Dr. Sandra Lee — better known as Dr. Pimple Popper — has built a devoted global following by doing something few dermatologists ever imagined: turning skin extractions into a viral phenomenon. But beneath the surface-level fascination with pimple-popping videos lies a deeper mission of helping people better understand their skin, their conditions, and the treatment options available.
“A lot of the issues we see as dermatologists affect people both physically and emotionally because they can be embarrassing,” Dr. Lee tells Katie Couric Media. “It’s not just about what’s on the surface — it can impact self-esteem.”
In our conversation, Dr. Lee opens up about one of the most overlooked skin conditions: hidradenitis suppurativa (HS), a chronic disease that causes painful bumps to form under the skin, often in places where skin rubs together, like the armpits or inner thighs. She also talks about how social media is changing the way we think about dermatology, why acne tends to linger for so many women long past the teenage years, the skincare myths she wishes would disappear, and what’s next in her mission to educate, empower, and yes, pop.
Katie Couric Media: While many skin conditions are easily recognized and treated, others remain overlooked or misunderstood. One condition that often flies under the radar is hidradenitis suppurativa, or HS. Why do you think it has traditionally been more difficult to spot and treat?
Dr. Sandra Lee: HS is a very misunderstood condition. Oftentimes, you get boils and abscesses and scars with tunneling, but they occur in what we call intertriginous areas, or areas where you have creases, like the armpits, under the breasts, the tush, inner thighs, and under the stomach. These areas are pretty easy to hide in general, so people oftentimes will have it, and they’ll feel embarrassed, so they don’t even reach out for help. They don’t even know that other family members may actually have the same condition.
But there’s been a real increase in knowledge and understanding about this condition, especially over the last 10 years or so. Even during my training, more than 20 years ago, what we were taught about why people got it, the etiology or pathogenesis, was very different from what we know now.
Why do you think there’s so much more awareness around HS now?
One of the benefits of social media is that people can anonymously reach out and talk about their own conditions, and realize that others are going through the same thing. That kind of connection can be powerful, especially when someone might otherwise feel embarrassed or alone.
That’s what social media has done with a lot of other skin conditions — people wear those star-shaped pimple patches on their faces for acne, like, “Yeah, I know I have a pimple here, and I’m not embarrassed about it.” It helps normalize things.
Speaking of perceptions, has social media changed the types of treatments patients request or expect?
People now have a better understanding of what they might need — or should have done — for whatever condition they have, whether it’s a wart, a growth, a cyst, or a lipoma. They have a sense of what can be done and what to expect.
I’ve even had dermatologists tell me that I — and social media — have, in some ways, made their jobs easier, because patients now know what a biopsy looks like or how it’s done, and they feel less anxious as a result.
You’ve built a global following by doing something no one else was doing at the time. When you first started sharing extraction videos, did you ever imagine it would lead to a TV show and so much fanfare?
I didn’t realize so many people were really fascinated by pimple-popping and that they enjoyed it specifically. We all know what skin looks like, so most of us are very attuned to it or interested in ways to improve it. So it became a wonderful way to both educate and entertain people — and that’s really how it grew.
Some people love pimple popping, others can’t stomach it. Why do you think these videos resonate with people so deeply?
You’re sort of releasing something that’s not supposed to be there — like you’re putting everything back in place. People have a bit of an obsession or a compulsion to make everything right. It gives you this weird exhilaration, too: It’s like watching a scary movie or riding a roller coaster. It also goes back to being primates, where we picked at our skin — we’re just compelled to do that. It’s fascinating what our bodies do and what they create.
There are also so many different types of acne — for some of us, it doesn’t ever seem to go away. Why is that especially true among women?
All acne, in general, tends to be hormonal. But it tends to stay with women for longer because of the surges of hormones that we experience throughout our lives. We’ll get them when we’re ovulating or when we have a period, which tends to be when we break out more.
Yes, I’m pregnant and I really didn’t expect to have breakouts.
With pregnancy, sometimes you’ll see people’s acne get better, and sometimes you’ll see it get worse. It sucks.
What are some skincare myths that you wish would just go away for good?
That getting a tan before you go out on vacation is better for your skin. Because anytime you get any color on your skin, whether it be red or whether you turn a darker color, that’s actually your skin scrambling to protect itself. If you have pigment in your skin, it’s going to turn darker because it’s trying to create almost an “umbrella” to protect your skin from the sun. So if you have a tan, you’ve already done damage.
The most ideal situation is if you go out on vacation and have been out in the sun, but you come back the same color you were when you left. Just get a spray-on tan, it’s better for you.
I think of those commercials with young women trying to prevent acne by washing their faces very thoroughly, but how much of a role does dirt actually play?
A lot of people tell others with acne that they just need to clean themselves a little bit more or scrub their skin better, but that actually does more damage than good. The trick is just to find treatment options that can help you. For instance, Accutane is the best in terms of acne treatments.
I’m curious about the personal side of your work. Is there a patient story that’s stuck with you emotionally — something that shifted how you view your work?
HS patients have certainly changed the way I view my work and improved the way I treat my patients. It’s important to find somebody who’s really well-versed in this condition. The reason that I know so much about HS is that it’s similar to boils and abscesses, which look like pimples.
But with HS, what’s different is you get these tunnels — they’re called fistulas — where you’ll get an area that has sort of a purulence or a discharge from it, but you’ll push it and then it’ll come out another area, kind of like gophers that dig holes under the grass. It’s very embarrassing. Can you imagine if your skin was oozing out of these little tunnels, and you’ve got a shirt on and you’re getting it wet? It’s very distressing.
What’s next for you — anything you’re excited about in the world of dermatology or beyond?
We’re in the middle of my lifetime show, Dr. Pimple Popper: Breaking Out. That is just my day-to-day — seeing my wonderful patients, who I just love and adore. I also feel a certain responsibility to really get the message out about HS. One of the biggest things you can do to help these HS patients is to make sure that they know that they’re not alone and that there are people on their side.
This interview was edited for length and clarity.
