Can I just vent for a second? Acne. Is. The. Worst. Let me put it this way, if acne were an adult human IRL, it would definitely be one who slow claps when the plane lands. Or stands up as soon as the seatbelt sign goes off. Pick your poison — they’re both equally annoying (and I know you agree).
If you struggle with persistent acne, my heart goes out to you. Truly. I’ve been there, and at 32, it’s still an ongoing issue I struggle with. From hormonal acne to painful cystic breakouts, I’ve experienced it all. When it comes to something as finicky as acne, you have to consult the pros. That’s why we reached out to Dr. Sandra Lee, AKA Dr. Pimple Popper. She’s hands down an expert in acne, cysts — you name it. She’s been there popped that.
Dr. Sandra Lee gave us the 411 on all things pimples like it’s her job, because it is.
CZ
How did you get started in dermatology?
SL
I’m a board-certified dermatologist in private practice since 2004. I specialize in cosmetic and surgical dermatology and work with my husband Jeff Rebish, MD, who is also a board-certified dermatologist. In the last 5 years I’ve grown my social media to over 15 million followers, with over 3.5 billion views on YouTube, and now have my own medical skin care line SLMD Skin Care, a book “Put Your Best Face Forward,” and an award-winning show on TLC called “Dr Pimple Popper”.
CZ
Were you always fascinated with skin, specifically, cysts and pimples? What sparked that interest?
SL
Ha! I wouldn’t say that I was “fascinated” with skin, cyst or pimples. But I did grow up surrounded by dermatology textbooks as my father is a dermatologist (now retired). I knew it was a greatly rewarding and very competitive medical specialty and this probably directed my attention to it. I saw how my father enjoyed being a dermatologist, and now as a dermatologist myself, I understand what the attraction is. You really develop relationships with your patients, you often get to know their parents, their kids, even their grandkids. You treat young kids for warts and rashes, then acne, then as they get older, for anti-aging reasons, cosmetic treatments and surgeries, and skin cancer detection and surgery. You see the whole range and you get to use your skills with your brain and your hands, to make people look and feel better about themselves, and even save lives. It’s an extremely rewarding specialty.
CZ
What was the most bizarre or shocking extraction to date?
SL
There’s often a level of “shock” to them, because many extractions are unexpected. You don’t really know what you’re going to get. And I joke that blackheads are like snowflakes, never is one the same as another. My TV show has certainly delivered more “bizarre” extractions to my office. People with very large cysts or lipomas that they have been living with for years, and are certainly difficult to hide. There are so many I cannot single one out.
CZ
What’s your #1 tip for acne prone skin?
SL
Use acne medications if you have acne, or are prone to acne. This is the best way to help prevent acne from occurring in the first place, or getting rid of your existing acne. If over the counter acne treatments aren’t working, seek help from a board-certified dermatologist.
“I joke that blackheads are like snowflakes, never is one the same as another.”
CZ
How do you treat an active breakout? Is it safe to pop at home?
SL
I’m going to be like every other dermatologist and tell you NOT to pop your pimples at home, but I realize that many of us cannot help ourselves, so I do feel that if you understand why you shouldn’t pop your pimples, or what may be the most effective and least damaging time to pop a pimple, this would help. This is why my personal mantra is: “Know when to pop and when to stop”. As dermatologists, don’t want you to pop a pimple at home because aggravating a red painful bump on your skin will likely make the bump angrier, redder, larger, and more painful! Also you risk local infection in the area and also the potential for permanent scarring. The most ideal time to pop a pimple is when it has come to the surface and is the most superficial in the skin. This is when most people call it a whitehead, but dermatologists know this is incorrect — it’s actually a pustule. You may be able to squeeze the purulent contents out at this point, with the least trauma to your skin and the least potential for scarring. Remember, in general, the deeper seated an inflamed pimple is under your skin, the higher the chance for a potential scar. If you feel compelled to pop your own pimple instead of seeing a dermatologist or letting the pimple run its course, it’s very important that your skin and hands/instruments are clean, and that you apply antibiotic or anti-acne treatments to the spot after. Most importantly, try to leave the area alone after you pop that pimple!
CZ
What’s the most common acne myth?
SL
Probably that a person gets acne because they are dirty and not cleaning their face properly. This is not true, acne is not your fault. It’s really a combination of hormones and genetics. Don’t over scrub your face, either! This can irritate your skin and make your acne look worse.
CZ
How common is body acne and do you treat it differently from facial acne?
SL
Body acne can be just as common as facial acne. It is not treated much differently but sometimes there are changes in a patient’s lifestyle that can improve acne depending on what part of the body it occurs.
CZ
What should you do if you see a big pimple or cyst forming?
SL
Leave it alone. If you push on it or squeeze it, you risk the pimple becoming more inflamed and angry and turning into an even bigger zit. If you have an over the counter treatment option like a benzoyl peroxide acne spot treatment cream, you can apply a dollop over this pimple and this serves two purposes: It can help treat and will remind you to not pick or squeeze the area. SLMD Skin Care is my medical skin care line, and we have a popular over the counter acne system, including a BP spot treatment, all available at SLMDskincare.com. If you have a special event coming up soon and you can’t let this pimple run its course, go see a board-certified dermatologist who can inject the area directly with low potency corticosteroid which calms down the redness, inflammation and pain — this can get rid of a growing zit within 24 hours!
CZ
What’s one acne product you swear by? Favorite treatment?
SL
Probably a retinol (which is over the counter) or its more potent counterpart, tretinoin, which is only available by prescription. SLMD Skin Care has a retinol serum that is gentle on the skin (because retinoids can be drying and irritating at least initially), and even ME with my super dry skin, I can tolerate it on a nightly basis. Retinoids are keratolytic, meaning they help to keep your pores clear of debris, dead skin cells, and excess oil, while also increasing the efficiency of skin cell turnover, AND they have the added benefit of even helping to prevent the development of skin cancers and slow down premature aging. Retinoids are certainly products that all dermatologists recommend to our patients. My favorite treatment for acne? Probably a glycolic or salicylic acid peel. These are great because they will help to prevent blackheads and whiteheads from forming but also help exfoliate the skin, lightening brown spots/pigmentation that are from old acne spots and even helping to even out general pigmentation of the skin.
Interview courtesy of Dr. Sandra Lee (@drpimplepopper)
