12 Dermatology Terms Defined By Dr. Pimple Popper
Viewers of Dr. Pimple Popper's YouTube channel won't be surprised that their favorite dermatologist—whose real name is Dr. Sandra Lee—is taking the world by storm. Not only does she have an explosively fun game, her SLMD Skincare line, and a new season of her TV show, she also just released a book, called Put Your Best Face Forward: The Ultimate Guide to Skincare from Acne to Anti-Aging. Dr. Lee stopped by the Mental Floss offices to define 12 dermatological terms that you'll often hear her discuss with her patients.
This word, which comes from Latin, once referred to what people in the 18th century believed were little worms in the skin. Now, Lee says, a comedo or comedone is "the medical term for a blackhead or a whitehead. It's essentially a pore that's clogged with dirt and debris, dead skin cells, oil."
2. and 3. Blackhead and Whitehead
Open comedones are blackheads and closed comedones are whiteheads, according to Lee. "The fact that a blackhead is open means that it's more exposed to oxygen, so it oxidizes, it turns darker—that's why it looks black," Lee says. "But a whitehead has a fine layer of skin over it so it stays unexposed to the sun. It stays a whiter color."
Whether you have blackheads or whiteheads, Lee says, the treatment is similar. One route is extraction: Blackheads can be removed at home, with the aid of a comedone extractor, which is Lee's preferred method; you can get the one she uses here. "It's a Schamberg type extractor and I use it because I think it does create less trauma,” she says. "I can go around the area and just extract the blackhead like that." Whiteheads can also be extracted, but because the skin must be pierced, Lee advises having a dermatologist handle that—if you try to do it yourself, "you can traumatize your skin," she says.
There are also products that will eliminate blackheads and whiteheads—look for ones that contain salicylic acids or retinol. You can find products containing those ingredients in Lee's SLMD Skincare line.
4. Hard pop
Viewers of Lee's YouTube channel will be familiar with this phrase, "a term that I sort of made up to describe pops or procedures that I do that are a little more invasive or a little harder, a little more advanced, maybe," she says. "I usually use it to describe the surgeries we do, something that requires a scalpel, maybe some stitches, there may be some blood involved." Hard pop compilation videos on her channel feature excisions of cysts, for example.
5. Soft pop
On the opposite side of the dermatological spectrum from hard pops are soft pops. "A soft pop is usually something that involves a comedone extractor or even your finger," Lee says. Think things like blackheads. "There's usually no blood or knicking or using sharp objects. And those are usually the most popular [videos] and really the gateway drug, so to speak, of popholicism."
6. Pilar Cyst
According to Lee, this type of cyst—which is also called a trichilemmal cyst, and is filled with keratin—occurs on the scalp 90 percent of the time, but "they can occur in any hair-bearing part of the body," she says. "It is derived from a hair root sheath, or part of the hair follicle, and it's a common growth—it can run in families, so it has a hereditary basis to it. This type of pop is really kind of cool to see visually because the wall or the lining of this cyst is thicker. It's almost the consistency of an olive." Because of this, Lee says, pilar cysts typically pop out whole, making them satisfying to see—"and satisfying for me as a surgeon, because I know I got rid of the whole thing."
7. Epidermoid Cyst
As with pilar cysts, epidermoid cysts can occur wherever there's a hair follicle (though it comes from a different part of the follicle). They're the most common type of cyst, according to Lee. "It's essentially just a balloon under your skin," she says. "Your skin sort of gets tucked under and it's now shedding into this closed space. That's why it grows, because there's just macerated keratin under there." On her YouTube channel, Lee describes the texture as having a "'cheesy' consistency, and there can be a pungent odor."
While pilar cysts have a thick wall, the lining of epidermoid cysts is thinner. Because of this, Lee says, an epidermoid cyst "tends to break easily, and more commonly gets inflamed or infected, because if you traumatize it and it breaks under the skin it elicits a reaction from your body. Your body tries to destroy this foreign body under the skin." This also complicates matters for her, because if she leaves any bit of the cyst behind, it can recur.
8. Dilated Pore of Winer
In her book, Lee calls the dilated pore of winer "the king of the comedones." They are, she says, basically giant blackheads. "It's dilated to such an extent that it changes the topography of the skin," she says. "They're particularly satisfying to see because they're usually huge and you can't imagine someone has something this size on them, and when you remove them they often come out entirely whole."
9. Keratosis pilaris
Colloquially called chicken skin, Keratosis pilaris is "a form of dry skin, it's a form of eczema," Lee says. The condition is characterized by tiny, red or brown colored bumps that typically appear on the upper arms, but it can also show up on the face, the butt, or the front of the thighs. "People don't like the appearance of it, and the feeling of it, because you see these little bumps, it's like your hair follicles are more pronounced—it's very bumpy. It's almost like a keratin plug, a skin plug there," she says. "It's really a self conscious thing—you don't want to wear things that bare your arms or your shoulders because you feel like people can see it, and also when people rub up against your skin, it doesn't feel soft, it feels prickly."
To get rid of the bumps, Lee says, you should use products that exfoliate your skin. "My skincare line, SLMD Skincare, has products specifically designed to help exfoliate the skin and to help improve this feeling, this roughness that you feel," she says. You can find them here.
In the season two premiere of her TLC show, Lee removes 68 lipomas from a patient's forearms. "A lipoma is a collection of benign fat cells in that space in us that has fat, it's called the subcutaneous space," she says. "I say it's as if one fat cell decided to divide upon itself and create its own little utopia under the skin, because a lot of times it's sort of walled off and separate and looks different than the regular fat under the skin."
According to Lee, lipomas are benign, and "they don't have to be removed, but they are bothersome to people because they can grow to pretty big sizes and really be a source of embarrassment," she says. Her patient had familial multiple lipomatosis, which causes many lipomas to form. "She was very self-conscious about it, and that’s very understandable. Because even though they're benign, they're pretty disfiguring," Lee says. "It makes you realize how often we expose our forearms. Most of us don't even think about it, we take it for granted."
Fans of Lee's channel will know steatocystomas thanks to her patient Momma Squishy, who has a number of these cysts, which form in the sebaceous glands. According to Lee, steatocystomas aren't as common as pilar or epidermoid cysts. "These cysts have oil glands lining the wall of the cyst, so these are particularly satisfying to pop because they kind of come out like melted butter," she says, also comparing them to linguine noodles. "The sac is very thin-walled but very strong and so you can usually pull it out with a tweezer and forceps and take it out in its entirety."
These tiny, keratin-filled cysts are "pretty common," according to Lee. "They kind of come out like little pearls. They're really pretty. They look like little birdseed, almost. We mostly get them around our eyes because it's a very thin-skinned area. They're deep enough under the skin that you can’t really squeeze them. You definitely have to nick the surface of the skin, which is again something that I don't advise a person does. They should see a dermatologist to do it. And it's nice to get them removed because they can drive us crazy. You can feel this little pebble, this little ball under your skin."