(humming)
(upbeat instrumental music)
- Hello everybody, it's me Dr. Sandra Lee,
aka Dr. Pimple Popper.
I am a board certified dermatologist
at private practice in Southern California.
And you may know me more for my pimple popping these days.
So I did a video called "Go to Bed With Me"
and today we're going to react to the comments
from the video.
And a little bit later I'm going to answer
some of your questions that you guys have about acne.
(upbeat instrumental music)
Here we go.
Okay Margarita says,
"Her, so cleansing wipes,
"me, screams in pain." In parenthesis, okay.
Cleansing wipes, I know there's a lot of debate
and there's a lot of controversy on the internet
about cleaning wipes.
There are a lot of people that are strongly against them.
I use cleansing wipes and I do know a lot of dermatologists
a lot of professionals use cleansing wipes
and I think that they're fine to use.
I don't use them on a daily basis.
I think that they can be rough on your skin.
I definitely pat my skin with them
and I don't use them solely to clean my face.
They're sort of used if I have heavy make-up on,
if I'm on the run, if I'm traveling
and I really want to get some make-up off
and clean my face, but I don't have a sink in front me
and I can't completely wash my face.
People complain too that it...
Or they say that it could be really bad for our environment
and I know that we're all doing the best we can
to save the environment and so I understand that.
So if you're against cleansing wipes, don't use them.
I mean if you feel better about not wasting something
I completely understand that.
But I do think that there is a place for them in a routine
because they do make life a little easier for us.
Okay so here's the next question, Lisa Rose says,
"I thought micro-tears were a myth."
Well anything can cause tears in your skin
I mean even if you rub your rough finger on your skin,
it can cause micro-tears.
And I mean that's what our skin is designed for.
Our skin is there to help protect what's underneath.
And it's there to handle any tears
or any disruptions in your skin.
I mean even the sun when it hits your face
it's gonna cause damage.
Everything does, pollutants in the atmosphere,
all of this, so.
I think as we get older we are certainly more careful
about things that really rub hard on our face.
And not even so much that our skin gets
less resilient to things,
but more so that we're so conscious of it
because we are more conscious of maybe like
fine lines and wrinkles on our skin.
And we're trying to keep our skin young
for as long as we can.
I'm certainly less rough on my skin, as I get older.
And I think that is probably the truth for many people.
But you know micro-tears it's a daily occurrence for us,
for many reasons.
"People should listen to these professionals only,
"don't listen to YouTuber's
"who just promote products/brands."
You just really have to be careful on the internet,
I find this more and more lately actually.
I think it's going to become a problem,
that people say things and it sort of like
it kind of snow-balls and then it becomes so
spoken about so often that it becomes like this truth
that everybody believes in.
Recently I talked about,
I think even in this "Go to Bed" series
I talked about using, CeraVe or Cetaphil Cleansers
and some people get a little angry about that.
And they say that there are carcinogens
or there are cancer causing agents in there.
I will tell you I don't know a single
board certified dermatologist that would say
don't use these products because they can cause cancer.
I mean, and that should tell you something, I think.
We went to medical school,
we did our residency for three years,
some of us did a Fellowship.
I got out of school when I was 32 years old.
I mean we had specific training
in all conditions of the skin, the hair, and the nails.
So I think the bottom line is
that you should do your own research.
And trust your own research really.
And really consult with experts in your area.
A great board certified dermatologist
would be a great start.
Lemon Sorbet says, "Since she applies deodorant at night
"did she insinuate she doesn't apply it in the morning?
"This is the simplest, most affordable routine as of yet,
"apart from the syringe."
I do apply deodorant in the morning too.
I apply deodorant in the night
and I think I explained it in the video,
because our sweat glands are not as active at night,
they're more dormant, they're sleeping, like along with us.
It's kind of better to apply deodorant at night
and it kind of helps to make it more effective.
But I definitely apply it in the morning.
I definitely apply it more when I'm sweating more
you know during certain times of the year.
But I also do Botox in the summer to my arm pits.
Not everybody may be able to do that,
I'm not telling people that they should do that.
But that actually does work amazingly well,
to help with sweat control in the area.
All right next, David Fletcher,
"It's amazing watching all of these celebrities
"YouTube stars, with their uber complicated
"expensive skin care routines,
"then most dermatologists have basic routines
"with basic products from the drugstores."
Yes, this is true.
And I do see this, and I notice this in the comments
and I notice this in a lot of videos.
You don't have to spend a lot of money
to take care of your skin.
I understand what it's like to use a really expensive cream,
it smells good, it feels good,
it makes you feel more luxurious.
But if you don't have the money to afford it,
it is not going to give you better skin than using a more
inexpensive drugstore variety cleanser or moisturizer.
I mean I love Aquaphor, I love just plain Vaseline,
to put in places that are really dry.
I love CeraVe, I love Cetaphil, I love Neutrogena,
all the products that are sort of, they're like
dermatology recommended.
So you know, don't discount
the inexpensive brands out there.
S-K says, "I love her"
I love you to S-K.
"And great tip before your wedding or special event,
"go to a derm and get the deep-zit injection for Cortisone."
That's true.
Cat in Wonderland says, "Love, love, love,
"when my dermatologist injects my pimples."
Yes that's a special kind of trick, sort of,
that we have as dermatologists,
in fact I carry that in my travel kit anywhere I go.
I have a little injection ready to inject a pimple
that I might have,
or even maybe a friend might have with me.
It's great because Cortisone,
a low-potency Cortisone injected directly into a pimple
will actually stop it's progression.
And potentially resolve it within 24 hours.
What I'm injecting is a low-potency Corticosteroid.
So a steroid like this, like Prednisone, or Kenalog
actually can be injected for multiple reasons.
What we do is we dilute this steroid to a really
really low-potency to inject directly into a pimple
so it does not spread systemically,
it doesn't affect the rest of your body,
it just locally calms that pimple down.
What they essentially do,
is they blunt your immune system.
Your immune system is so revved up,
it's attacking this pimple, this bacteria there
and making it really red and painful and swollen.
We are injecting something directly into it
to sort of settle it down, saying chill out,
just calm down and that's what it does.
Okay, Ryan Sims says, "Watching this I like
"getting a free consultation advice
"from a dermatologist without actually,
"you know having to pay for the session."
I think that's what it was meant to be.
I mean that's what I was trying to do
and that's what we try to do,
that's what I try to do in all of my videos, really.
And on my T.V. show is really just try to
give you advice honestly, from my perspective
as a board certified dermatologist
and I think that's what we all try to do.
Really the point of it is really making sure that people
feel good in their own skin.
Sometimes when you get down this rabbit hole
of watching all these skin care advice videos,
from various people, it can make you feel bad about yourself
in your own skin, you compare yourself.
Just know that there are really simple things
that you can do.
And to really feel proud in whatever skin that you have,
and feel good in the skin that you're in.
It's Echo says, "One thing I regret too,
"is rubbing my eyes, it would feel so good
"now I feel like I have dark circles from doing that."
Yes I think I talked about that a little bit,
how maybe I have a little bit of darkness around my eyes,
and rubbing your eyes, like if you have a little allergy,
and you rub your eyes every now and then,
that actually contributes to darkening around your eyes,
and dark circles.
Especially those of us who have a little darker complexion.
We're more prone to that.
So if you find that you have dark circles under your eyes,
or around your eyes, and you tend to rub your eyes
a little bit, you might want to really
focus on taking an anti-allergy medication,
to try to nip your allergy issues in the bud
so that you won't have this tendency to rub your eyes
or really try to focus on keeping your hand off of it.
Because the more you rub the more the skin
gets a little rough or thickened
and looks older and the more the area can darken.
Okay next.
Karen Fulton, "Any ideas on how to prevent milia
on the eyelids and eye area?
"I have heard that eye shadow with fragrance
"can aggravate this condition."
I don't know about eyeshadow with fragrance specifically
but I think that just products that occlude your skin
there more so, can promote milia formation.
But the skin there is very thin,
it's the thinnest skin on our body.
So it is probably more prone to being a occluded or blocked
than other areas of our body.
So that's why, that is an area
that is more prone to milia development.
So milia are those white pearly bumps that you get
predominantly around your eyes.
You'll kind of feel them and they'll feel,
your fingernail will run over them,
they're under the skin so it's not like a pimple
that you can really squeeze them out,
but they're usually like,
they look kind of like a pimple,
just like a white bump.
We as dermatologists we can remove them in the office
if we nick the skin and kind of use a Comedone Extractor
and push them out, it's like a little pearl we call them
because they look like a little perfect circle.
They're actually just really superficial, tiny cysts.
Sot they have a tiny little thin sack around them.
And that's what makes them sometimes difficult to push out.
I just had a milia right on my upper eyelid here
a couple of weeks ago,
and it was hard to take out,
especially when you're trying to do it yourself.
I should probably videotape myself doing that one time,
people will probably be like, (exclaims)
because I am a big wuss.
So I can not, it's really hard for me to just nick
my skin, I have to inject it first,
injecting is so much more comfortable.
Then you can go ham on something.
But that's not what I want you to do,
I'm not really going ham, my version of ham.
Actually my husband is a dermatologist
and he's wonderful, he's a great dermatologist
he's wonderful, but he's also my husband.
Every time he does something to me he's like,
"I'm never doing it again!
"'Cause you tell me what to do,
"and you know you can't tell me what the do."
I'm like because you're not doing my way,
my way is the best way.
Rebecca Yip says, "Why Dr. Lee doesn't put on a moisturizer
"after the hyaluronic acid serum?"
She does the, face.
"Just using the HA Serum can't keep the moisture."
Actually hyaluronic acid is hydrophilic,
meaning it draws in water.
So HA is really great to keep the moisture on your skin.
It is a moisturizer, I actually do double-up though,
I use multiple moisturizers 'cause I am very dry.
And I just think it depends on the person
and your skin type.
I think in this video I used my own HA Serum,
which is my brand SLDM Skincare,
and it also has Squalene in it,
which actually helps to retain the moisture
in your skin as well.
So it's more of a super moisturizing serum.
I think that the things that I want people to understand
is you don't have to spend a lot of money,
and you should pay attention to your own skin type,
if you feel like you're more dry,
despite using a product,
maybe you need to add more moisturizer.
If it feels like it's too oily,
maybe you want to back off
and these are all things that I think are key.
You need to listen to your own skin.
Well that was really fun
and I didn't have to take off my make-up
so that was all good.
Now lets move onto some acne questions.
(upbeat instrumental music)
Lady Liza says, "How does someone treat acne
"when they have dry skin?
"I feel like all acne treatments on the market are
"targeted to people with oiler skin types."
Yes that is true, and it makes sense if you think about it,
because usually people with oiler skin
are more prone to acne
because that oil, that sebum that we create
on our skin is one of the participants in acne.
It acts in clogging up the pore,
that causes a blackhead and whitehead,
it's clogged with oil and debris and dead skin cells.
But people with dry skin can also get acne.
It is a little bit harder to treat
because a lot of acne medications
are specifically targeted
to decrease the oil production on your body.
The key part to this is really knowing
what products dry out your skin more.
Benzoyl Peroxide dries out your skin more.
I would concentrate more on a glycolic acid,
or salicylic acid, because those are exfoliants
that get rid of the dry, dead skin layer
but they're not going to necessarily dry out
your healthy alive skin cells.
Retinol, Retin-A can be really drying
but it is important for blackheads and whiteheads,
usually people adjust to it.
So if you're getting a prescription
I would recommend a weaker prescription of tretinoin
and certainly there's retinol, that's over-the-counter
which is great and is less drying
than the prescription variety.
But really easing into it is key.
That's what we tell our patients too,
when they're using a prescription tretinoin.
Don't be afraid to use moisturizer.
If you are dry, and you have acne prone skin
use your acne products but follow them up with moisturizer.
That will help to balance out the dryness.
"What are the different types of acne scarring?"
Okay sometimes people say something is acne scarring
when it is not in my mind as a dermatologist
really scarring.
And that's when you have red spots or brown spots
after you have acne.
People call it scarring, but I actually love to correct them
because to me scarring is permanent.
And when you have red spots or brown spots
after your acne, for the most part
those should usually resolve.
So red spots we call post-inflammatory erythema, PIE.
And brown spots we call post-inflammatory hyperpigmentation.
These are when you've had an area of inflammation
in your body and if you have a redder complexion,
you get red spots.
If you have a darker complexion you get brown spots.
So those resolve.
Now sometimes you have that
but then you have a true acne scar that remains.
So there's different types of acne scarring
that you may see.
There are ice pick scarring, there is box car scarring
there are rolling scars, there's different types of scars
that we identify or name because of the way that they look.
And that helps us to categorize them
into different treatment options.
But really the whole key point for this is that,
if you have severe acne that you're not treating
you really should try to treat it
because you don't want to end up with a scar like this.
Because that makes it really difficult to treat.
Once you have a scar it's much harder to fix it
then to try to prevent it in the first place.
Okay the next one,
"I'm 31 with oily skin and have had my nose full
"of blackheads literally every single pore since puberty.
"If I extract them they're back in two days.
"Am I going to deal with them forever?
"Is there a way to keep my pores clean?
"I currently use salicylic acid 2%
"and Niacinamide Serum daily."
Well you probably have some blackheads
but also some sebaceous filaments.
Which are interesting, you can go down a little rabbit hole
if you Google that on the internet.
You know you have pores on your nose,
and we can see them
because you're looking directly at them
as opposed to at an angle on other parts of your face.
Sometimes if your pores do get clogged a little
and the dirt and the debris inside them oxidize,
they turn a little black
and that's why you might notice them more,
so yeah using a good glycolic acid,
a good salicylic acid.
Actually I have a new product,
it's called, Resurfacing Acne Swipes
and it has glycolic acid in it
and salicylic acid in it.
Which are two great chemical peel ingredients for your acne.
You can swipe them across your nose and those,
especially salicylic acid will settle down within your pores
and help to keep the pores clear of debris.
They're both exfoliators so they help to minimize that
collection in there.
And that's what you're seeing,
the black oxidization of the debris
that's stuck within your pores.
"Is it okay to do a peel off clay mask
"with active pimples?"
It's okay to do one.
I think that if your skin is sensitive
and you're actually peeling your skin off with it
I would say, back off.
Sometimes retinol or tretinoin
can make your skin more sensitive
and you have to be careful
if you wax or do any kind of really strong peel.
Obviously those videos that you see
where people are screaming in pain
while they're pulling it off
I think they're also pulling off their baby hairs.
And that's part of the reason why
they're waxing their skin at the same time.
But if you're really pulling so hard that it's painful
I don't think that's a great idea.
I think you can get the same kind of result
with glycolic acid, with salicylic acid,
they're gonna help to clean out the debris within your pores
without having to be so aggressive
and so brutal with it.
Next question, "Is it okay to pop whiteheads?
"It is so satisfying I can't resist."
So I'm gonna say no it's not okay technically
because as a board certified dermatologist
I can't tell people, I shouldn't
it's not right for me to tell people
to pop their own pimples,
or their own blackheads or whiteheads.
But I know that a lot of you are going to do it anyways
so I feel like it's my responsibility to really tell you
how to do it in the safest way possible.
It is the best or ideal circumstances
to be able to pop something,
when somethings a whitehead or what we call a pustule,
when you have that pimple that comes up
and then suddenly it comes up white at the end
and you're like, "I can't go anywhere
"with this thing on me.
"Everyone's going to look right at it."
They're very easy to notice your face.
That is actually the ideal moment for a pimple to be popped
because you have to imagine that,
that is actually white blood cells, that's neutrophils,
that's your body trying to extrude this pimple.
You're helping it's release
by taking a nice, really clean sterile needle,
make sure your fingers are clean too,
any instrument that you use is clean,
like a Comedone Extractor,
and if you just superficially nick it,
you want to squeeze all that purulent,
and let that puss out,
and that's gonna help to keep it clear
and probably resolve a little more quickly.
As long as there's not still puss underneath there.
The trick is really not squeezing too much,
and really making sure it's really superficial
because the more superficial you traumatize your skin
the less chance you have
of causing any really permanent damage.
Okay, "Is the acne face mapping a thing?
"I mean is it true that certain areas of your face
"are connected to problems with other organs, et cetera?"
No it's not true, it's not true.
I think that there are some truths to it mildly
where I know that as a dermatologist,
somebody comes in with a acne
more in what we call the beard distribution,
you know along the jaw line, along the neck.
I am more suspicious of hormones,
specifically testosterone,
that can cause acne breakouts.
Sometimes that actually clues me in
that somebody might have PCOS,
or Polycystic Ovarian Syndrome.
Because they tend to secrete,
they have cysts on their ovaries
that secrete testosterone.
And testosterone can really make us breakout
as females, but more in this distribution.
But it's actually gonna be associated with
more hair growth in this area,
imagine things that testosterone can trigger.
Hair growth and maybe even a little deeper voice.
So those are all sort of things I pay attention to,
if somebody comes in specifically with an issue
in that area.
But other than that,
you're getting breakouts in your forehead,
on your nose, in your chin,
because you have oily skin,
you have hormones that are making you prone to it.
If you have breakouts along one side of your head
where you put your hair, and you have product in your hair,
that's probably because of what's called pomade acne.
So there's a lot of reasons for it,
acne breakouts in your face don't reflect
some internal problem going on.
Okay that's it.
I hope I answered a lot of your questions.
This is again Dr. Sandra Lee
aka Dr. Pimple Popper, and this is "Derm Reacts"
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aka Dr. Pimple Popper and check out my skin care line
at slmdskincare.com