More Than Just a Zit! The Ultimate Guide to Dr. Pimple Popper

posted on: July 14, 2015

Thanks to the coverage of Dr. Pimple Popper by way of Buzzfeed, UK Mirror, and more, we have now reached 205k followers on Instagram! Who would’ve thought that there were so many popaholics in the world? The idea for the Dr. Pimple Popper instagram was brainstormed when Dr. Sandra Lee and I were talking about how her most popular posts were on cysts and extractions. An instagram fully dedicated to these procedures seemed like the most logical step, hence Dr. Pimple Popper was born. There is more to this instagram account then just “popping pimples”. I thought it was time for a comprehensive guide to everything we’re “popping”. After reading this article you can consider yourself an Dr. Pimple Popper expert!

Check out Dr. Lee’s full videos on YouTube.

The Dr. Pimple Popper Instagram shows many different types of extractions using different tools and an array of “pimples”-all of which have specific terms. Below are definitions of the different terms of what we remove or “pop”.

 

Comedone: Open Comedone are also known as “Blackheads” (comedo is singular). Comedones are formed when cells lining the sebaceous duct build up and there is increased sebum production. In simplest terms it is a plug in your pore; made up of dead skin cells, oil, and bacteria.

Blackhead/Comedone Extraction

Dilated Pore of Winer:  Named after the Doctor who first desribed it, a dilated pore of Winer is a hair structure anomaly that appears as an enlarged solitary comedo. In layman’s terms-a big and usually old blackhead that hardened, one that has been building for years! Sometimes a stitch or 2 is required because the gaping pore needs help closing.

Dilated Pore of Winer

Lipoma: Lipomas are the most common soft-tissue tumor. These slow-growing, benign (harmless) fatty tumors form soft, lobulated masses enclosed by a thin, fibrous capsule. In non-med terms, Lipomas are typically a soft and rubbery glob of fat that does not cause pain. They usually remain the same size over time.Surgically Extracting Bumps on the Arms, Called Multiple Lipomatosis

Epidermoid Cyst: Epidermoid cysts are the most commonly found cysts and they contain a soft “cheesy” material made of keratin, a protein component of skin, hair, and nails. The surface of your skin (epidermis) is made up of a thin, protective layer of cells that your body continuously sheds. Most epidermoid cysts form when these cells move deeper into your skin and multiply rather than slough off. Think of it like a “snowball effect” of collecting more and more dead skin along the way.  A cyst appears as a domed-shaped, skin-colored growth that usually moves when touched and pressed upon. It may have a small opening in the center called a punctate.

Removal of a large epidermoid cyst, upper back

Pilar Cyst (Cyst on Head): Pretty common fluid filled growth that forms in hair follicles, most often found on the scalp. They are smooth and filled with keratin (that soft “cheesy” material I referred to in the Epidermoid cyst). In the animation below, the cyst is removed while the keratin stays intact in the sac, popping out like a garbanzo bean. Excellent removal!

Pilar Cyst Removal

Milia: Milia are very common, benign, keratin-filled cysts. Milia occur when dead skin becomes trapped in small pockets at the surface of the skin, forming a tiny little cyst.  An individual milium (the singular of milia) is formed at the base of a hair follicle or sweat gland. Milia appear as 1–2 mm white-to-yellow, dome-shaped bumps that are not painful or itchy. Many patients try to remove these themselves, thinking they are whiteheads, but they are difficult to remove without the help of a trained professional.

Milia Removal

TOOLS OF THE TRADE & PROCEDURES

“Punch” aka Biopsy Punch: This disposable biopsy instrument handles like a pen, with a grip at the top that allows you to twist, apply pressure, and drive the stainless steel blade into the skin with ease. It creates a very clean, perfectly round incision which leaves minimal scaring. This is best practice when excising a small cyst.

Punch biopsy on neck cyst

Comedone Extractor: The wire loop of this tool when pressed on the skin, creates a pressure which forces the blackhead (trapped sebum) up to the surface which then can be easily removed. Official Dr. Pimple Popper comedone extractors are coming soon!

Solar Comedones Extracted, aka Favre Racouchot

Forceps: Small forceps, which look like tweezers, are used to grasp fine objects. In the animation below, forceps are used to pull out the growth.

A Dilated Pore of Winer. For medical education- NSFE.

Excision: Simply put, to remove completely.  In the animation below, a pilomatricoma (benign tumor) is removed from behind the knee with dissecting scissors and a tug!.

Excision of a pilomatricoma behind the knee

I&D (Incision & Drainage): Slice and squeeze! Below is an animation of a cyst I drained

Incision & Drainage of cyst

Thank you for following! If any of our posts help answer your questions or demystify dermatology, then I am a happy Physician Assistant.

  • Gayla

    When will the Dr. Pimple Popper comedone extractors be available? Until then are there brand(s), types and/or features to look in extractors? Thanks!

    • Erin

      They should be available in the next few weeks! I don’t have much experience with ones from beauty supply stores as I only use medical grade ones in our office. The Dr. Pimple Popper ones will be medical grade.

  • Lynn

    Hello:

    I’m in Canada and have been following the Dr. P. videos with a kind of horrified fascination. lol Seriously though, Dr. P’s videos are informative and I like the fact that in almost all of them, she is gloved and the environment is clean/sterile. You won’t believe how many videos there are on the net of people lancing boils, zits, etc. where they don’t bother to wear gloves, clean the area before and after, use sterile tools, and apply topical (at least!) antibiotics after the removal of the pus/sebum/keratin (depending upon what kind of popping/cleaning they are doing)! Some of them are quite disgusting!

    I have mild milia and would like to try and deal with it myself as funds are limited for dermatologists and beauty spas. I would like to invest in professional grade extractors, forcepts, and sterile disposable lancets or a reusable piercing tool. I am wondering if you have any recommendations on where to purchase stainless steel professional grade supplies. Obtaining disposable gloves, sterile gauze pads, and topical over the counter antibiotics will not be a problem.

    There are companies that sell some of these products (Beauty Toolz is one) on line but many of the reviewers say that the piercing tool is not sharp enough and that it involves “digging” (which I think would be more painful and bad for the skin). I like the fact that you give one “little nick” to break the milia sac and then express it using the comedone extractor rather than digging around ripping the skin using a needle. I am still looking for the very sharp, very narrow kind of piercing instrument that will “nick” as opposed to ripping the skin..

    In any case, any constructive information you provide would be greatly appreciated. Also, will you comedone extractors be available for sale in Canada?

    Thanks so much.

    Sincerely,
    Lynn

  • Angelica

    Hi! I just found your page. I’ve been following Dr. Pimple Popper for a long time and was so excited to find her PA! I am entering my junior year of my undergrad of Biomedical Sciences. I feel this is an awkward question to ask a PA I know, so being that you’re a public figure and open to questions I’d like to ask you: are starting salaries as accurate as they are portrayed online? I have shadowed and love this profession already but don’t want to ask about salaries because I don’t want it to seem I am only interested in the money, but being it is something I will be doing I am curious.

    Thank you!

  • katie cunningham

    SO informative. I will be the first to buy one of these instraments! obsessed. thank you so much. I look forward to the day when I am a PA in dermatology.
    Thanks again