Confession: The editors of Mental Floss are popaholics. When we need a break from editing, you can often find us watching Dr. Sandra Lee’s videos on YouTube. Lee—otherwise known as Dr. Pimple Popper—has more than 2.5 million subscribers; her channel features everything from soft pops (blackheads) and hard pops (cysts) to Mohs surgery, rhinophyma treatment, and earlobe repairs. In other words, there’s something for everyone. Lee stopped by the Mental Floss offices in late April to talk about developing her new skincare line, choosing videos for her channel, and why people love watching blackheads being popped.

Your channel started with mostly blackheads, and now you post a wide variety of videos, showing many of the different things that dermatologists do. How do you decide what you put on YouTube?

I put up almost everything that I tape. Most days I [film] at least one video but some days I get five, so I probably have about 30 days of content backed up. I try to put one video up every day. Let’s see how long this lasts, because I see all these vlogs dropping off. There was the time when you saw all these other people [posting daily] and you’re like “OK, I can do that, too.” And they’re all dropping off and I’m like, “They’re all leaving. Can I still do this, too?”

It seems like a lot of work.

It is a lot of work, but that’s why we have a team working on it. I have a little bit of a problem letting go because I feel like it’s my responsibility. They're my patients, and I try to keep them private and anonymous. If [the team leaves] something in accidentally, then I’ll feel really bad. But it's harder and harder to [do every video].

Initially, [the stuff on YouTube was] such a small percentage of what I did as a dermatologist. I say did because now, all my surgeries are cysts and lipomas. Before, I would do lipomas once a year, I’d say. Now I’m doing it on the daily. I didn’t really know how to do them that well, and now I’m a freaking expert. Now I know, “OK, they’ve been pushing on this one. This one’s going to be a pain.” That kind of thing.

The [most] highly viewed things are blackheads, which I’m getting less of now because of the fact that all these cysts and lipomas are coming in. The blackheads are usually the older gentlemen and women who don’t even know they have that huge thing on their back, so I recruit my other providers. I’m like, “You better bring me those blackheads you have!”

I try to throw in some of the things that I really do because there’s a lot of people that watch the videos and want to do what I do, and [extracting blackheads and cysts is] not exactly what I do. I guess I’m a surgeon, but that’s not what all dermatologists do. People will go, “Why are you doing this? I go to see my doctor and they won’t do any of this.” Some dermatologists won’t take a mole off on the face because it’s considered more cosmetic, but that’s just my training. That’s my bend, and I do a lot of cosmetics, too: liposuction, laser resurfacing, eye lifts, skin cancer surgery, Botox, and fillers. But I don’t really show that. There are other people [on YouTube] that show that and so sometimes I consider doing that, too. It’s just a different kind of clientele, and they’re more self-conscious.

So, I watch your extraction videos before I go to sleep. Last night I was like, “I need to prepare for this interview, and I also need to relax.”

You were actually doing research.

Yes, I was! But a lot of people find these videos satisfying and relaxing. Why do you think people like these kinds of videos?

I think it’s a strong reaction either way. Usually, people are either really obsessed with it like you are. It captivates you. And then there’s the opposite, people who cannot even stand it.

I really think that people like this because, in general, it makes them happy, for multiple reasons. Either it relaxes you, decreases your anxiety as you feel a sense of completeness. It gets rid of your compulsions. It’s like something is not there anymore that isn’t supposed to be there. It’s this ASMRYou got me addicted to these videos, so now I watch you and several others. And some of these people use needles instead of a comedone extractor to extract blackheads. What’s up with that?

I don’t know for sure, but I do believe it’s because of the different rules [that vary by state]. Aestheticians in some states can’t use a comedone extractor. They can’t use a blade. They don’t have access to numbing. Things like that. So it has to do a lot with rules.

[Some people also believe] the comedone extractor is damaging to the skin. That is B.S., but I’m not even going to start the conversation. People have different techniques, though, [and] these people find those to be superior.

It just seems like using a needle to get out blackheads must be so painful! Speaking of, here’s a fun fact: Back in the day, like in the 1600s and 1700s, people thought that blackheads were little worms in the face.

There are bugs on the face that live with us, you know. The Demodex mite lives on our face. That’s what we believe promotes rosacea. And I don’t think that it’s completely convincing, but there have been multiple studies finding that people with rosacea have more of these mites that live on their face or they react more to them and that’s why they get red, but there’s a lot more people with Celtic descent, so …

That's going to give me nightmares! So, you just started a new skin care line, SLMD. What was the inspiration behind it?

This is something that I’ve always wanted to do, but lots of dermatologists do it. I had ideas on how to do it differently—but also, now that I have this channel, I have all these people asking me about how to take care of their own skin. I know that they trust me, and it’s important for me to maintain that trust, so I’m trying to create things that essentially bridge the gap. This is really for people who can’t see a dermatologist or don’t have the time. Their parents won’t take them. They don’t have insurance for it. These are products that I myself would give to my own patients. In a way, my videos work with this too because I want to teach people why some of these products work and what they work on specifically.

Retinol works specifically on blackheads and whiteheads. It can help to prevent them and help to soften them up to make them more easy to extract, a la the Masked Man. You hear me talking about that with that kind of thing in the videos—we cannot give Tretinoin [in these products] because it’s a prescription, but I have retinol in the Nighttime Clarifying Treatment. It’s good if you get acne hormonally. People can even use this half of the month when they feel like it gets active, but you can use it all the time. In fact, I would use the retinol all the time because it’s anti-aging.

So if you learn and you understand what the reason is [for using a product]—that Benzoyl peroxide works because it’s anti-bacterial, so that’s used if you have more active acne like the red bumps. Or that salicylic acid is great because it can help to prevent blackheads and whiteheads but also helps to lighten brown spots. If you know those things, maybe it motivates you to use it, and also you can even try to change the way you use it. If you feel like it’s too drying, it’s probably the Benzoyl peroxide, and so you’ll leave that off it and won't use that as often.

There are so many products in dermatology that are given for one purpose that can also be used for other skin conditions, and people just don’t know. So this is what we’re trying to bring to people, because I can’t give them a prescription, but if somebody doesn’t know what this rash is on them and they have to see a dermatologist, and they don’t have time and they don’t have the money, they’re fretting. If I can help them to figure out what this is and then actually tell them about something that is over-the-counter to use, then that’s amazing.

So how can people get their hands on this?

It’s all on SLMD Skin Care. And this is just the beginning. An acne line is the first thing that makes sense, but it’s going to hopefully be even bigger.

The basic kit is the SLMD Acne System. It has four products in it. It’s very simple, just three steps: treat, cleanse, and moisturize. There’s a cleanser, which is salicylic acid. It’s not really drying—people can even keep it on their skin. You can literally put it on and leave it on and do other things in your house and then go take a shower and wash it off. And then "treat" is two parts: It’s a Benzoyl Peroxide Acne Lotion, which is the one that can be potentially drying—though most people are oily when they have acne—and then the Nighttime Clarifying Treatment, which has retinol. And then there’s a facial moisturizer, which has some anti-aging vitamin C and antioxidants.

Our other products include daily moisturizer with SPF 15. I do get questions about why it’s not SPF 30, and that’s purposeful. It’s because the higher SPF, the thicker the product. It’s avobenzone, which is a great sunscreen, but it’s not going to give you that whitish look, because [when] we already have acne, we don’t want to blow it up with white powder over it. We also have a Benzoyl peroxide spot treatment and a Pimple Popper Spot Treatment that’s a roller ball, which I really like because it’s salicylic acid—you can roll it across areas that are brown from acne, and it can make those spots go away more quickly.

That’s what we’ve got right now. We’re adding some things to it, too—we have a couple acne products coming up. But there are things in here that you can use even if you don’t have acne. Like I said, the retinol. The salicylic acid—great for brown spots as well. And the sunscreen, certainly.

Yeah. I think any kind of product that has multiple things in it—that can be used for multiple purposes—is really nice.

Especially because 50 percent of people—even though women pay attention to this more, plenty of boys and men get acne, and to make it simple for them, too, is key.

This interview has been condensed and edited for clarity.