Dr. Sandra Lee has seen it all, dermatologically speaking. A cyst as big as a grapefruit. A blackhead so large it looked like a worn penny. A benign fatty mass sticking out of a neck like a second head.
By comparison, the growth she was removing on a sunny California morning in December was small potatoes. Smaller than a potato, even: the size of a grape.
The patient of the moment, Mike Nixon, had traveled to Dr. Lee’s Inland Empire office for help with a bothersome bump on his head. Using a pair of scissors, Dr. Lee created an almond-shaped opening in Mr. Nixon’s mostly bald scalp. “You’re doing OK, right?” Dr. Lee asked. Numbed up, he replied succinctly, “Mm-hmm.”
A medical assistant stood behind Dr. Lee, filming it on an iPhone attached to a stabilizing gimbal. In exchange for Mr. Nixon’s permission to share footage of the extraction on social media, Dr. Lee had waived his co-pay. It was the second time the pair had agreed to such an arrangement.
The doctor widened the incision with her scissors, and a cyst came into view — a pilar cyst to be specific. Its texture, Dr. Lee explained, is just like that of an olive. Dr. Lee, 54, has a tendency to compare her patients’ growths to food. The contents of an epidermoid cyst can look like mashed potatoes. The sebum inside a steatocystoma is smoother, like custard. Such statements flow out of Dr. Lee, effortlessly.
“I like to pop ’em out whole because it’s a lot more satisfying that way,” Dr. Lee said in her characteristically perky tone.
Unfortunately, today’s cyst would not be coming out in one piece; when Dr. Lee had sliced open the scalp, she had nicked the cyst’s wall. So she resorted to squeezing instead, like an adolescent popping a whitehead. The cyst’s insides oozed out, thick and chunky, the color of ivory, streaked with bright red blood. Using a pair of tweezers, she then plucked out the sac that had encased it.
“There’s our little cyst,” she said to Mr. Nixon. “I’ll show it to you in a little bit, let you get in your final goodbyes.” She dug around inside the opening with a cotton swab, making sure to remove all remnants of the cyst while checking in with Mr. Nixon to make sure he wasn’t in pain. He actually did feel a little pinching, he said. “I’m not a barbarian!” she exclaimed, before injecting the area with more lidocaine, a local anesthetic.
She then stitched him up, and presented him with his cyst.
“Here’s your little friend,” Dr. Lee said.
“Weird,” Mr. Nixon replied.
“He’s cute,” she responded. “His name’s Frank.”
Better known as Dr. Pimple Popper, Dr. Lee has built a dermatologic empire over the last decade sharing cyst removals with the world. On her reality TV show, “Dr. Pimple Popper,” she excises cysts much larger than Mr. Nixon’s, squeezes out benign fatty tumors called lipomas and tries to cure mysterious skin conditions. And she does so free of charge, with a smile.
The work itself is not for the squeamish, but a sizable subsection of people (called “popaholics,” naturally) delights in the pleasures of the pop. “It’s just so satisfying,” said Lalaine Hill, 36, who lives in Maryland. Ms. Hill said she enjoyed watching the show while eating. “My husband was like, ‘What’s wrong with you?’ I was like, ‘I don’t know.’”
The show, the 10th season of which premieres in April, this time on Lifetime, together with her online videos have made Dr. Lee perhaps the most famous dermatologist in the world. Even when the cameras aren’t rolling, people now flock to her from as far away as Australia and Africa. Seventeen million people follow her on TikTok — more than follow Beyoncé and Britney Spears combined — and an additional 13 million make up her fandom on YouTube and Instagram. She appears in ads for medications for conditions including atopic dermatitis and acne, and has her own skin care line, called SLMD (short, of course, for Sandra Lee, M.D.).
On the surface, Dr. Lee’s rise to become the world’s most celebrated pimple popper might seem strange. But she has come to offer a sense that, on TV at least, tension can always be alleviated, and health problems neatly resolved, their solutions freely and easily obtained.
Despite her celebrity, Dr. Lee still fields clients (and films her show) at Skin Physicians & Surgeons, the same place where she has practiced for over 20 years. Located east of Los Angeles, in her hometown, Upland, Calif., the office is situated in an unassuming strip mall, just off Route 66. The single story building could be mistaken for any suburban doctor’s office, except for a sign out front that states, in large letters, “Home of Dr. Pimple Popper.”
Inside, a neon sign, in glowing blue cursive, demands that “Popaholics unite.” Phrases like “I’ve got 99 problems but a pimple ain’t one” plaster the novelty T-shirts that hang for sale. A cadre of young female medical assistants surround Dr. Lee and review pictures of a patient’s lump.
The office is in many ways an extension of Dr. Lee. She has a tendency to emanate an almost childlike exuberance. During a photo shoot that day, she played with her medical tools, squirting lidocaine out of a syringe and shooting liquid nitrogen out of a canister typically used for wart removal. Her descriptions of her success and work can feel almost unsophisticated for such an ambitious medical doctor and entrepreneur. Getting famous, she said, was “cool and fun.” When it comes to being a physician, she doesn’t feel she is “anything special.” She is “so happy that pimples are apolitical.”
Nowadays, the business of being Dr. Pimple Popper has mostly shifted to her public-facing work — the show, the skin care line, the pharmaceutical endorsements — which means Dr. Lee sees paying patients only once or twice a week, partly to keep her skills in shape for the show. “I can’t just step in and remove a giant lipoma without having done anything in my life for the last months,” she said.
On the days she does practice, patients journey from far and wide to see her. For all her fame, Dr. Lee is by her own admission a rather standard dermatologist. She specializes in skin cancer removal surgery and cosmetic procedures like Botox, not complex and puzzling skin conditions. But as her celebrity has grown, so has the illusion that she can cure the incurable.
The day I visited, Dr. Lee met with Ingrid, a woman who had flown in from Guatemala. (Ingrid, like some other patients, asked to be referred to only by her first name for privacy reasons.) Her father, who acted as Ingrid’s translator, said they were there in part because of Dr. Lee’s fame. Ingrid had itchy, purple-tinted bumps on her arms and chest, caused by the skin condition lichen planus, and was dissatisfied with the treatments that her doctors in Guatemala had recommended.
The appointment lasted maybe 10 minutes. Dr. Lee asked Ingrid about a biopsy that she had back home and the medications prescribed by the doctors there. She reassured Ingrid that her condition was not life-threatening or contagious, but said she was not able to provide her with the miracle she desired. There is no known cure for lichen planus, only various treatments to assuage the itching, many of which Ingrid had already tried. Dr. Lee prescribed a new medication, but was frank about Ingrid’s options.
“It’s just going to be very difficult to resolve this completely,” Dr. Lee said.
After the appointment, Ingrid appeared dejected. Because of the language barrier, she hadn’t understood much of what Dr. Lee had said. At least in Guatemala, she said, the doctors had spent a bit more time with her.
That same day, Dr. Lee saw Maribel, who was self-conscious about her melasma, a skin condition characterized by dark, blotchy patches, typically on the face. She had tried various products she had seen in TV advertisements to treat her condition, but nothing had helped.
Then, Maribel saw Dr. Lee treat a person with melasma during an episode of “Dr. Pimple Popper.” She booked an appointment and made the two-hour drive to Upland. “I told her, ‘This is my last hope,’” Maribel said.
This time, Dr. Lee delivered. During Maribel’s initial appointment, Dr. Lee prescribed her tranexamic acid, which has only recently been used as a melasma treatment. A medical assistant displayed an iPad with before-and-after photos. It had been only two weeks, but there was already noticeable improvement.
“I’m glad you’re smiling,” Dr. Lee told Maribel. “Hopefully, we’ll see even bigger smiles next time.”
Dr. Lee wasn’t born a popping obsessive — she calls herself a “born-again popaholic” — but dermatology was probably always in the cards. Her father was also a dermatologist, and as a child she would thumb through his textbook while eating breakfast, fascinated by images of skin diseases.
Her initial forays into online video, beginning in 2011, mostly focused on standard dermatologic procedures, with titles like “Dr. Lee on skin cancer month” and “Cankles Be Gone! Dr. Sandra Lee to fix a woman’s chubby ankles.” Then one day, several years into her experiment, she posted a video in which she removed an enormous blackhead known as a pore of Winer. People were “either disgusted or obsessed,” she said. But “either way, they tagged a friend.”
Takeoff was not instant, but it was pretty close. The first month she tried to monetize her YouTube videos, in 2015, she made about $30. “The next month, it was like $300, and the next month, it was like $3,000,” she continued. By 2016, she had more than a million YouTube subscribers and was making “very close to six figures a month,” she said.
Then, Ping Pong Productions reached out with an idea: How about a reality show? She had reservations. An avid consumer of reality TV herself, she said she was afraid of “looking crazy” and not having control over her own image. “I was scared to make a mockery of dermatology,” she added. “Some dermatologists knew me on the internet, and they were like, ‘Is she making fun of our specialty?’”
But she decided to make a pilot episode anyway. After “Dr. Pimple Popper” premiered on TLC in 2018, she was no longer uncertain. The show was a hit. She appeared on “Jimmy Kimmel Live!” and Rachael Ray’s show. Wherever she traveled, people recognized her. “It’s such a weird thing to feel like you’re on display,” she said of becoming famous. “It also drives you.”
There is no shortage of theories about why some people find solace in popping videos. Dr. Lee herself speculated that it was enjoyable to watch a conflict get resolved and a doctor “put everything back in place.” Or maybe, she said, it was “this primate tendency, of wanting to pick at things and get rid of things.”
Anne Schienle, a psychologist at the University of Graz in Austria who studies disgust, put forth another hypothesis.
“Some people enjoy disgust,” Dr. Schienle said. Such people, she explained, can take pleasure in a sort of “benign masochism.” It is a similar displeasure to that which can come from eating spicy food.
“They like it because they know it’s not actually threatening,” Dr. Schienle said.
In 2021, Dr. Schienle coauthored a study on people’s reactions to pimple-popping videos. Everyone who participated in the study found the videos disgusting. But curiously, those who enjoyed these videos had unique neurological responses; in fact, the videos activated parts of their brain’s reward systems.
Dr. Lee also offers what could seem like a fantasy: free help from a doctor who treats her “patients like people and not freaks,” said Sue Constantine, a 47-year-old fan who lives in New York City. “No matter who she meets, no matter how obvious their skin issue is, she never walks into the room and says, ‘Oh, I see why you’re here.’ She shakes their hand. She greets them as a person first.”
Sometimes, the reason people have appeared on the show in the first place is to receive free treatment; insurance companies aren’t exactly rushing to cover the removal of a few benign but gumball-size cysts. And in the carefully edited world of reality TV, there is no problem too complex to be solved.
“That’s part of the allure of the show,” Dr. Lee said. “You want to feel like you can go somewhere and get fixed.”
The morning after her appointments with Ingrid and Maribel, Dr. Lee was at her new home in the upscale Los Angeles neighborhood of Brentwood, wearing heavy makeup, her long black hair twisted in pink curlers. Bopping around her house, still full of boxes, she dreamed up ideas for the photo shoot she was about to do. Maybe she could ride a stuffed unicorn? Or shoot a bottle of bubbly out of a champagne gun? On the floor of the living room, there was a sculpture of a four- or five-foot-long scalpel and comedone extractor, a tool for removing blackheads.
She and her husband, also a dermatologist at her practice, moved 90 minutes away from Upland to this modern two-story house last October, after their youngest son went off to college and they became empty nesters. She is a bit demure about the money she has made as a result of her success, saying only that she makes more now than she did when she simply practiced medicine five or six days a week, and that she didn’t get into medicine for the money. (“I’m not a plastic surgeon that charges $100,000 for a surgery,” she said.)
There are moments when she gets nostalgic for the days before she was famous. She feels bad that patients like Ingrid travel great distances to see her, only to leave frustrated. (“You don’t want people mad at you or upset or disappointed.”) Her patient population has changed, too, and she misses treating the local teenagers struggling with acne and the older people with skin cancers, who used to come in regularly. Not knowing her patients like she once did “really took some of the joy away from dermatology,” Dr. Lee said.
She worries about not being there for her former patients, and sometimes feels that she’s “letting a lot of them down.” She complains a lot, too, she added. “But it is what it is. I’ve made this bed and I’ve got to sort of sleep in it.”
Since becoming a celebrity, she has tried to shield her children from the limelight; no photos of them on social media, for example. Her younger son doesn’t love her show, but will watch it with her when a new episode airs.
Her elder son, on the other hand, wants nothing to do with it — it’s too gross for him. “When the show first came out and I was watching it,” Dr. Lee recalled, “he was like, ‘I’m going to my room. I’m sorry, Mom. I love you, but I can’t watch that kind of thing.’”
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