Dr Sandra Lee, aka Dr Pimple Popper, is a dermatologist and skin cancer surgeon with over 2.3 million followers on Instagram and 2 million subscribers on YouTube. She's famed for her can't-tear-yourself-away online videos showing her extracting spots.
We asked her about all things skincare - from the best products to use on acne to if it is ever safe to pick a spot.
When should and when shouldn’t you pick a pimple?
I think the mantra I have for people is know when to pop and know when to stop. There’s a particular time in the life of a pimple where it’s best to pick it, which is when it comes to a head. If you pick it too early it’ll get red and inflamed and potentially increase the chance of infection and scarring. So you really want to wait for the prime moment to pick at a spot. But, on the whole, I don’t advise that anyone picks at a spot.
What’s the best way to pick a blackhead and what’s the best way to pick a whitehead?
First of all, the difference between a blackhead and a whitehead is really in the description. A whitehead is a white spot and a blackhead is a dark spot. The difference between them is that a blackhead is open to the skin surface - it’s called an open comedone. It turns black because keratin plugs the pore.
A whitehead is different because it’s covered by a layer of skin so is protected from oxygen and stays white. Therefore, the easier one to pick is a blackhead because it’s already open to the environment. Ideally you should use a comedone extractor to pick a blackhead, which is an instrument that can apply even pressure around the blackhead. Or you can use your fingers, but make sure they’re clean. You might want to have a little traction by having some tissue paper wrapped around each finger. You should squeeze it in all different directions, but don’t overdo it. If it starts to cause you pain or nothing is coming out, I would leave it alone as it might not even be a blackhead.
A whitehead is a little different because you have a surface layer of skin which is hard to break through, and can cause lots of trauma, so I don’t advise people squeezing them. However, if there’s something ready to pop and you know it’s on the surface, you can sterilise a needle and make a little nick in the skin - but remember that the deeper a nick or trauma in the skin, the more potential you have for scarring. That’s why you should wait for things to be very superficial before you attack them.
WATCH Dr Sandra Lee in pimple-popping action below, if you're game. Article continues after video...
What is the best overnight pimple treatment?
I think the best overnight spot treatment is something that’s going to keep the area clean and dry, and have some active ingredient that we know can fight acne. One ingredient that’s good for this is salicylic acid – it’s actually a chemical acid but it crystallises and settles within your pores to help prevent new acne from forming. It’s a good overnight treatment because you can treat areas of your skin where you don’t yet have acne and hopefully prevent future breakouts.
I have a skincare line called SLMD that has salicylic acid in it, but there’s many over the counter products that use it as an ingredient.
What should you do when you feel a spot or a pimple brewing under the skin?
In this instance you shouldn’t pick at it, because it’s not ready to pop. When you feel a spot under the skin which hurts when you put pressure on it, but you can’t see it, you should leave it. If you want to bring it to a head sooner, I would advise using hot water and putting a hot compress on it. However, if you’re in this kind of instance and you have a big event coming up, you should see a dermatologist, as they can inject the pimple with a steroid that can get rid of it in 24 hours. It’s a fantastic treatment but requires a doctor’s visit.
Makeup over spots isn’t ideal, but if you have to what would you recommend?
Most of us have to use makeup to conceal a pimple, but if you can, apply some acne medication under your makeup. Also, you should try to take your makeup off as soon as you can, and try to keep things on your skin for as little time as possible. You should also avoid any acne product that is too heavy as it may promote more acne instead of help it.
WATCH The weirdest looking lumps Dr Pimple Popper has extracted. Article continues after video...
On your Instagram you use scalpels to pop blackheads. Are they OK to use to home?
A lot of aestheticians, at least in the States, use a sharp needle. I like to use an eleven blade when I’m in the office because it comes to a very sharp point, but I don’t think they are sold to the general public. If you feel like you might be a bit clumsy or tend to be more aggressive with your skin, I wouldn’t recommend using them because you could cause more damage than good to your skin. The main thing I want people to know about dealing with sharp objects on your skin is that the deeper you go the higher risk of scarring there is.
What foods should people eat for great skin and what foods should people avoid?
In general, people often feel good when they eat healthier, so I would say that reflects in our skin. I would say most likely it’s going to be the healthy fruits and vegetables and getting a lot of sleep and hydration that makes our skin look better, because we’re rested, and more comfortable. I think when we eat really heavy and fatty foods, for example, we’re just really tired. But I will tell you, pizza does not directly cause acne. I joke with my patients that the only way pizza causes acne is if you rub it all over your face, so it’s really the oil that we’re concerned with.
However, I will say something about milk products. Milk contains a lot of hormones, and we know that hormones can promote acne (which is why we get acne when we’re hormonal teenagers). So if you have high levels of hormones, you may find that eating milk products can actually provoke your acne.
Who, in your eyes, has the best skin in Hollywood?
Well, there’s so many of them who have beautiful skin, but I would have to say my idols Chrissy Teigen and Halle Berry have great skin. I think they really take care of it.
What can you use on acne scars to help diminish them?
A lot of patients come to see me and point out red or brown spots on their face thinking they are scars, and they are really upset by them. The good news is that they are not technically scars – they are temporary and they will fade. Scars are when you have deeply set acne and you pick at your scars, and there are different treatments necessary for different types of scarring.
We can use fillers to lift up underneath or stretch the skin a little, or for people who have a box park scar - where the scars are really etched in your skin creating a deep hole - we will probably use lasers that help to tighten and thicken the skin. We might also use a chemical peel to take off a layer of skin and try to diminish the depth of a scar.
Can perfume cause body acne?
I think perfume can cause body acne but it depends on the type of vehicle the perfume is in. If it’s a heavy cream it may cover the skin too thickly and not allow the pores to breathe, which could promote more acne.
Also, if you’re putting perfumed products on an area that tends to sweat more it could promote more acne, but I don’t think it’s necessarily due to it being perfumed.
Do you have a good tip for those who suffer from spots on the backs of their necks and shoulders – perhaps because they wear their hair down a lot?
My tip is going to be to wear your hair up a little more. I see this occurrence a lot and it’s called pomade acne – where someone will have blackheads on the side of their face or in their hairline caused by the products in their hair. If you have hair that’s really heavy, or is damp and wet laying against your body, it’s going to promote an acne breakout. Keep hair away from skin as often as you can or apply anti-acne products to keep the skin as clear and clean as possible.
KP (the bumps you get on the back of your arms) is the most-searched thing on Google. What are they and how do you get rid of them?
KP stands for Keratosis Pilaris and it’s a very common condition. The bumps are typically seen on the outsides of the upper arms, or you can also see them on the front of your thighs, on your buttocks or on your cheeks. Essentially it’s a form of dry skin but it’s not harmful or life threatening. The main problem is that it’s not something you can exactly cure – it’s just the type of skin that you have. The skin can feel bumpy or scratchy and they can be red. Some people try to pop them because they think they’re pimples.
There are some things you can do to treat these kinds of skin concerns, such as applying creams that contain salicylic acid, or using a chemical peel to exfoliate the skin to make it smoother. If somebody has some redness we might try to improve it with some over the counter steroid which can help minimize redness, or even consider some laser treatment. However, it isn’t something that some people can ever completely get rid of, it’s more a reassurance thing, like, hey, lots of people have this. You can disguise it with fake tan – it’s not worth focusing on too much.
This article first appeared on Grazia UK.