Girl Meets Pimple

YOU KNOW THOSE TIMES WHEN—BING!—YOUR EYES JUST POP OPEN WITH some profound realization you had overlooked before? For me, it was just past three o’clock in the morning when I felt a wave of anxiety wash over me. “What did I do yesterday?” I thought to myself. Did I really just start a GoFundMe page for one of my patients, whom I affectionately call Pops, without asking his permission? The day before, I had posted a video on my YouTube channel, Dr. Sandra Lee (also known as Dr. Pimple Popper), of some amazing blackhead extractions I had done on Pops. Blackheads, which are open comedones, are like snowflakes: each one is an individual; they are so satisfyingly unpredictable. Sometimes you squeeze one and get the most amazing pop: you never know if it will sputter out with a little light pressure from my comedone extractor or if it will slide out smoothly. Pops’s blackheads were no different, and removing them had been an ongoing journey for us, since he had so many of them.

I have to back up a bit here for those of you who are not avid “popaholics,” as I like to call them. The story of how I came to be Dr. Pimple Popper was unexpected—kind of a happy accident that I noticed and seized upon, and Pops has a lot to do with it. I have been a board-certified dermatologist in private practice for more than a decade, specializing in skin cancer and cosmetic surgery and reconstruction and laser surgery. You may wonder, aren’t extractions something a dermatologist does regularly? Isn’t this what a dermatologist is supposed to do? It’s not that dermatologists aren’t capable of “pimple popping”—that is, extracting blackheads, whiteheads, and milia, and surgically excising cysts. It’s that this is such a small part of what our profession is about. We are experts who deal with all medical conditions of the skin, hair, and nails. And believe you me, there are so many!

In 2014 I had started an Instagram account, @DrSandraLee, intending to showcase my life as a dermatologist—to educate people on the many facets of my profession. Instagram is flush with gorgeous filtered images: mouthwatering pictures of food, exotic places traveled, and beautiful do-it-yourself makeup, hair coloring, and styling tutorials. I saw a quickly increasing popularity among makeup and hair gurus, as well as a growing interest in spa treatments and cosmetic treatments. Would these same people, and others, be interested to see what I do day-to-day, as well? Hmm . . .

One day Pops came in for a regular appointment, but something was different. For years, I had seen him as one half of a whole, or what I lovingly call a “package deal,” meaning that he and his wife came together. Always. Except this time, his wife wasn’t with him. I knew she had been ill; recently, she had taken to waiting in the car during his appointments, not feeling up to coming into the office. I couldn’t help but ask how she was doing, and instantly regretted doing so.

“She’s gone.” Pops choked back tears and looked down at his hands. She’d been his whole life. She ran the show. And now he was lost without her. I noticed that his clothes weren’t as neatly pressed as they usually were, he had a stain on his slacks, and his hair appeared a little more disheveled. Nothing I do can take away a person’s emotional anguish, but I wish I could have waved a magic wand and made some of that pain and sadness disappear. Opening a GoFundMe page in his name was an impulse move—a result of my learning about his economic hardships and overwhelming grief since his wife had passed away. People who watched my videos from around the world sent the kindest messages of hope and love to Pops and donated money to help someone whose face they’d never seen! They’d just heard his story and knew every blackhead extracted from him by heart! My popaholic fans are amazing: we ended up exceeding the $5,000 goal and raised more than $14,000 for Pops!

Pops and his wife had been my patients for many years, but in all that time, I was examining his skin and mainly treating and controlling his precancerous skin lesions and skin cancers (non-life-threatening but locally destructive squamous cell carcinomas and basal cell carcinomas). It actually took the unfortunate passing of his dear wife for me to bring up the fact that those bumps on his nose were benign blackheads and whiteheads. It wasn’t until this point that he confided that he knew they weren’t dangerous, but he absolutely detested them. Not because he could see them; his eyesight was failing and he couldn’t. But because he could feel them, and he couldn’t get rid of them himself, and they made him feel ugly and ashamed.

So I asked him, “Would you like me to extract as many of these as I can? This is a procedure I can’t bill to insurance, but if you allow me to film the procedure for others to watch, I won’t charge you.” He immediately agreed, very happy that I was going to take care of them. This surprised me. I had never offered this service to my patients in the past because, as a dermatologist, I avoid extractions that aren’t medically necessary, as health insurance doesn’t cover them. Patients normally have to pay out of pocket for these “cosmetic” procedures, and they can be very expensive because they are time consuming.

Just a couple of months prior to this, I had posted a video on Instagram of me extracting a blackhead on the back. To my surprise and curiosity, there was a noticeable increase in “likes” on this post and, subsequently, on any posts involving “pimple popping.” In fact, my most popular Instagram posts were simple blackhead extractions. Would followers be interested in other things that I pop out of people’s skin? Yes! People were mildly interested in what it looked like to administer Botox or treat a wart, or even to see what psoriasis looked like. People seemed to get really excited, though, when I posted a milia extraction or a blackhead squeeze. Once they saw that, they were hooked. I am talking about unbridled enthusiasm. People who liked it loved and obsessed about it. People who hated it detested it. Either way, they tagged their friends because they just had to share. I had happened upon the discovery of a pretty substantial demographic of popaholics.

No longer wanting to limit myself to fifteen-second clips on Instagram (today the app lets you post one-minute clips, but back in the olden days—a couple of years ago—fifteen seconds was its limit), I posted a full-length pimple-popping video to my YouTube channel, a platform I had created and originally used for TV appearances, and which was meant to appeal to a much smaller fan base. What should I call this Instagram page and YouTube channel that I would devote mainly to sharing things that I’m able to pop from the skin? Well, I gave myself the moniker Dr. Pimple Popper, and things really erupted from there.

People were demonstrating a substantial interest in an area of medicine that usually doesn’t get much attention. My YouTube videos of Pops, his blackheads, and his emotional progress after losing his wife have been viewed—get this—more than sixty million times! As I write this, I have exceeded 2.5 billion total views on my YouTube channel, with the vast majority of them coming since 2015. Because of this social media exposure, which I created in a very DIY fashion, I went from being a private-practice physician to an international social media personality and influencer, with beauty magazines and TV talk shows seeking my expert opinion, and my social media pimple popping being featured in the Wall Street Journal, the Washington Post, and New York magazine.

I’ve come to realize that it’s a shame most dermatologists don’t treat these benign cosmetic conditions, because it’s very obvious to me that these “ugly” bumps and embarrassing spots on our faces and bodies have so much to do with how we feel about ourselves, and this, of course, affects every aspect of our lives.

Now if I notice that one of my acne or skin cancer patients has a blackhead or milium, I like to offer to extract it for free in exchange for permission to videotape the procedure so I can post it on my social media. Happily, very few people decline this offer. I’ve been pleasantly surprised to learn that they are extremely grateful that I suggest it, making for win-win-win situations. My patient gets rid of something that has been bothering them for some time, and at no cost. Viewers of my YouTube channel, Instagram, Snapchat, Twitter, and Facebook page get to witness the glory and satisfaction of a good blackhead extraction. Finally, for me it’s been an unexpected win, as I hadn’t realized how very appreciative many of my patients would be after I removed a growth that had been a source of embarrassment, shame, and even depression because other physicians may have refused to remove it.

I really have no simple clear concrete idea why people like to watch pimple popping, but I certainly have some theories. For many, it’s akin to slowing down and staring when driving past a car wreck, while for others, there is this feeling of fright followed by euphoria and exhilaration, similar to riding a roller coaster or watching a scary movie. And for those who keep coming back, there is something hypnotic about watching a pop or a squeeze or even an incision; it’s satisfying on a deep psychological level, perhaps because eliminating a blemish of any kind offers a sense of closure, resolution, and accomplishment. Ultimately, the reason I continue to do this, and why my viewership continues to grow, is that watching pimple popping seems to make people happy. Can you believe that? It’s fascinating to me and mind boggling at the same time.

How my life has changed since I started posting my work on social media. I would have thought the private practice I share with my dermatologist husband, Jeff Rebish, in a quiet suburb of Los Angeles would continue to grow gradually over time and that my workdays would be filled with surgical and cosmetic procedures: Mohs micrographic surgery (a technique to remove skin cancers), Botox and fillers, acne treatment, eyelifts, liposuction, and lasers to treat brown spots, red spots, and fine lines and wrinkles. A few years ago, I never would have believed that I would be extracting thousands of blackheads, cysts, lipomas—anything that pops from the skin. I have removed more blackheads, excised more cysts, and popped out more lipomas in the last few years than I have during my whole dermatology career before then—times a hundred!

I still do all the things a dermatologist does in private practice, but the other day, before my first patient arrived, I filmed a segment with a British TV talk show about how celebrities with acne get red-carpet ready. The next day, I talked to an Australian morning radio show about what makes people obsessed with popping pimples. A few days later, I answered questions about skin on Facebook Live with a well-known American magazine. After that, I collaborated on a video with a famous YouTube star from Amsterdam. And now I have a television series on the TLC channel, named, appropriately, Dr. Pimple Popper.

Fame has its moments too—good and bad. My least favorite experience was when I just had my first child via C-section and I was in the hospital recovering. The nurse came in the day after delivery, woke me by opening the drapes to bring light into my room, and announced I needed to get up and use the bathroom. One of the first major steps you have to take to get a hospital discharge is to be able to use the bathroom on your own. Man, that was tough! I hobbled slowly, completely stooped over, making my way to the bathroom while almost overcome with waves of nausea and light-headedness—I thought I was going to pass out! I left the bathroom door open so the nurse could get to me in case I hit the floor. As I was sitting on the toilet trying to catch my breath, I’m sure with no color in my face, the secretary at the labor and delivery desk darkened my bathroom doorway. “Hi, remember me?” she said excitedly. “You saw me for the spots on my back a few months ago, and I have more and was wondering if you could take a look and tell me how I can get rid of them?” Please don’t do that to anyone.

Another instance was when a patient’s daughter approached me on the golf course. I was in midswing when I heard a golf cart approach me from behind. Her father had instructed her to cross over two golf fairways to ask me to look at the mole on her back and tell her it was okay! Please don’t do this to your dermatologist. It’s difficult to assess your moles or give you any skin advice when we are away from our office and don’t have your personal history in your chart or our instruments to properly assess your skin growth. Needless to say, I took a mulligan on that hole!

It’s not that I don’t want you to say hello when you see me, but try to save the medical questions for the office setting, please. Okay, well, I do secretly have a favorite time when a patient of mine approached me. In the grocery store, this happens every now and again: A sweet patient will come up to me and say “Hi, Dr. Lee, it’s So-and-So. Remember me? You did surgery on me last month!” My favorite response: “Oh, hi! Sorry, I didn’t recognize you with your clothes on!” I love doing that. Makes my day, haha.

Putting my work life on display on social media was eye-opening to me, because it validated to me that the hard work I put into making sure my patients are comfortable and relaxed in my office is truly one of my best attributes as a physician. And I really learned this from my father. I still recall the words he told me in the first few weeks I began work as a dermatologist myself. He said to me: “Always remember, Sandra, that the physician that graduates at the very top of his medical school class, who receives the most respected accolades and awards in medical school and residency, who is considered one of the most intelligent physicians around, can have a crappy bedside manner—be cold and curt, impolite and condescending, and will quickly be regarded as a terrible doctor. Conversely, the physician who had mediocre grades and accomplishments during her training but who has a wonderful bedside manner—who is open, warm, inviting, confident, and inspiring—will easily be touted as an excellent physician in intellect and skill.” Obviously, we all ideally want to be smart and accomplished and have a great bedside manner, but this advice was meant to explain to me that how we treat our patients emotionally is just as important as how we treat them physically. This is one of the very best (but certainly not the only) pieces of advice my father has given me.

LET’S REWIND

I should explain how and why I became a dermatologist, which was much more complicated than a standard résumé can express. The most obvious reason that dermatology was on my radar at all was because my father was a dermatologist (now retired). My father grew up very poor in Singapore, one of ten kids. As a child, he loved to read and was obsessed with books. He would stare longingly into the windows of bookstores. All the money he could scrounge up by doing odd jobs was used to buy books. Needless to say, the house that I grew up in was full of books, with stacks of volumes on every conceivable subject to be found on every table, bedroom nightstand, and even available counter space.

If my dad didn’t know the answer to a question or was just curious about a particular subject, what would he do? He’d buy a book! I knew the aisles of our local bookstore intimately. Nearly every weekend, we used to spend a couple of hours at the shop, where I would wander off to discover the wonderful titles lined up neatly on the store shelves. I’d listen for the comforting sounds of my dad’s keys jingling in his pockets and his whistling familiar tunes—reminders that he was close by. I think my father bought every dermatology textbook ever published!