, and the Labor Market

We use data from the National Longitudinal Study of Adolescent to Adult Health to investigate the association between having acne in middle to high school and subsequent educational and labor market outcomes. We find that having acne is strongly positively associated with overall grade point average in high school, grades in high school English, history, math, and science, and the completion of a college degree. We also find evidence that acne is associated with higher personal labor market earnings for women. We further explore a possible channel through which acne may affect education and earnings.

Here is the full piece by Hugo Mialon and Erik T. Nesson.  For the pointer I thank Daniel Gross.

Comments

This is researched? And not whether credit risk adverse bank capital requirements weaken the real economy and endanger our bank system?
What has research come to? How much of this “high priority research” is supported by student debt?
http://subprimeregulations.blogspot.com/2019/03/my-letter-to-financial-stability-board.html

Would you like every researcher to focus on the same topics?
Should everyone simply focus on the financial systems and capital accumulation, and treat other topics that consider the human experience as relevant?
Is exploring the human experience and how we are systematically affected really useless?

Maybe this is the reason men in the US are ending their lives at such a worrying rate... If it's not about money, it's irrelevant...

Credit risk adverse bank capital requirements does not weaken the real economy and endanger our bank system. Corporate greed run amok does it. Time after time it has been proved. The S&L scandals, Brazil's 1990's bank collapses, repealing Glass–Steagall, etc. The thighter the control over banks, the safer the banking system is.

Goddammit, TR, as a native English speaker, you know the correct word is 'averse.'

I am not a native English speaker. I don't speak English at all. None of my forefather had since my family left England. I used the same word he used because I am talking about the same thing he is. Using "averse" would introduce needless, unwanted and unwarranted noise to the communication.

Is Ribeiro your English forefather's surname?

No. It is Portuguese. My mother's maiden name was Canto, from the the English Chandos. Sir Chandos was a famous English knight. https://en.m.wikipedia.org/wiki/John_Chandos

Economics imperializes a lot of topics that might seem better suited to sociology or other social sciences. But economics is less politically correct than sociology, so economists winds up doing these kind of fun, interesting studies by default.

Much as it would like to appear otherwise, economics is itself a social science. The numbers, statistics and graphs involved are meant to create an aura of empiricism but it's a sham.

The mechanism could have been time spent hitting the books rather than socializing due to physical unattractiveness.

That's my guess too, not having access to the article.

Presumably, but another mechanism could also be greater testosterone leading to more acne.

Also, people have a lot less acne than they used to. Are we sure that the powerful drugs used to achieve this big change in society haven't had any social side effects?

'people have a lot less acne than they used to'

Nope - 'As of now, the rising incidence of acne vulgaris in late adolescence is a global issue; however, it is unknown whether this increase is a result of higher prevalence of the Western diet, earlier onset of puberty, genetic drift, or a byproduct of unknown environmental factors.' https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4769025/

Perhaps globally, but in the US, high school students these days have less acne than in my day due to Accutane.

'these days have less acne than in my day due to Accutane'

No, they have less visible signs of acne, which is not quite the same thing - though clearly, for a teenager (and one assumes the person paying for the treatment), the only concern is about appearance.

Of course, this leads to a discussion of what is meant by 'acne' - and as noted in another comment below, the term is used more broadly than merely describing acne vulgaris. The same problem comes from using the term pimples.

And this is just another sign of how distant the U.S. has become in my life - to the best of my knowledge, basically nobody uses Accutane (certainly not any of the adolescents I have known, or their parents) in Germany, as acne is not considered anything but something that happens in puberty. Yet in the U.S. a transient problem involving appearance, with a major dietary component is not reduced through changing diet, but instead is reduced by keeping the same diet and simply buying another product, which has its own side effects - just part of the endless spiral of disposable consumer capitalism.)

Yeah, who cares if you wind up with acne scars on your face, shoulders and back? And blood and puss oozing out your face is no biggie, either. Enlightened Germany has this one right.

'And blood and puss oozing out your face is no biggie, either.'

How did American teenagers survive in 1978, one wonders, with all that oozing blood and pus coming out of their faces?

And of course someone with blood and puss oozing out of their face receives a prescription. Admittedly, out of a sample size of around 100 teenagers over the last couple of decades, only one person required a prescription. Oddly enough, she was Scottish, not German, and it was the French health care system that prescribed medication.

Great anecdata. Very scientific and convincing.

'Very scientific and convincing.'

Nothing about a Scottish teenager with severe acne receiving an Accutane prescription was meant to be scientific or convincing. And as you failed to note (maybe it just needs to be highlighted, like now), it was not the enlightened German health care system that provided the prescription she used.

But possibly, in a way you find scientific and convincing, you can explain how American teenagers were able to survive 1978, with oozing blood and pus coming out of their faces.

"Nothing about a Scottish teenager with severe acne receiving an Accutane prescription was meant to be scientific or convincing."

Then why did you waste my time and yours typing it?

Well, mainly because you seemed to be trolling, and I generally cannot resist replying to blatant silliness (something this web site provides in endless abundance).

Though you seem to not be wasting your time explaining how American teenagers were able to survive 1978, with oozing blood and pus coming out of their faces.

Which could just make one wonder why you originally wrote 'who cares if you wind up with acne scars on your face, shoulders and back?'

Not sure why you bothered to type that either, frankly.

Because I enjoy playing with trolls, obviously.

And cutting and pasting is easy, particularly when such amusing imagery is used.

Though you still seem to not be wasting your time explaining how American teenagers were able to survive in 1978, with oozing blood and pus coming out of their faces.

Are you suggesting a dietary link? Most studies seem to be inconclusive as to the cause.

"Yet in the U.S. a transient problem involving appearance, with a major dietary component is not reduced through changing diet, but instead is reduced by keeping the same diet and simply buying another product, which has its own side effects - just part of the endless spiral of disposable consumer capitalism."

Or is your response an excuse for an anti-American rant? If so, carry-on.

There does seem to be reasonable empirical evidence that changing diet reduces acne.

From the section of the linked article entitled diet - 'Some evidence to support this concept comes from a randomized, controlled trial in which recruited male participants, aged 15–25 years, with mild-to-moderate facial acne were separated and instructed to eat a diet of high protein low glycemic index foods or the conventional high glycemic load diet. After 12 weeks, total lesion counts had decreased more in the low glycemic index diet group than in the control; moreover, this experimental group demonstrated lower free androgen index and insulin levels than the control. Other randomized controlled trials have since been released, similarly demonstrating the definitive effect of high glycemic index foods on acne in young adults across different ethnicities.' This section spends a fair bit of time on insulin, actually.

If indeed there is less youth acne than in the past it might be due to new environmental factors. For instance, if the electro-magnetic spectrum that is used to carry cell phone messages can help cure acne there won't be a pimple on any college campus.

There is a small female predominance, especially for those whose acne persists into middle age. It does appear as though the absence of acne is associated with relative poverty and living in primitive conditions on islands.

https://jamanetwork.com/journals/jamadermatology/fullarticle/479093

Steve

I thought about that, too, but I'd kind of expect the opposite result: if your parents were gonna shell out for dermatology appointments and drugs, they probably had some means, which would translate into the kids generally doing all right, too, so less acne, more money. The testosterone thing you point out is interesting, though.

I don't have a good feel for the other correlates, but I think the correlation between acne and athletic ability is high.

I don't think the correlation between acne and attractiveness is of a high magnitude at all.

The testosterone correlation could be be tested via things like bicep size.

To be honest I am little surprised by these results. It seemed to me that jocks were the most pimply kids at school, not the nerds.

They cause acne. So yes it's a testosterone thing.

Maybe there's a correlation between acne and self-esteem/body image. (an inverse relationship).

In general, acne is pretty interesting topic, especially due to its relationship to sex hormones, which tend to have wide social ramifications.

Why put up these useless correlations? This is why economics will never attain the respectability of the sciences. The field is already littered with the same old formula of data mining + speculation = social science "analysis" with some flavor of neocon/neoliberal spin. And people wonder why nobody trusts expert opinions.

I'm guessing a lot of economists had pimples growing up and led sad incel lives of resentment and heavy masturbation. That's why this article passed peer review and is making the rounds on econ blogs. Not sure how to explain the other crap that passes for research, so I may be wrong on this.

Don't know what they controlled for. Most promising explanation would seem to be that different ethnic groups have different amounts of acne.

'that different ethnic groups have different amounts of acne'

Nope - 'The production of androgens during puberty explains, in part, why acne vulgaris is so prevalent in this population regardless of socioeconomic status, nationality, or sex' https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4769025/

Maybe student just need to eat the right candy
https://xkcd.com/882/

The causality is probably the other way around, that nerdiness and time spent in classrooms with teenagers of your age or above induces acne.

The possible mechanism that links acne and higher earnings, from the the article: https://sites.google.com/site/hugommialon/Pimples.pdf

"We further empirically explore a possible mechanism through which acne may affect education and earnings. In theory, having acne may reduce feelings of being socially accepted, thereby reducing time spent socializing and increasing time spent studying, which may be conducive to educational attainment. We find strong evidence that having acne is associated with feeling less socially accepted and less attractive. Interestingly, we also find that acne is associated with reduced participation in sports clubs and increased participation in non-sports clubs, suggesting a possible shift from physical to intellectual pursuits."

@Tsai-2 & mkt42. Yes, more time with the books. What is funny is the inverse correlation between acne an sport club participation. Perhaps it's more important to be nice and socially acceptable that training, eating and sleeping well for athletic performance.

"An important component of our work is determining the extent to which acne, and the reporting of acne, are plausibly exogenous............ We provide evidence that while acne in adolescence is related to certain fixed and observable characteristics, including age and race, it is not related to measures of socioeconomic status, including parental education levels or most measures of family structure. "

This part is interesting. There's a genetic component, but there's no poor/rich component. So, it's not rich kids with acne do better, but seems to be all kids with acne do better.

Of course, it's only a correlation. Then I remember that people that pay for acne treatments might also pay teeth bleaching, aeshtethic surgery (implants), nails & hair care, etc. Perhaps the use of acne drugs is a good and simple indicator of how much time, effort and money is put on personal image. The situation screams OPPORTUNITY COSTS.

I also remember some friends avoiding alcohol because it reduces the efficacy of the acne treatment. It's always complex to establish causality.

Assuming acne -> more studying -> better labor market outcomes, it is strange that acne is heritable but supposedly not associated with parental income or education.

You may want to read this link too - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4769025/

Which basically says that much of what the authors linked by Prof. Cowen are writing is simply not relevant. Admittedly, the additional article is only dealing with acne vulgaris, which is not the only form of skin problems that are often described as acne.

What is fascinating is indications that increasing global rates of acne vulgaris seem to be linked to diet - in part, through insulin as a mechanism.

And the article provides much more nuance to the idea of a genetic component - basically, diet trumps genetics, it appears. 'As these types of foods become cheaper and more ubiquitous, it comes as no surprise that nations outside the US are starting to see a similar trend of rising rates of obesity, insulin resistance, and acne among the younger populations. Conversely, there are also populations documented that abstain from a Western diet, eating meals low in meat and devoid of grains or dairy products. As a result, acne vulgaris is absent in these populations'

"eating meals low in meat and devoid of grains or dairy products"

My grandparents were subsistence farmers and all four suffered stunted growth due to the scarcity of high-calorie food. They were lovely and caring; albeit, short and died relatively young due to their stressful life. So, please don't glorify famine. People don't abstain from a Western diet, they simply have no food, it's not a (short term) choice.

'So, please don't glorify famine'

Far from it. And in all fairness, 'devoid' is a strange term in this context, as pretty much everyone on the globe (including famine victims) eats grains as a part of their diet.

'People don't abstain from a Western diet'

Um, some people most certainly do, though 'abstain' is a bit like 'devoid,' particularly depending on how you define 'Western diet.' Is the typical Mediterranean diet 'Western'? How about the typical diet of a well off Indian? Or in Japan?

As noted above, this discussion has been interesting in providing a bit of insight about a place that grows ever more distant to me. In my personal experience, Germans today seem to consider acne pretty much the same way most Americans considered acne in 1979 - an unfortunate transient problem involving teenagers. That the U.S. has apparently grown considerably more extreme in how it looks at acne is not a surprise, exactly - but still depressing.

I think acne drugs are just a flag for a larger behavioral pattern:

No acne drugs implies also no investment on hair, nails, aesthetic surgery, etc -> more studying -> larger income.

I don't think you use Accutane prophylacticly. You get acne and then you get Accutane to fix it.

Plus the paper is reporting results in the other direction: acne leads to wealth.

I have heard that Accutane is used as a PED in some circles. Starlets with clear skin take it to improve their complexion further. But I don't think that's the normal usage.

Accutane, a popular and effective anti-acne drug, is quite powerful. I wouldn't be surprised if it tends to have some subtle psychological effects. For academics looking for understudied research topics, this one could be interesting.

It comes with a big warning about depression and suicidality (as well regular liver function checks) as so yes, there may be something to that.

Next to that it wreaks havoc on skin and they make women sign that they use dual contraception methods.

Effective but nasty stuff.

I'm Romanian. Quite a few people I know took Accutane. I did as well. That list of potential side effects was so horrendous that it became funny. However, the ones that did use it had very bad cases of acne, or late onset. I barely had a pimple until age 19, when it came in a rush and was going to leave a scar. I had no side effects, but one friend reported feeling depressed. Then again, his doctor recommended a higher daily dose than mine did.

Also related to what you said is how girls in some countries are prescribed birth control pills for skin disease like acne.

If someone has access to the paper, I'd like to know more about the data. When I look at the Survey website, the question regarding acne appears to be:
"For which of the following conditions have you taken prescription medication in the past 12 months? acne"
The responses are from 2001-2002 when these children would have been around 7 years old. It also appears that 40% of the responses are indicated as "legitimate skip." I'd like to know more about what a legitimate skip to that question means. Also, having taken medication for acne is not quite the same thing as having acne, so I wonder about the intervening socioeconomic background of respondents - I would expect that some groups are less likely to have been diagnosed, given a prescription, and then filled the prescription than others.

'Also, having taken medication for acne is not quite the same thing as having acne'

It really isn't - though headline writers cannot resist writing something like 'Do Pimples Pay? Acne, Human Capital, and the Labor Market' when at least 85% of people have had pimples during puberty.

'I would expect that some groups are less likely to have been diagnosed, given a prescription, and then filled the prescription than others'

Well, yes, but there is a group - one would expect at least as large as those taking any medication for acne - who would never have been diagnosed with 'pimples,' nor given a prescription, not to mention never having it filled.

(One should never blame a writer for the headline, as pointed out in this case of a serious dissident - 'In September 2016, Crisis Magazine published an article by Esolen titled "My College Succumbed to the Totalitarian Diversity Cult." Crisis Magazine wrote the title for the piece, according to Esolen.' which is quite credible, as headline writers are always looking for attention.)

sociologists do acne research!
so who sabotaged/tried to sink
the saudi oil tankers?
it wasn't us

The no-pimple, socially popular and busy, medium SAT kid in house thinks this is a coincidence.

I wonder if the flavor of acne matters?

Facial acne vs. backne vs. buttne?

If you have all three is the effect stronger? I can't access the full text and I'm dying to know.

Acne prevents people from having a girlfriend/boyfriend and thereby causes them to spend more time studying.

Possible confounding variable. People that are more socially astute (or socially inclined) may spend more time washing their face and or applying acne remedies, and therefore are less likely to have acne than the dorks. Also richer people are less likely to eat acne inducing fatty finger foods like fries and thus less likely to get grease all over their face.

"richer people are less likely to eat acne inducing fatty finger foods like fries"

That's the popular stereotype, but this research says no:
https://twitter.com/DegenRolf/status/854581412753805312/photo/1

(I basically don't read twitter, but ever since Tyler linked to that Alexey Guzey fellow who posts a "best of twitter" once a week, I do read Guzey's emails and occasionally click to read the linked tweet. The one above is from Guzey's email yesterday.)

I sent this study to my 14 year old daughter. I will quote her directly:

"That’s because people with higher grade averages tend to be more stressed about school, causing acne. The acne doesn’t affect the grades, the grades affect the acne."

I am feeling proud right now :)

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