“Right now, I’m at home, professional on top and pyjamas on bottom,” says Dr. Sandra Lee – better known as TLC’s Dr. Pimple Popper – speaking to us during lockdown level 2 during the COVID-19 pandemic… with occasional interruptions from her cat, Dim Sum.

She chats about her new show, Dr. Pimple Popper: Before The Pop, which returns with new episodes from Saturday, 17 October on TLC (DStv 135) at 20:00. And along the way we find out all sorts of pop facts, skincare tips and more about what Dr. Sandra loves and what freaks her out.

While waiting for the series, fans can enjoy new episodes of Dr. Pimple Popper: Pop Ups on Saturdays on TLC (DStv 135) at 20:00.

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Dr. Pimple Popper, socially distanced

“Dr. Pimple Popper: Before The Pop was an opportunity to really talk to these patients, and get the ball rolling while still being safe and trying to get closer to an answer, or get closer to helping them,” says Dr. Sandra. That strictly videocall interaction had its positives and negatives. “The fact that I can’t touch them, that’s the main thing, I couldn’t reach out and feel things. That is a lot of what is involved here when I examine my patients. But I get less anxiety because I don’t have to try and treat them the same day. I get to meet them and get to move forward and figure things out and figure out what we’re going to do, but there’s no pressure there. And like I said, I’m in pyjamas, too, when I’m talking to them. I can start to figure out a plan with them and get to know them and connect with them. And they’re piling up! We’ve seen some of them already now (since shooting the series) since we’ve opened up a little bit, but we still have more to see. It’s super interesting. You’re going to fall in love with a lot of them before they even see me face to face.

“The challenge is to be able to help these patients without really seeing them in person, which is really needed in most cases to be able to help solve their problems. It’s difficult to connect with people, too, but even when you do get the opportunity to do so now, it’s with a mask. So, things are a little different. You really have to just adjust to the situation.”

Asked if there have been any surprises during these sorts of consultations, Dr. Pimple Popper admits, “My cat always comes and joins, that’s Dim Sum, she’s 20 and she can’t hear very well, but she seems to know when I’m on a Zoom call. But the big surprises are just the cases. They’re amazing. One is Roger (episode 6), who has Rhinophyma, where you have extra growth on your nose. He has the biggest that I’ve seen so far, and we looked up the literature just to get an idea of how to treat him, and he beat everybody that we saw. I think he could have the record. It’s quite remarkable looking, very impressive… as we say as physicians.

Hands off!

But without hands-on treatment, there’s little that Dr. Sandra can do to treat her patients. This is not a DIY show! On the show, previously (S1, episode 5) we’ve seen what happened when one patient, Nick, came to Dr. Sandra after removing his own lipoma with a craft knife, leaving him with a gnarly scar. “During this pandemic I’ve gotten a lot of interviews with people who wanted me to talk them though popping a zit and I pretty much say no to all of that.

“I get anxiety, I start sweating when people send me what I call ‘amateur popping’ videos. Like when they’re at the pool and somebody has a cyst or an abscess, and they’re squeezing it with their bare hands and people are holding beer bottles and laughing next to them. And they have paper towels and no gloves… I get anxiety. I think it’s partly because I feel like that person is in pain and has real risk for infection. And if you squeeze a cyst and don’t actually excise it and remove the sac, it’s going to come back, it’s going to be worse and it’s going to create a bigger scar. And then sometimes people send me animal abscesses (videos). I can’t even open those. I cannot. Don’t send them to me.

“My whole mantra is that I’m going to be like every other dermatologist. I’m going to say, ‘Do not pop your pimples.’ I cannot tell people to do that because I don’t know what they're doing in their own home. I don’t know even if that is a pimple or if it’s poppable. However, I do know that a lot of people, myself included, are going to do it anyway. My angle is more to explain to people why they shouldn’t pop at home but give the most ideal sort of situation to do so because then they get a little education there.”

Pandemic skin issues

Aside from keeping her from touching her patients, the pandemic has given rise to some interesting skin conditions itself, as people around the world mask up.

“People are getting what we call ‘maskne’, where you’re getting acne under your mask. Or they’re getting eczema, they’re getting irritated by their masks. It’s a big problem for me, too. I was just filming this past weekend, wearing a mask all day, almost all my waking hours, and it really does aggravate your skin. I feel like when I’m wearing my mask all day, that I am literally standing inside my mouth. You sneeze in there, you may cough in there, you’re talking in there and it’s just a really humid environment, you may have make-up on, you may have oily skin… and you’re just accumulating all of this under there. And with sweat and things like that, it clogs your pores, and that’s a perfect environment for acne to form. We also get acne mechanica, which is when you rub the area, like if I have a pimple on my chin or one wants to come up, the mask is directly rubbing on the area and really promoting them.”

“My best advice is to use some acne medications in a different way. A salicylic acid body spray, you can use to spray the inside of your mask. That’s what I do. I spray it, then I wave it and dry it out, and then I put the mask on. Salicylic acid gets down in your pores and helps to exfoliate and helps to clean them out. And if you’re wearing make-up, it’s nice to put the spray on the mask.”

“One of the (other) issues that we have, especially during this pandemic, is that we have a lot of time at home and we’re doing a lot of these (video) meetings where you’re looking at yourself a lot of the time. And we have magnifying mirrors at home and people get stuck in front of their mirrors and emerge an hour later with all these little poke marks on their face. That’s a trouble that people can get into. And the stress going on in the world really does manifest in our skin because a lot of us tend to pick more when we are stressed out. It’s important to be aware of that if you have that tendency, and to try to stay away from your magnifying mirror. Try to distract yourself. Keep busy with something else with your hands.”

What grosses Dr.Pimple Popper out?

Dr. Sandra can happily remove a stinky pilonidal cyst or drain chunky, oatmeal-like lipomas. But she’s not immune to being revolted. “Yeah, things gross me out. I’ll tell you a secret – I’m grossed out by the raw chicken that I cook. I cannot touch raw meat with my hands. I cannot clean chicken, I don’t want to take the fat off with my hands. I wear gloves. It’s the same thing at work. I think that has messed me up with cooking. I think it’s very similar. I feel really weird touching any kind of raw meat with my (ungloved) hands,” says Dr. Sandra.

“At work, as long as I have a splash screen if I need it, as long as I have my gloves on and I have my mask on, I’m not grossed out. I’ve trained myself mentally and my staff knows this, too, not to react, not to feel grossed out, because most of your patients, especially in dermatology, are coming to you for a condition that is causing a lot of embarrassment from them. The last thing you want to do is to act like you're disgusted by whatever they have. That would be the worst feeling for them. If there’s an odour or something splashes on you, you want to make sure that it’s a ‘funny, hey things happen’ sort of thing. It’s life.”

But there are certain patients who come to her with skin issues on one part of their bodies that Dr. Sandra will almost immediately give a referral. “Feet. I’d send them all to My Feet Are Killing Me,” she jokes. “I am not into feet, really. I’ve never taken off a toenail. I can’t. My husband does those. He’s a dermatologist, too. He has no problem shoving a device under there to loosen up then nail and… ough,” Dr. Sandra visibly shudders, “that gives me the shivers. I don't like that. I send those kinds of things to him. We all learn medical dermatology, but I am now more focussed on surgery and pimples and cysts and cosmetics. So, I don’t have as strong a tie into some of the more medical dermatology-related conditions – like there’s a lot of blistering diseases and things like that. I’ll enlist another expert in that field of dermatology.”

Adult acne tips

During the interview session, people from all around the world were asking about one main skin issue: acne. “If you have mild or moderate acne, you may be able to clear it up with over the counter medications. In America, we recommend Retinol, Salicylic Acid, Benzoyl Peroxide, and Sulphur. Topical antibiotics and anti-blackhead products are really important. But if you have cystic or nodular acne, you need to probably see a dermatologist because you may likely need prescription medication,” says Dr. Pimple Popper. “Acne may not threaten our lives, but it can certainly threaten our emotional wellbeing. And if it’s severe, it can leave you with lifelong scars, and that can definitely affect you emotionally as well.”

To treat blackheads, Dr. Pimple Popper advises, “You want to look for things that have hydroxy acids in them, like Salicylic Acid, Glycolic Acid, Lactic Acid. Some products even in your pantry may have elements of this. We’ll tell people to make masks of crushed up grapes or a little lemon or milk. These things have hydroxy acids, which help to exfoliate and settle within your pores and clean them out. Salicylic acid can crystalise into a small enough size to get into your pores.”

In terms of her own skincare outline, Dr. Sandra says, “I’m pretty boring. There are definitely people who get into dermatology because they’re obsessed with skincare. But I am not someone who has a 20-step treatment, and I think the tide is turning from that, too. It’s too much, sometimes. It’s a billion-dollar business and there’s a reason for that. There are a lot of topicals out there that are supposed to do this, or that – anti ageing or help with brown spots or things like that. But mine is really simple. I wash my face with Salicylic Acid. I put on a retinol (treatment) at night, and I’m really dry, so I put on a good moisturiser that has hyaluronic acid in it. It’s really basic. I also only wash my face at night because it’s clean in the morning. I might just do a little splash (of water) in the morning and then (apply) sunscreen.”

New developments

There’s always hope. And that’s one of the major messages of the show. Dermatology is a developing field of medicine and there’s always new hope for previously difficult-to-treat conditions. “If you’re talking about the medical side, we’ve seen wonderful advances in treating psoriasis, treating eczema, and hidradenitis, with a whole group of medicines called biological medicines. They're usually administered via an injection or even IV. They have transformed people in terms of helping them with conditions that can be chronic. It also helps other conditions in a rheumatology field, like ankylosing spondylitis and rheumatoid arthritis. In terms of cosmetics, there are always new innovations in terms of lasers and devices. There’s always focus on trying to do things that are non-invasive. So, we have tissue tightening to try avoid facelifts, to melt fat instead of doing liposuction. There are plasma pens to try shrink your skin instead of doing a more aggressive laser resurfacing. There are always new innovations. Some of them pan out and they don’t do so well, but some of them are quite amazing.” says Dr. Sandra.

Become a Popaholic!

Dr. Pimple Popper’s fans are after something quite special, and she believes it’s not just the car crash, ick factor for the show. “In the last month, I’ve started TikTok (a short form video streaming platform) and it’s grown really quickly and brought back the fun that I had in the beginning. It makes me see how it grows. Some people love it, it actually relaxes a lot of people and makes them feel good because everything is put back in place, and something that’s not supposed to be there has been evacuated. Some people get that absolute opposite reaction. They cannot handle it. It grosses them out. Either way, they tag their friends and want to show them. That’s why this grew.

“It’s interesting, it’s science. And people want to learn. They feel good about understanding what happens in acne, or why a certain product works, what the active ingredients are, or how we do a surgery, how we remove a cyst. And now a 5-year-old knows what a lipoma or a blackhead or milia is. That’s crazy. I am trying to normalise skin conditions and show that how somebody appears, that’s not who they are. We all can learn from that. We all understand that. The show makes us happy to be human, and to see somebody’s life changed so they can feel human again themselves. We need that right now.

“There’s a lot of reality shows out there that are really dependent on people being nasty to each other. The drama that’s involved with that. There are shows where it’s a group of girlfriends and the reason that they’re on the show is to fight with each other. I just think sometimes when I look at a show like that, I feel so lucky that I’m not part of that. That’s such a negative way to live your life. In normal life, we don’t do that. We don't confront people and yell at them and tell them they’re idiots to their face or find out that they said something really terrible about you later when you watch the show back. That can’t be good for your soul. I think that can change a person and really make you become nasty, and think that’s normal.

“This (Dr. Pimple Popper) is like the opposite. It starts with something that people are shocked by or grossed out even, and you’re making it normal again or happy again. We’re taking something negative and making it something positive. That’s why it’s popular. And it’s a great way for people to feel accomplished because while they’re watching, they’re learning something. That’s always great.”

Watch Dr. Pimple Popper: Before The Pop, new episodes from Saturday, 17 October on TLC (DStv 135) at 20:00. And Dr. Pimple Popper: Pop Ups on Saturdays on TLC (DStv 135) at 20:00

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