Entries Tagged as 'Video'

Buff & Shine: A one-two punch!

posted on: July 22, 2015


The Buff and Shine Treatment, a term coined by us here at Skin Physicians and Surgeons, is ideal for the individual that struggles with acne scars, fine lines, wrinkles, uneven pigmentation, brown spots or skin laxity (saggy or loose skin). This procedure combines skin blading to remove unwanted peach fuzz on the face along with a fractionated mixto laser resurfacing treatment. Due to this new technology, in as little as one treatment, the Buff and Shine Treatment can give you healthy, younger, more vibrant looking skin.

First we “buff” the skin by preforming skin blading. This part of the procedure utilizes a sharp blade to shave off peach fuzz and dead skin cells covering the surface of the face. After that a numbing cream is applied to the face for about 20 minutes. After the face is numbed we preform a treatment with the a fractionated CO2 laser. This procedure is fractional meaning that it is only exposing a part of the skin at a time to the laser. This means less downtime and less risk of scaring. The procedure is very tolerable.

The Mixto laser works by using tiny beams of light penetrating into the top layers of the skin. When the procedure is finished you will see these tiny little dots on the skin. Those little dots will flake off and reveal rejuvenated skin. The flaking process takes about 3-5 days. During that time you can continue your normal skin care routine and wear make-up. There is essentially zero downtime to this procedure. To see the best results, a series of treatments are needed.

Buff and Shine is a suitable treatment for almost anyone: the combination of removing the dead skin layer then using a laser to rejuvenate can help achieve beautifully textured and evened-out skin! Add it to your skin care repetoire.


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


“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.

The Ultimate Guide To Sunscreens: Physical vs Chemical

posted on: July 1, 2015




Sunscreen and Sunblock are descriptions used interchangeably but it is important to know that technically they are different products-it is a matter of chemical protection versus physical protection.

Here are some abbreviations you may not know the meaning of:

UV=Ultraviolet referring to radiation.

UVA Rays=Long wavelengths which penetrates skin deeper, the culprits in premature aging, wrinkles and sunspots. Present whether it is sunny or not. Weaker than UVB rays, they can still contribute to skin cancer.

UVB Rays=Slightly more energy than UVA rays, exposure can cause skin to burn and  lead to melanoma and other forms of skin cancer.

Here is a quick comparison of Chemical Sunscreens VS. Physical Sunscreens


-Noticeable on skin, most sunblock leaves a thin white-ish layer on skin

-Contains ingredients like Zinc Oxide and Titanium Dioxide which physically block the sun, reflects the rays off skin, almost like a mirror.

-Effective immediately after application because it remains on the skin surface-doesn’t need to be soaked into the skin

Deflects UVA and UVB rays, reduces the radiation that hits the skin

A few Physical Sunscreen I recommend:

1. Blue Lizard Sunscreen– This is the best sunblock that is difficult to find. It is an Australian based company and can be purchased online. You can even buy this stuff by the gallon! The bottle also turns blue when exposed to UV rays. No need to question if you’re getting  UV exposure on that cloudy day, just look to the bottle for the answer.

2. The Honest Company Sunblock Stick– Putting sun protection on your kids faces is the worst (even for this Derm momma). Most kids hate putting lotion on their face and with one quick move they always end up getting it in their eye. This stick makes physical application of the sunscreen a breeze with no mess.

3. Colorscience Sunblock Powder– I’ve talked about this product many times before. While it wouldn’t be my whole body go-to if at the beach it’s great to apply over make-up or even put on the part on your scalp, an area that is often overlooked when it comes to sunscreen application and easily burned.

This YouTube clip below shows with a UV camera how Sunblock acts as a physical barrier on the skin, you can see clearly once the subjects smear Sunblock on their face!


Chemical Sunscreens:

-Usually appears clear on skin

-Contains special ingredients that act as chemical filters and reduce ultraviolet radiation penetration to the skin

-Must be applied at least 30 min. before sun exposure to soak into skin

Absorbs UVB rays

-Any sunscreen with less than 15 SPF is a waste of time and money

1. Aveeno Protect and Hydrate Lotion Sunscreen– One of the biggest complaints I hear about physical sunblock is that “it’s too thick”. This product absorbs quickly and moisturizes the skin, plus it is recommended by the Skin Cancer Foundation

2. Sun Bum Original Sunscreen Lotion– This product also absorbs easily into the skin and has that classic beachy scent. Is it weird that I keep a bottle of this stashed in my desk, and take a whiff when I need a mental break? “Sun Bum, take me awayyyyyyyyy!”

3. Supergoop Everyday Sunscreen– Non-comedogenic formulation designed for everyday use over the whole body. This is a great choice is you are particularly sensitive to paraben, synthetic fragrance or oxybenzones.

Please note:

  • “Waterproof” is better than “water-resistant”, but it doesn’t mean that lotion can be applied once and you’re covered for the rest of the day. “Waterproof” can maintain an SPF level 80 min. after swimming or sweating, whereas “water-resistant” maintains SPF only 40 min. after being in water.
  • Oils, even if they have SPF, aren’t really a protective form of sun protection. The oil intensifies the rays, as if you are basting your body. Unless you want roasted turkey skin, don’t use tanning oils.
  • According to the Melanoma Foundation, Even on a cloudy day 80 percent of the sun’s ultraviolet rays pass through the clouds. Especially important to wear sunblock even on an overcast day.

I personally hate spray-on sunscreens. Yes, they are convenient as can be, but almost no one applies them correctly. To get the level of SPF protection suggested on the can you must apply the sunscreen to dry skin with no wind present and you must apply a LIBERAL amount of the spray to the skin (the skin should look wet) and then you need to rub in the spray into the skin. You then must wait for everything to dry and absorb into the skin before it starts working. Do you know anyone who does all of these steps? I have some patients refuse to wear anything but sprays (cough…cough…my husband) so I tell them it’s better than nothing, but in general I highly advise against them. Also, you want to avoid inhaling spray sunscreens as there is still investigation occurring on any potential risk in the lungs.

Bottom Line: These days, sunscreen and sunblock are so interchangeable, they are not scientific terms to describe sun protection. In my field we compare the two as “chemical vs. physical”. Many lotions are a combination of both so it is best to look at the labels; mineral ingredients like Titanium Dioxide or Zinc Oxide-those inorganic ingredients physically block the sun.

Regardless of whether you use sunblock or sunscreen, they both have the ability to protect you from damaging ultraviolet rays and should be a part of your daily routine.


Dr. Pimple Popper: Your Guilty Pleasure

posted on: May 21, 2015

Untitled design (1)A few weeks ago, Dr. Lee and I were discussing one of the segments she had taped on The Doctors Show. Her most popular clips seemed to be the ones in which she was removing cysts or blackheads.

“Why don’t we create an Instagram account that only shows us removing things that pop? Blackheads, etc..?!” I asked her.

Thats when @drpimplepopper was born.

There is something deeply satisfying about watching the removal of these skin imperfections. What I didn’t realize was how many other people felt the same way! Almost overnight, @drpimplepopper gained thousands of followers (at time of publishing 154,000 are following these 15 sec. videos of guilty pleasure)

Our Instagram has touched all corners of the world thanks to coverage by Buzzfeed USA, The Guardian, Allure Magazine Blog, Cosmopolitan.com, Daily Mail UK, Irish Mirror, Huffington Post UK, Terra Brasil. Thanks to such exposure, we have been able to give back to one of Dr. Lee’s special patients, Mr. Wilson.

Mr. Wilson lost his wife recently, and for each visit while Dr. Lee squeezed him, he would share more of his story, which touched many viewers. Thanks to a Gofundme.com collection started by Dr. Lee, Mr. Wilson was gifted $6,800 to help his current financial situation, and brighten his day since his wife passed away.


If you haven’t already, make sure to follow @drpimplepopper, my personal account @whitecoattreatment as well as @drsandralee


Baby #3 is a…

posted on: May 13, 2015

Gender Reveal Piñata

I must say, I was ready to see 2014 go. Last year was a rough one- to say the least.

I found out I was pregnant for the 3rd time earlier in the year. The love and joy that my first 2 children had brought into my life made me feel so excited to welcome our new addition. 10 weeks into pregnancy I suffered a miscarriage, something I was not prepared for, but who really is?

I never considered the possibility of having a miscarriage, although approximately 20% of pregnancies end this way. Time has healed the pain, but I still keep the memory of my angel baby close to my heart.

Later in 2014, our Medical Assistant Alicia, only 25 years old and a mother of 2 young girls, passed away in a tragic motorcycle accident. Alicia was beyond sweet-the most personable woman with a beautiful smile, she was the most bubbly person I’ve ever met. More importantly, she was a wonderful mother. She adored her daughters and loved them more than anyone could. Everyday we talked about her daughters, her life revolved around those 2 little girls, her love for them was immeasurable.

I worked with Alicia for 5 years, we were pregnant at the same time and our daughters are now the same age. I mourned the loss of a dear friend, and also grieve for her 2 daughters and how they will never see their mother again. Fortunately the girls have a wonderful father who is taking care of them and doing a wonderful job.

Alicia’s death coincided with what would be the due date of the 3rd child that I miscarried, and the emotional pain weighed heavy on my heart. The outcome of the experiences of 2014 have made me a different person; it has deepened my appreciation for my husband and children. More than ever I am grateful for the people I have in my life. Knowing that life can change so drastically in an instant makes me put even more priorities into my family and personal life.

In early 2015, I was excited to find out I was pregnant again! Feelings mixed with caution knowing how fragile a pregnancy can be. I held off on telling people I was pregnant until we reached that magic 12 week mark so when my first trimester came and went, I breathed a sigh of relief. While I know a pregnancy is never “safe” the risk of miscarriages significantly decreases after 12 weeks.

My type-A personality could never fathom waiting until the birth of the baby to find out the sex, so we set up a gender ultrasound at 15 weeks. My husband is worse at waiting than I am, but for this time around I wanted to do a fun surprise. My husband said if he could find out the gender at the ultrasound then he would plan a surprise for me on mother’s day for the reveal. With out further adieu, take a look at what our tie breaker baby is going to be…


Someone wasn’t too happy about the results of the reveal but she has since become more excited about another baby in the house and another kiddo to boss around.


Dermaplaning: Painless & No downtime

posted on: April 23, 2015

Dermaplaning or Skin Blading is one of the most painless and effective ways to achieve smoother more vibrant looking skin. The procedure is simple involving a small and sterile surgical blade held against the skin at an angle and stroked along the surface of the face. The treatment is extremely safe and there is not much more risk than actually shaving your face. Skin blading removes the villous hairs as well as terminal hairs (for men). A question that may be of concern for this procedure is, “Will my hair grow back thicker if I have dermaplaining”? The answer is no, your villous hairs (thinner, soft hairs) will in time grow back, but it will not cause them to be thicker or darker. Skin blading is only performed on the face, not including the nose, eye lids, neck or chest. Blading can be performed as much as every 3-4 weeks but that is not always needed. After dermaplaning the skin can sometimes peel, but this is normal.

A very simple procedure which you can add to your skin care repertoire!

Why you should be thinking about bikini season now: Laser Hair Removal

posted on: February 12, 2015


Is anyone else ready for summer time? I sure am. When we start thinking about summer time and hair removal it’s often too late to start treatments. Most laser treatments require you to avoid the sun or be very careful about avoiding the sun after the treatment. Patients must also wait until their tan has faded from the previous summer before receiving most laser treatments. Now is a great time to get started. Another advantage of undergoing laser treatments during this time of year is that most lasers require a series of applications to yield optimal results. For example, laser hair removal typically requires 5-7 treatments, while vein reduction with sclerotherapy usually requires 2-3 treatments, etc. Therefore, it’s wise to give yourself a little extra lead time if you want to be able to show off your results on that beach vacation you’re planning this summer.

Laser hair removal is the best way to permanently reduce unwanted hair. Laser Hair Removal will not remove 100% of your hair. Typically it removes 70-85% of the hair, but the hair that is left is thinner, finer and grows in slower. Laser hair removal involves a beam of highly concentrated pulses of light penetrating through the skin being absorbed by hair follicles. The heat that is generated will ultimately destroy the hair and it’s potential for regrowth.  Learn more about laser hair removal in the above video.

Moley, Moley, Moley: What to consider when evaluating your moles

posted on: January 29, 2015

Moles can appear anywhere on our bodies from the bottom our feet to the top of our head and everywhere in-between. While most of them are harmless, some may be cancerous and cause harm if not treated in a timely manner.  To decide if you should seek evaluation about a particular mole that may be dangerous, follow the ABCDE rules for potential skin cancer at home.

  • A is to see if your mole has asymmetry, meaning one half is larger than the other.
  • B is to look at border irregularity. Borders with jagged edges that are uneven can be some of the first warning signs.
  • C is to look at the color, if the color changes or is a shade of black or bluish-grey you can be at risk.
  • D is to look at the diameter of the mole, if it is greater than six millimeters, about the size of an average pencil eraser then you may want to have it evaluated.
  • E is evolution. This is probably the most important factor. If your mole is evolving (aka: growing and changing) it is very important to have it examined.

Although skin cancer seems scary, most moles are benign and we are able to test it in a timely manner. Having a cancerous mole is not the only reason to have a mole removed. Many people choose to have multiple moles removed for their own convenience due to factors such as; they simply do not like it, to it being in a highly seen place such as the face. The mole removal process is quick, safe, easy, and low on the pain scale. If you are questioning a mole, or feel at all uncomfortable about one, make an appointment to see what your treatment options are.

Acne Treatment With The TriBeam Laser. Video

posted on: November 5, 2014

I discussed how lasers can work to treat acne in this previous post. Below is a video of the laser in action. First, a lotion is applied to the face that contains very small carbon particles, small enough in size to settle into the pores. With the first pass of the Tri-Beam laser, heat is generated within these particles, which destroy the bacteria, called P.acnes, which resides within our pores and cause acne. The second pass removes the carbon lotion on the surface of the skin by disrupting these tiny carbon particles, thereby superficially peeling the skin and efficiently cleaning out and shrinking the pores. It’s pretty neat to watch the carbon lotion being removed. Enjoy!


Laser Tattoo Removal

posted on: October 14, 2014


Do you have a tattoo that once seemed to be a good idea, but now you want removed? You’re not alone. Over 45 million Americans have at least one tattoo. I’ve seen a statistic that says 20% of people regret their tattoo within one week of getting it. Laser tattoo removal has proven to be the safest and most effective form of tattoo removal.

How does laser tattoo removal work?

The laser light is delivered to the tattoo so rapidly that the ink is broken up into tiny particles. These fragmented ink particles are safely cleared by the body through its own processes. The tattoo will fade after each treatment.

Will the tattoo completely disappear?

In some cases, the tattoo will disappear completely, while in others it will usually be lightened significantly. The ability to completely remove a tattoo depends on several factors, including size, location, type of ink and depth of ink.

Does it hurt?

In so many words: yes. However, the use of topical numbing medicine greatly reduces the discomfort and for most tattoos the treatment only takes a few minutes.

How Many Sessions Will I Need?

Every patient and tattoo is different. Homemade tattoos with dark ink can be removed in just a few sessions spread 6-8 weeks apart. Professional tattoos are usually deeper, larger and vary in color. These usually require more sessions.

Are there any side effects? 

There is a low risk of scarring. Redness and/or discoloration can occur, but is typically temporary.