Every week on Dr. Pimple Popper, dermatologist Sandra Lee, MD, meets with men and women suffering from rare, often confidence-crushing skin conditions. The boils they carry are massive. The cysts are bubbling up to balloon-sized. But it's the people underneath the incredible lumps and growths that make the show worth watching. Just cover your eyes through the pus-filled eruptions, if you must.
If you're still embarrassed to call yourself an out-and-proud popaholic, maybe Gwyneth Paltrow can pull you out from your pus-curious closet. As Paltrow revealed in a recent podcast, the jade egg-wielding Goop founder and her daughter Apple cuddle up every Wednesday night and flick on the feel-good, pus-oozing melodrama of Dr. Pimple Popper — just like us. So, if that makes getting through this week's episode, filled with fleshy skin tabs, spider veins, and one farting cyst easier to stomach — then godspeed. If not (there are a lot of Goop skeptics out there), we've got the CliffsNotes version up ahead.
Case #1: Diane
The first patient we meet this week struggles with one of the most heartbreaking skin conditions we've seen. Sixty-three-year-old Diane has what's medically referred to as neurofibromatosis, a genetic disease that results in thousands of bumps and craters all over the surface of the skin. Though it's understandably a huge blow to her self-confidence, Diane is not at all bitter about the fleshy, raised dots that cover her entire body, including her whole face. But the saddest part is that the hereditary condition has kept her from ever having kids, for fear of passing it down to them. "The condition runs on my dad's side; my dad had it and his mom had it," Diane explains. "The doctors said that there was a 50 percent chance that my kids could have it, so I never had kids because I didn't want to pass on this disease."
Knowing Diane's condition is relatively untreatable due to her genetic disposition, Dr. Lee knows not to get her hopes up. "We both know that we can't cure this," she warns Diane at her consultation. "But there are some things we can do to make this more comfortable for you both physically and emotionally." And if anyone can help a woman out, it's Dr. Pimple Popper.
The bumps that bother Diane the most are the ones that cover her stomach area, and obviously the rough, fleshy dots on her face, so Dr. Lee starts numbing and nipping. Starting on the stomach — this part is particularly gnarly — Dr. Lee takes tiny serrated scissors to each bump, cleanly snipping them off one by one. You can even hear the snap of the scissors cutting the skin, which is strangely even more nauseating than seeing the bloody holes left behind.
For the face, Dr. Lee uses a tiny razor blade on Diane's chin area, where a ton of bumps are clustered, and carefully slices them away to try and smooth out the rough surface. This part is very, very bloody, to the point where Dr. Lee has to hold a cloth to Diane's face to mop up the blood dripping from each cut. Then, Dr. Lee brings out a high-tech CO2 resurfacing laser to sand down the top layer of rough skin and even out the overall texture. Essentially, the laser works by burning away a thin layer of skin; when that layer heals, it come back smoother and less puffy.
As is the case with many heavy-duty resurfacing procedures, the scabby skin looks worse before it gets better. The laser leaves dark-brown burn marks all over Diane's face, but after a week or two, that dead skin flakes off, giving way to fresh, new skin. Diane stays positive and upbeat about what Dr. Lee is able to do for her, but as the camera pans over the excised flaps of flesh lying on the surgical table, for better or worse, Diane and her case of neurofibromatosis will certainly stick with you.
Case #2: Will
The next case takes us to Georgia, where we meet 57-year-old carpenter Will, who is sawing wood in his front yard. Will has a golf ball-sized lump sticking out of his shoulder, which is becoming a concern because he's not really sure what it is — or what might happen if he accidentally jams it against a nail jutting out of a wall. So Will and his squishy shoulder pad head out to L.A. to pay a visit to Dr. Lee.
Meeting with Will for his consultation, Dr. Lee initially diagnoses the nubby bump as a lipoma, but she isn't 100% sure. (As loyal viewers know, you can never be positive about what's hiding under the skin until you cut it open.) Dr. Lee straps on her splash mask, and carefully cuts into Will's lump. Slimy white gunk immediately starts spilling out of the skin, which tells Dr. Lee she was wrong with her initial diagnosis. She shouts a command we never thought we'd hear: "Get me a kidney basin, please — this cyst is about to blow."
With the proper spillage apparatus at the ready, Dr. Lee squeezes Will's bump, and piles of pus dribble into the metal basin. Then, with the liquid drained and only a floppy skin flap left — sound on — Dr. Lee yanks out a cyst sack, which makes a loud farting noise that she calls a cyst poot. "A cyst poot happens when the skin gets a little loose, and grabbing into it makes a squelching noise," Dr. Lee explains. Add "cyst poot" to the list of pimple-popping terminology you never needed to know, but won't be able to forget.
Case #3: Anthony
Anthony begrudgingly trudges into Dr. Lee's office flanked by his two teenage daughters, Juanita and Rosetta. At first glance it looks like Anthony is a regular old dad, and he is — but from the back, you can see a tennis ball-sized pimple popping out of his neck. Anthony has recently dropped out of his dart league, which makes his family think that the big neck pimple may be hurting his self-confidence. So, as good daughters do, they've brought him to the pro.
Dr. Lee immediately diagnoses Anthony's neck lump as a lipoma, because she's able to smush it from side to side with her fingers. At first glance, she also knows that the lump is going to be tricky to pull out because the skin on the back is super-thick, which means you have to dig down at least an inch under the skin to find where the lipoma is rooted.
The girls put on their surgical masks, dubbing themselves official popaholics for sitting through their dad's pimple procedure. Dr. Lee slices open Anthony's lump, and pokes her finger around the gaping incision to try and feel where the pus ball is buried. "There are important spinal structures that run through the neck," Dr. Lee explains. "So I don't like to stick sharp tools blindly under the skin." Eventually, Dr. Lee locates the lipoma, pushes it towards the surface of the skin, and latches onto the sticky, yellowish ball with rounded scissors, yanking it out from Anthony's neck. Dr. Lee then stakes her claim as the coolest doctor in the world, letting the girls check out their dad's bouncy pus ball for themselves. Because one kid's candy store is another's fluorescent-lit exam room.
Case #4: Kal-Elle
The final case of the episode brings us to New York City, where we meet 47-year-old Kal-Elle. Kal-Elle has recently transitioned from a biological male into a female, and is currently in a stage of puberty 2.0. "I feel like a 17-year-old girl starting my life over again," she tells us. "But what's standing in my way of becoming this Superwoman are these huge, dark purple veins on my legs." She explains that her legs have been this way for her whole life, but as a woman, she's started to feel insecure about them. "I can no longer hide these behind leg hair like I used to," Kal-Elle says. "And after everything I've done to transition, getting over the fear to become my bold and authentic self, this sets me back."
Kal-Elle flies out to meet with Dr. Lee, who immediately recognizes the condition as spider veins. "Spider veins are the very fine, superficial blood vessels that you see on the skin," she explains. "They're actually quite different than varicose veins, which are those thick, deep-rooted vessels." To treat the dark veins towards the surface of the skin, Dr. Lee uses a technique called sclerotherapy, injecting a gel into the veins that counteracts the purple hue and turns them translucent.
Dr. Lee puts on huge magnifying goggles to help her to see Kal-Elle's vessels clearly, then sticks a small angled syringe into her leg — which leads to a little bit of blood, but nothing more than a knick you might get from shaving. This part is pretty cool: The moment Dr. Lee injects the needle into the leg, Kal-Elle's deep-purple spider veins instantly disappear into her skin. It's a little pinch-y and painful for Kal-Elle, who's not under and anesthesia or numbing medication, but she knows that the results will be well worth the momentary discomfort.
In the end, Kal-Elle's procedure allows her to feel comfortable wearing short skirts and dresses, to dress as the woman she's always envisioned. It's a happy ending to an episode that we're sure Gwyneth and Apple enjoyed as much as we did. Tune in next week for a whole new cast of patients, and a whole lot more pus.