IamA Dermatologist, Dr Sandra Lee, aka /u/Drpimplepopper, who in the last year and a half has gained over 3 million subscribers/followers on my YouTube channel & Instagram combined. And all this had a lot to do with my discovery of the subredd...

I love your videos, not only are they mesmerizing but they are also very informative. You seem to be very resistant to the "grossness" of your work, but has there been any situation where you could not contain your disgust?

I'm not resistant.. or ok, maybe I AM resistant compared to the average person, but certainly there are times that I may feel surprise or disgust... but the key is NOT to show this. The patient is the MOST important to me, and I never treat anyone under general anesthesia so patients can hear everything we say. We never say "oops" or "oh my god what is that?!" etc, nor will you hear us gasp or scream... even if something takes us by surprise.. I don't want to alarm or frighten my patients. Later, amongst ourselves, we may comment on what happened but we never do when the patient is present.

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That depends on the friend. If they're nervous abt something I prob wouldn't joke. But yes if pranked many friends haha that's part of them being friends with me. Telling them that their mole or bump could be herpes and, you know... Herpes is forever...

Hello doc thanks for doing this AMA!!

What is the worst fake/false skin advice you've seen circulating the internet?

That if you shave hair in an area, the hair grows back thicker. This is NOT the case and is a myth. If this were true, then balding men would be shaving there scalp every day to grow more hair!

Hi Doc ! As 1 of your many addicted followers, I'm wondering about your patient load. Are you seeing a marked increase in office visits as a result of your youtube 'fame' or have you closed the doors on random new patients? :)

yes, and we are still learning how to deal with it. The problem with it all is that I'm the "rate limiting step". I can only see so many patients. Of course I'm so flattered that people are willing to travel far to see me.. I've had people from across the state and other countries, even from as far as London, France, Saudi Arabia!

Do you ever get asked to 'take a quick look at this' in social situations? Like, a friend takes you to the restaurant bathroom cause she just noticed a weird mole or bump.

yes, and in general, it's pretty annoying, unless of course it's a good friend of mine, then of course I don't care and am happy to help. It's annoying because when I'm not working, I don't really want to talk about work, just like any other person in any profession. The worst situation for me was when I was playing golf one weekend and in my backswing I could hear someone driving up behind me in their golf cart. It was a young woman who's father was playing on another hole and told her to ask me to look at a mole on her back...

You're in LA ish area right? What's your home course? If you're ever on the west side, Rancho park's my stomping grounds.

And ... is there a Mr. Dr. Pimple Popper?

yes there is a Mr, BUT he hates being called that! hehe He is saying he's pretty much the best thing since sliced bread.. That's him talking. Yes, I'm outside of LA between LA and Palm Springs.

California translation: Don't ask me where I live. Haha.

Ha sorry. I thought most people knew I'm in Upland ca. Right next to Claremont, Ontario, Pomona... ;)

Hey Dr Pimple Popper, I'm a huge fan from Ireland! I love your videos - not only are they informative but they're so good to watch. My question is, what do your colleagues/family/friends think of your fame? Are they confused as to why people like your videos? Keep up the great videos :)

First time I told my dad (a retired dermatologist) was last March 2015 when Buzzfeed made a video about my pimple popping on youtube. I told him that I had this youtube channel and that I had been posting videos on it and that one of them went viral. He asked me what type of vids was I posting. I said.. uhhh, well, they are blackhead extractions. He just looked at me and said, "well, that's just ridiculous". Next day, he happened to have an appointment at the Apple store to learn about his computer. He asked the teacher to show him how to post videos on youtube and the teacher said something like "oh my gosh, speaking of youtube you HAVE to see this amazing channel". Yes, it was my channel. That night, I had all kinds of respect from my dad! haha He pulled me close and said: "Sandra, I think if you go to the Apple Store, I don't think you will ever have to stand in line!! " ;)

What has been your worst procedure to date? Also, did you ever think this many people would be watching you?

I never imagined that this many people would be so interested in what I do, or that it would grow this quickly.. but I do enjoy "feeding the fire", I imagine everytime i post a vid it's like throwing another log on the fire. My worst procedure? I'm not sure, but to me, my "worst procedures" are ones that don't turn out as well as I hoped. I always under promise, because it's much better for patients to be pleased at the outcome that is better than they expected then for you to promise them the world and they are left disappointed. If you mean "worst" to mean grossest.. well abscesses are pretty gross in general, not gonna lie.

HI Sandra!!! Super huge fan here!!! I've always wanted to know... How do you get your patients to agree to be on camera? If I'm being honest, if I had a cyst the size of my fist... the last thing I'd want to do is to get it on camera!!!

Ha, I don't know, my staff says I just have this way of charming them! I just ask if they don't mind if I film this extraction or surgery because there are people who follow me who really love watching this stuff. 99% of the time they say yes! I'm knocking on wood now, don't wanna jinx myself!

Dr. Lee!! Love your videos. I have what I think is a pilar cyst. My derm says to remove it they have to shave the area on my scalp. Why is that?

Well, most docs will shave an area of the head.. in fact I will clip the hair short in an area of the scalp if I'm removing a skin cancer. However, I don't do this when I remove pilar cysts. It makes it a little more of a hassle but I think it's worth it to the patients.. no one wants a bald patch when they're trying to have a bump removed that they're already embarrassed about! I've found it's not necessary to shave / clip and area but I can't speak for all physicians

Hello Doctor Lee! I'm a huge fan of your videos! I was wondering if you enjoyed popping before you became a dermatologist? It was it something you discovered during your work?

Thank you so much for doing this AmA. :)

Good question. Actually, the answer is "no" but not a resounding "NO". I call myself a "born again popaholic". I enjoy it now, but mainly because I know when I have a "good one" how excited some people are gonna be! haha

Hi Dr. Lee, Beyond how much I love your video's watching them has helped me deal with some of my own medical issues. Just by seeing what a punch excision is I was able to be calm during two different punch biopsies I've had recently. Your video's are making a difference in people's lives. I wanted to say thank you for your kindness and generosity to your patients who might not be able to pay for treatments. I just love Pop's. Such a sweet guy. How is he doing? Will he be back again. And Mr. Wilson, a very stoic man. What a incredible journey these men have had. I am blown away by Mr. Gold's transformation. He looked like nothing had been done. You are truly gifted. It's got to be incredibly painful healing from that surgery. I always think to myself how strong they must be to endure it. How much blind faith they put in your skills. I love all the pops, splats and squishes! More splats please, I love the messy ones. Trends come and go but you are building on something that is going to last beyond a fad. Thank you

You are awesome, thank you for taking the time to write such kind words to me!! xo

At what age did you know you wanted to become a dermatologist ?

Honestly, I don't know. My dad's a dermatologist and I guess I've just been exposed to derm all my life... I remember opening my dad's huge textbooks at home and being grossed out. One picture I will always remember was of this kid probably under 10 years old lying down with tapeworms coming out of the "other end".. I can still see that pic if I close my eyes.. eeks. Anyway, when I got into med school, I found out derm was one of the most competitive specialties - very difficult to get.. it think that's when I decided I wanted to try to go for it. And it wasn't easy.. big failures before any success..

I knew my mother had some textbooks laying around and took at look at them after reading you answer here. First page i opened was Steven-Johnson Syndrome on a 2 year old girl. Not touching those books again

Yes that and/or TEN, toxic epidermal necrolysis is one of the few "Derm emergencies"

I want to Google that but I'm deeply scared too.

Yes it sucks. I remember I had a patient in my residency. We had to order "dilators" for her private area so that it wouldn't scar down and close. Amongst other things. Eeks

What are your thoughts on this Seinfeld, episode #907?

of course I know the episode and it's what sparked the idea for the name! ;)

can skin ointment and creams really go bad? do they become unhealthy or do they just not work as good anymore?

some ingredients can spoil but I think all products have to have an expiration date no matter what and this doesn't mean that the effectiveness expires. If something has turned a different color or smells bad I would certainly throw it away. If it has expired via date, there is more of a chance it has lost its effectiveness but this can't be proven.

Sandra! I love your work! I only have two questions: Have you ever refused care with a patient? What was the worst skin care case you have ever had?

I have refused care and this is something that takes a while to learn how to do and it's actually important to know how to do as a physician. Don't let a patient bully you into doing something you don't feel comfortable doing, or may not be the best treatment. Esp if they have body dysmorphia. My dad has great advice: he says you have to say "It's not you it's me.. I'm not good enough to treat you" I don't know what the worse case is i guess cases that I know I can't solve.

Out of all the popping you've done, which one has been your favorite?

I like the ones that tell a story. I think there is no one favorite over time but there are always favorites of the moment. Like The Masked Man, Mr & Mrs Gold, Mr Wilson, Pops... one of the most gratifying things about what I do that I didn't expect before becoming a dermatologist, is the wonderful relationships you develop with some of your patients. You get to meet and speak to at length, and really get to know someone that you may have never spoken to or been associated with in your own personal like. Like Humans of New York, I like to call it Humans of Dermatology or Humans of Popping.

Whohoo! I'm so glad I requested you do an AMA! Your videos help me relax at night before I go to bed. I also find myself popping and picking at my face so hopefully I can ween myself off of creating scars on my face. Do you have any tips for preventing scars (like better technique) or ways to acupuncture getting pimples and blackheads?

Thank you for inviting me! Tips for preventing scars: know when to stop. Only pop a pimple when it's come to a head. Don't press too hard with the comedone extractor, pretty common sense things I think but sometimes when it's your own skin, its hard to stop.

Thanks for the advice! My sister goes to school near LA, and she has some huge blackheads in her ears. I'm going to try to convince her to see you and beg her to film it!

Well, if she comes to see me I will certainly ask her if I can film it! ;)

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ha, no Tipsy Bartender didn't give me alcohol in exchange, i did it for "free" but it was worth it.. my first collab and he is the sweetest guy with great advice in general for me about youtube/social media, etc I always thought that people would be interested in seeing what we do as dermatologists. Our specialty is much more visual than other specialties so people can relate easily, and works well for video/social media. I know this really exposes us as physicians but I guess I know what I'm doing and that it's all about the patient and so I can hold my head up high and not worried by any naysayers.. been lucky that there are few!

How should my teenagers treat their acne? Pop, or no pop?

They have to know when to pop and not to over pop. Know when to stop the pop.

Have you ever seen Vikram Yadav's youtube videos on blackheads?

https://www.youtube.com/user/shaziajafrey8

I have, and he seems like a wonderful man, very intelligent in all aspects of medicine. I don't know if he is a dermatologist, but he certainly knows a lot of dermatology and much more too!

Have you ever treated someone with hidradenitis suppurativa?? If yes, how so?

I ask because it seems like something not a lot of dermatologists know about, and from the support groups I am in, it seems very difficult to treat.

I think we as derms have all seen HS, but it is VERY difficult to treat. There has been some recent reports of biologics being successful treatment options (Embrel, Humira, etc). So, we know about it, but again, there is no treatment option that is excellent, unfortunately.

WHERE can we find the EXPLICIT video of the 20 year old cyst being popped for the doctors episode? I can't seem to find it on your site.

I don't think you will ever see that video.. I'm sorry but I don't have rights to it. That was my patient, but The Doctors filmed the surgery for their TV show, and so I don't have any rights to the film. Don't worry, I wont be doing that again! Those big ones I'll save for my youtube channel from now on!

Do you believe you inspire young people who want to go into the medical field?

I do feel new responsibility, since I get letters and messages often from young people who are interested in medicine and possibly dermatology, after seeing my videos. I'm proud of that and wish them all good fortune!

How do you, if at all, recommend treating pseudofolliculitus barbae in Black guys?

best thing for you to do is not shave your hair that short so the hairs don't curl under or get caught under the skin

Hi Dr Lee, the neatness and dexterity of your work is impressive on its own, but the level of respect, consideration, care and integrity with which you treat all of your patients is what sets you apart from other Web Drs. Is this something you were taught at school or learnt from your Dad ? I hear the way some of your older patients talk about him, with such respect, that I expect him to be a stickler for respectful patient care !

I think it's both what I learned from my training in derm residency AND what I've learned from my father. My dad has excellent advice that he has given me over the years, and it's not usually about how to treat a particular skin condition, but rather, it's about how to interact with patients. Yes, I have big shoes to fill, indeed ;)

Are you having to "fix" many failed attempts at DIY procedures (specifically, people trying to remove cysts or large blackheads) as these have increased in popularity over sites like YouTube? If so, any stories you can share?

I don't really see people who have really damaged themselves from trying to remove a cyst themselves. Many people squeeze their own cysts and try to get rid of them, but not many attack themselves with a box cutter.. I think those are the crazy ones who will video tape it! I can't think of any stories that include a failed attempt at home. And personally I prefer the "virginal" cysts and blackheads. Much easier to remove/ no scar tissue that makes for a much prettier, cleaner video with less blood, difficulty in removal.

Oh my gosh, what a coincidence, I just discovered your channel a few days ago!

Two questions if that's okay? First, why does the nose seem so rich in terms of blackheads to extract? And second, the procedures on your channel look so awesome, but I always wonder if the extractions smell bad or do you just get used to the smell?

The nose is rich in sebaceous glands / oil glands which produce sebum / oil. Fertile ground for blackheads. Blackheads don't really smell but in all honesty, I don't smell them, do I wouldn't really know. Sometimes cysts have an odor, sort of the kind of smell that they look like they should have I guess? Sometimes they don't though. When you have a particularly ugly looking extraction you kind of brace yourself waiting for there to be an odor, but I'm wearing a mask and I don't breathe in deeply and they don't always smell from afar. I don't go looking for it I guess I should say.

What's the deal with thedanger triangle of the face was this just a myth to stop people from self popping?

There is something called the danger triangle but you would have to really go to work on a pimple to cause an infection to spread to these important vessels in the area. I think it has to do with the fact there is a closer connection to the brain. They talked about it in Med school but I've never seen or heard of anyone dying or getting really messed up from popping a pimple in the area and things getting out of control.

How has the recent phenomenon of 'Pimple Popping' changed your life, career, or dermatology in general? Also have you ever gotten pus into your mouth?

Don't even SAY such a thing! NEVER had pus. In the mouth. Never had and NEVER will! I have been in practice for over 10 years and in the last year and a half I have done more blackhead extractions, cyst and lipoma removals than I have in my whole career times TEN. And now, I get recognized as DrPP in the real world, usually when I'm wearing mismatched pajamas to run errands with no makeup on, of course. But it's all in good fun!

What is your opinion on pharmaceutical reps? And what do you like to see in your reps who visit the office? Thanks!

pharm reps are fine they are doing their job. I like the ones who are friendly but recognize when you are busy and back off. I think most of us would agree on this

Not related to acne but can you comment on any exciting advancement in the treatment of stretch mark suffers?

We are always trying new things, there are always new developments but so far there is still nothing that is excellent and a home run. Hopefully in our lifetime. presently, there are some lasers and also people are trying micro needling/ micropen treatments

Thank you for replying. Any opinion on stem cells for acne scars then?

honestly? meh.. I think the introduction of a needle in an area of scarring spurs more collagen synthesis than anything else. hard to know whether stem cells applied to an area can actually incite change in local tissue. but we shall see. techniques are always being refined and I think we are traveling in the right direction!

Dr. Lee, I'm absolutely in LOVE with your videos. I just wanted you to know that I love hearing your rapport with your patients and how you handle talking about what's going on during the procedure. I'm an RN student and they constantly drill into us about being mindful how we handle talking to patients when things catch us by surprise or gross us out. Hearing you in natural conversation in those situations with your patients has definitely helped me with my patient communication skills.

Do you have any further advice about patient communication and how you learned to hold back the gasp when things catch you be surprise?

Thank you for the kindest of words!! The fact that you are mindful of these things tell me that you will be a fantastic RN indeed! I would just say that you learn to hold back that gasp pretty easily it's not that hard, esp when you don't have to look the patient directly in the face. Advice I have: There are two kinds of people in the world, those that feel that the glass is half full and those that feel that it is half empty. At work, be that person that feels the glass is half full. Happiness and positivity is contagious.

You just made my whole day! Thank you for the advice and thank you for sharing your fantastic work with everyone!

Aww thank you! have a great weekend!

Doc---Do you use more than local anesthesia when you do an excision from a patient's scalp? And why? I really enjoy following your social media accounts!

no, I use just local anesthesia. Rarely, I'll have a patient who is extremely nervous, and if they have a driver, I can give them oral anti anxiety meds but that's it, and that is a very rare occasion.

Hey Doc, greetings from Moscow! Sorry for asking personal question, do you have children and if so, how do they react to your job?

Yes I have two boys in grade school. One doesn't like the popping stuff, the other one tolerates it because he just wants to support me any way he can. Some of their friends on the other hand, sometimes they want to spend more time with me than with them! ;)

What made you choose to be a dermatologist?

My father is a dermatologist so I grew up around it. I'm a lot like my dad too, in personality and I think proficiency, so I was very lucky that I got a position in a dermatology residency!

When psoriasis is gone why does it leave a white spot and how would you get rid of that?

PSO doesn't necessarily leave a white spot, I suspect what's happening is that noninvolved skin has tanned and when a spot of pso has disappeared there is a color change there b/c that area is not tanned.

Any advice for sufferers of rosacea?

really depends on what your particular rosacea issues are. some people get "pimples" some people get flushing/redness alone. Best to see a dermatologist to be accurately assessed.

Hey Doc! What's your opinion on the satisfaction people get watching you "pop it"? Do you think the rise in fascination is brought on by a kind of social rise in self-acceptance? Thanks!

I think that people who knew they liked it in the past kept it a secret. And now, people are not so embarrassed to let others know that they like it, because they see that there are many other people out there like them. They are not alone!

We only ever see your 'popping' videos on YouTube. What other aspects of dermatology do you enjoy? Are the bulk of your patients now those looking for cyst treatment?

I try to put other things in there every now and then but yes the bread and butter of my youtube channel is the popping. I consider myself to be a dermatologic surgeon, so I most enjoy procedures.. two days a week I do Mohs skin cancer surgery, which involved repairing skin cancer defects on the face with flaps and grafts - creativity is involved and this is very rewarding. I also like to do some cosmetic surgery procedures such as liposuction, eye lifts, laser treatments...

Hi Dr. Lee! Medical student here currently studying for Step 1. Any tips for avoiding burnout/going bonkers?

oh gosh, I don't know, we all have our own ways of dealing with stress. But it is important to make sure you have an outlet so that you are not so consumed with all the stressful stuff. You can do it, and i think this is part of your training. As a physician you will have to deal with many stressful situations, and in fact, your current situation is helping you to learn how to do this! Take breaks then study hard! Good luck!

Hi Dr. Lee! Thank you for doing this! I'm a huge fan!!! Love to pop! I don't do a whole lot to my skin because it looks pretty good. I do get nose blackheads and some whiteheads on my chin but I extract those and I'm good to go. The only thing I use is rosewater to cleanse and almond oil for moisture, but as I get older I'm wondering if I should be doing something else to protect my skin. With so many products on the market (and so much debunking as to the actual effectiveness of most of these products; lookin at you, sunscreen) it's very hard to choose, plus I don't want to freak my not-that-bad skin out with a bunch of different products. Should I just stick with my regimen, or is there something else I should be doing?

SUNSCREEN ;)

How do you treat scalp psoriasis?

There are many treatment options, usu we start with topical corticosteroids, but it depends on the severity

How do you deal with striae that end up with cysts/ingrown hairs on the border?

you can extract those blackheads. if the ingrown hairs are recurrent, you may want to consider laser hair removal or excision that local area depending on how large an area it is

How do I get rid of dandruff? I've tried everything from vinegar, some red prescription shampoo, some tar type of shampoo. Nothing helps.

It's over my entire scalp.

There are prescriptions that a physician can give you that can help. Can't really cure it but you can learn to control it. If you don't wash your hair very often, I would start with reversing that, some ppl think washing your hair less will prevent it and it's usually the opposite.

I always wondered how long the wait list is - How far out do patients have to make appointments with you?

it depends on what kind of appointment it is. Some things need to be treated/addressed sooner, like melanoma or other skin cancers, of course ;)

Hi, Drpimplepopper! I was just browsing AMA and as someone who has picking issues...I have to say I'm now sucked into your videos and can't look away. It's brilliant that you're sharing them.

My question is in regards to Keratosis Pilaris. Do you see a lot of patients who have both KP and problems picking it?

we see a lot of people with KP, not a lot of people pick at it but they do hate the bumpiness.. the problem is there is nothing to really squeeze out and your arms will look worse if you pick

Just wanted to say how inspiring you are in interested in being an esthetician now. How similar are they? I know dermatology is more complex and knowledgable. You are so smart and still so kind to her patients! It's a wonderful thing you do thanks so much :)

thank you! they are complimentary professions and have some overlap but not that similar.

Your videos are my bed time ritual... I have watched many of them more times than I care to admit. I especially enjoy the multi-part 'story' series, and the follow-ups. After Noticing my addiction to these types of videos, my girlfriend suggested I look into training to be an esthetician. For one interested in the dermatological field, but lacking the resources for medical school or any real degree program, do you think esthetics could satisfy my LUST?!

I think it could satisfy you esp if you mainly love blackhead extractions. Maybe it's a sign to pursue what you love. I don't think it's a huge investment in time and money... go for it if you think it's for you!

Hi doc! I'm brazilian and in love with your work! I'm studying medicine and hope to become a dermatologist! I admire you for you're always so clean and correct in your procedures! Do you ever accepted interns for a few weeks? I'm a candidate! :D <3

I get requests often for people to shadow me, and unfortunately I can't accept the requests. I don't want my patients to feel they are on display, and it can really slow me down at work. I reserve shadowing positions for people who are already dermatology residents or applying to dermatology residency positions, but I really don't like to do it not because I don't want to, but it can really slow down my day. So, I don't do it often. Thank you for being such a wonderful fan! Love you fans in Brazil!!

I've got some ice pick the acne scars on my cheek that won't seem to ever go away. I'm 24 now they've been there since I had moderate acne in my teens. I use retain a 0.05% a couple times per week and moisturize and use sunscreen every day. Are laser and micro needling the best options?

Those are probably the best options. Ice pick depression scars are very difficult to treat! Hopefully the future will bring even better treatment options. They are always working on it!

Hi Dr Lee! Been following you for over a year now! I was wondering if Mr Wilson was on rentin-a? It worked so well for the masked man...

I can't remember exactly but I think I probably did give it to him. However, I think his blackheads came out pretty easily so wasn't really a problem with him

How can someone prevent hands from aging?

protect them from the sun, use retinA, consider chemical peels and filler if needed or desired, etc

How long can someone realistically prevent their hands from aging do you think?

if you're pretty fanatical about it at a young age then you are a good chance of avoiding a lot of things, but genetics plays a role as well. Really is a case by case basis I would say

An adult friend of mine has clear skin and said he used to have acne. What changed things for him was that he started just using an anti-dandruff shampoo (Head and Shoulders) and using the suds when washing his hair to also wash his face. Since then, his skin has always been clear.

Is there anything in anti-dandruff shampoo that will help some people's complexion?

I recommend anti-dandruff shampoo if a patient has facial seborrheic dermatitis but as far as I know, it doesn't help acne.

Thanks. The reason I ask is that my mom had a cyst removed a few days ago and they sedated her when they did it. She wanted only local but wouldn't do it that way. The one that you removed recently that was HUGE (green liquid inside) --- same patient with the "smallest cyst you ever removed"---looked just like hers before it was removed. Would this be the physicians preference or (hate to say it) but just wanting to make a little extra cash due to the anesthesia being billed as well? Thanks so much for sharing your work with all of us!!!

So, we as physicians in different specialties are trained in different ways. In general dermatologist are pretty comfortable with local anesthesia since we use it all day every day, in simple biopsy/procedures. Not many of us put people under general anesthesia. There are other specialties that train to do everything under general anesthesia.. they are very comfortable and proficient at surgery under these circumstances. It really has a lot to do with they type of doc that your mom saw. And yes, gen anesthesia usually comes with a heftier price tag, but this is not necessarily a determining factor.

Can you purchase effective retinol without a prescription? If not, can I make my own safely?

I don't think it can be made on your own. You can buy retinol but it is 20 x less effective than tretinoin which requires a prescription

What was your experience going through college/medical school? Did you have any doubts about becoming an MD?

I didn't know what I wanted to do, it took me a couple years to get into med school ( I did the 5 year plan at ucla) and I was the kinda person who didn't go thru undergrad or med school with this drive towards a certain end goal. I just went with the flow and enjoyed myself in med school. But I studied or course when I had to. I guess I got that drive when I actually became a dermatologist and realized I really liked what I do

Does micro dermabrasion really work for acne scars and enlarged pores?

to a minor degree, it depends on the level of acne scarring and the size of the pores. unfortunately there is not much you can do to change pore size and there are diff types of acne scars and diff types of treatments accordingly

Hi Dr.Lee, Love your videos, and thanks for doing this AMA.

My question is, has posting videos increased your workload? Have you seen a large increase in referrals?

yes it's increased my workload, but i can only work so much i'm only one person, and now I'm editing video at home (I have people helping me as well, I'm certainly not the only one doing it). I'm not necessarily getting an increase in referrals from doctors but I'm getting many people who are traveling from a distance to see me because they have seen my videos

I have had consistent acne since I was in elementary school, I'm almost 23 now. But every time I get horribly sunburnt (about 3 times now on my face) my face is crystal clear right afterwards! I know getting sunburnt is horrible for your skin, but does it contribute to clear skin somehow? Or could it be from all the moisturizer and aloe I put on my face during that time?? Thanks for doing the AMA!

Sun/ ultraviolet ray is a mild antiinflammatory which is why is helps to clear up acne, psoriasis, and eczema - all inflammatory conditions. But there are risks to it.. Premature aging, skin cancer, brown spots.

have you ever met someone in your day to day life and noticed they may have a skin cancer on their face/body?

now that my dad is older and i work in a pharmacy, i look at him and my older patients and wonder whats what haha. like is that an age spot or not. you can def tell the difference so ive always wondered

I would only say something if I thought something was life threatening.

I just wanted to say I love your work! Will you ever come to Canada? Are you planning any cross country popping tours?

Have a lovely evening.

I have no plans right now to come to Canada, but who knows what the future will bring! I hope so! Thank you and I hope you have a lovely evening as well!

My brother has severe guttate (sorry if I spelled it wrong) psoriasis and I have a minor case myself. When he goes to the doctor they always prescribe him medicine without really looking, even dermatologists. They walk in and are out within two minutes. We don't know what to do. He's in constant pain from it and he's very embarrassed by it. Any leads on any treatments or websites or anything to look at? I'm in Bloomington, il and the doctors here are so disrespectful about his psoriasis, despite him telling them about the constant pain. Love your videos. Been a long time watcher. I have a lot of respect for you. Thank you for your time if you read this.

You spelled it correct. Really, you're in Bloomington? I trained in Springfield Illinois. I recommend you may want to see someone there if you need a second opinion? Dr Lucinda Buescher is the Derm program director there and she is part responsible for my bedside manner. She is an excellent clinician and has a better bedside manner than I. I think she could help you and your family member. Good luck and if you see her please tell her I say hello and miss her! :)

Thank you for answering me. It's been a struggle that's gone on for many years and I really appreciate it.

Of course. Wishing you luck I'm sure you'll persevere! ;)

Do home remedies for milia (on the eyelids for example) work? I'm seeing honey, sugar scrub, cornstarch and vinegar, and a whole bunch of other DIY remedies.

As far as I know they don't work, but I don't know much about them.

Hey Dr. Lee! Lurker fan here, I have a question;

Hows it feel to be revered as an internet god in the /r/popping circle?

Edit: On a serious note... Do pore strips actually work? I can never get a straight enough answer as to whether or not they're effective or just a bad idea.

I think pore strips can work I'm sure there's a prob with overdoing them as with most things. It's not necessary to do them and certainly use common sense don't pull skin off with them. Ive said before sometimes I feel like Daenaryus (sp?) with an army of the unsullied behind me ready to jump on anyone who insults me so that's pretty darn cool, ha. Other than that it doesn't help me out in my daily life I still gotta work ;) but I'm very thankful for all these supportive people who have my back.

Hi Dr. Lee!

I have been a 'pop-a-holic' since adolescence; the fascination has always been there (and has gotten me into some pretty gross situations; after reading your reply to someone earlier, my new mantra is "know when to stop the pop").

Thank you for doing this AMA! I have a few questions if you have the bandwidth:

1) Do you find your skills improving now that you are filming? In a way, is the practice of continuously filming your work nudging you to grow and improve your craft?

2) Someone once told me that you should always wash your hair before washing your face, and then wash your body last. Their justification is that most shampoos can leave your face oily, and they suggested that getting the shampooing done first and then cleansing face is the way to go. What is your opinion on this matter?

3) I am a chocolate fanatic. Growing up, my family told me that I got zits because I ate so much chocolate. Do you ever end up having any patients alter their diets to improve skin conditions?

Many thanks! You rock!

1) absolutely, I know so much more about cysts after removing so many this last year. Also, I can better guess when a lipoma may be relatively easy to remove.Little things here and there that really add up and help me to best treat a patient, so I'm thankful for that! 2) I don't think it really matters, i don't think shampoos leave your face oily they are soap based and they remove oil from your hair that's how they work. 3) I usually say "pizza only causes acne if you rub it all over your face" that's actually a quote from one of my derm profs. Now, that being said, hormones that are in foods like milk I do believe can promote breakouts. I don't think that chocolate caused you to get zits, I just think you were in that hormonal stage that will lead to more acne breakouts.

Hi Dr Sandra Lee! Love watching your videos, people do not know how I can watch them lol. Do you know of any good dermatologists in the Chicagoland area? I have a few areas that I would like to get checked and taken care of. I would love your input! Thank you so much!

I always recommend that people check out aad.org which should list all the board certified dermatologists in your area. I don't know any off the top of my head, but I trained in Springfield, IL, not too far away from you and I highly recommend the dermatologists there at SIU!

I have reoccurring pimples on my nose is very embarrassing I pick and it leaves a lot of black spots what can I do to stop this problem?

you need to not pick at them bc this causes brown spots called post inflammatory hyper pigmentation which will go away but can take a while to do so.

Would you recommend your field to prospective college students? Also, if you weren't the cult leader of r/popping, what job would you like to have?

sure, dermatology is a great medical specialty, but I warn people that it is highly competitive and there are not many positions available haha, am I a cult leader? well that's not my job "popping" is my hobby.

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I don't know. That may be a ganglion cyst b/c of its location and I don't excise those. sorry :(

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Because there is often a connection with the joint space (space between two bones) and this is beyond my scope. I can drain them, but they can reoccur.

Do you get a lot of people coming in asking you to cysts that they think are alien implants?

Followup, how many cysts turned out to be alien implants?

Nah but some do look like they could be

Hey Doctor, I love your videos and they have helped so much with dealing with my anxiety. Eternally grateful for that.

I am wondering, when you ask patients permission to film, do you have them sign a form? Also, have your sons shown any interest in derm?

yes they sign a consent form. My sons haven't shown any interest but either did I at their age ;)

I notice in some of your videos that the blackheads are on patients with skin cancer. Is there any connection between skin cancer and blackheads?

Not a real direct link, but people will skin cancer likely have had a lot of sun exposure and excess sun exposure also causes solar comedones a la Favre Racouchot (the masked man is an extreme form of this). Blackheads can occur particularly around the eyes and these are often due to sun exposure

Is there a social media policy outlined by your governing body in medicine within north america? How does your work on fb and yt fit in with this?

There is no social media policy outlined by any governing body but certainly I get written consent from my patients to video them.

My Wife has taken a liking to your Youtube, and will watch it while I'm sleep, I woken up many of time to a big pimple, or other puss fill sac erupting. She claims it helps her sleep, my question is have you thought about doing some AMSR stuff while popping?

I guess a lot of people who are into ASMR watch my videos, so I guess my vids are already fulfilling that need? Thank you wife for watching!!! ;)

I doubt I'll get a reply but worth a shot. I have mildish rosecea. I find that milk and beer not together hahaha seem to really tick it off. Have you ever heard of that?

yes I think both of those are somewhat common trigger factors.. so when you know that something triggers a breakout with you, you should avoid them when you can

How much money do you make from both avenues?

I don't feel comfortable asking this kind of question. How much money do you make? ;)

I've got heaps of pimples on my back and neck that never seem to go away- any tips for that? Should I just go see a doctors?

if over the counter treatments don't help you should go see a dermatologist who can prescribe meds for you if needed

I have oily skin and lots of clogged pores, but they never develop into pimples. How/why is that?

because you're LUCKY ;)

I have this weird triangle thing underneath the skin on the shaft of my penis. It is hard, and small pieces of it sometimes come out of the pores on my shaft when I squeeze it. I am tood I dont have an STD, but I have no idea what it is, or how I should react to it.

Any thoughts?

it's somewhat common to get calcified cysts on the genital area, if you're concerned go see a dermatologist or your PCP