Wednesday, March 4, 2009
Debating Piazza's acne issues
In the midst of conducting some long-running and apparently endless business with an ill-liked colleague, Murray Chass writes about the pimples on Mike Piazza's back:
Now as na´ve as I might have been about steroids, the one thing I knew was that use of steroids supposedly causes the user to have acne on his back. As I said, Piazza had plenty of acne on his back.
When steroids became a daily subject in newspaper articles I wanted to write about Piazza's acne-covered back. I was prepared to describe it in disgusting living color. But two or three times my editors at The New York Times would not allow it. Piazza, they said, had never been accused of using steroids so I couldn't write about it.
But wait, I said, if I write about it, I will in effect be accusing Piazza of using steroids and then someone will have accused him of using steroids. No can do, I was told. I always took the veto to stem from the Times ultra conservative ways, but I also wondered if it maybe was the baseball editor, a big Mets' fan, protecting the Mets.
Whatever the reason, I never got Piazza's suspicious acne into the paper. Then all of a sudden the acne was gone. Piazza's back was clear and clean. There was not a speck of acne on it. His back looked as smooth as a baby's bottom.
What a remarkable development. It was a medical miracle. If teenagers could get hold of whatever Piazza used to clear up his back, they would be rid of the acne problem forever.
But the method Piazza used became apparent to me. It wasn't medicine or any substance; it was abstinence. This was during the 2004 season, the first season baseball was testing for performance-enhancing substances with identification and penalties attached. If Piazza had been using steroids and didn't want to get caught, he had to stop using. If he stopped using, his back would clear up.
His back cleared up. Completely.
Look, I'm not saying that Murray Chass is wrong about Piazza. My personal opinion about power hitters of Piazza's era is that they're mostly guilty until proven mostly innocent. You might think that's terribly unfair. But this isn't a court of law. It's a court of opinion, and I'm entitled to form mine however I like.
To that end, I ran Chass' piece past my friend Rany Jazayerli. Now, you probably know Rany as a brilliant writer with Baseball Prospectus and his own blog. But his patients know him as Dr. Jazayerli, Crack Dermatologist, and I'm lucky to have him whenever the baseball talk turns to pimples, blemishes and oozing pustules. Rany's take:
1) Anabolic steroids certainly can cause bad acne, and it tends to be worse on the trunk (i.e. the back and chest) than on the face.
2) I would guess that some steroids are more prone to this effect than others, but I have no idea which ones; I've only treated one or two patients for acne that admitted to using steroids. Will Carroll might know.
3) Severe back acne is certainly not solely the province of steroid users.
4) The fact that Piazza's acne cleared in the span of one off-season could be the result of him no longer using steroids ... but it could also be the result of a course of Accutane, which can clear even the worst acne cases in the span of about six months.
So, bottom line, the fact that Piazza had such severe acne is circumstantial evidence he used steroids, but not a smoking gun by any means.
That is just about my take, too. If we do take Chass' word and his memory at face value, we're looking at just one more piece of evidence. There will, I suspect, be more.
(H/T: BTF's Newsstand)