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00:00The following program contains medical procedures and treatments involving dermatology. Viewer
00:04discretion is advised. I'm Dr. Sandra Lee, aka Dr. Pimple Popper. Pretty sure that was the coolest
00:09thing I've ever seen. Come break out with me and all my new patients. Plus, I'll share my expertise
00:15with some amazing young dermatologists. Pimple popping is not taught in residency. We'll see
00:22how they break out, seeing things they have never seen, and of course, seeing how they pop.
00:28I can't believe it's not butter. On Dr. Pimple Popper, Breaking Out.
00:36Tonight on Dr. Pimple Popper, Breaking Out. People watch me and stare at me being like,
00:43oh my God, what's on our ears? I've been living with the pain for 32 years. I'm a transgender man.
00:50I was born female. The bumps are the last part of my transition. I don't want to be disappointed.
00:56I did not get any answers. Oh, hi. I just graduated from residency. Let's go see the patient.
01:04Be careful. It means that...
01:09What the heck is going on here? Working alongside Dr. Lee is humbling.
01:26I thought I'd tell you guys a story. Why did this shadowy, mysterious figure stay by me? And I cocked
01:32my head to the side. I'm like, he just stole my phone.
01:35My name is Tierra. I'm 22 years old. I'm from Milwaukee, and I have extreme ear keloids.
01:40The keloid on my left ear is about the size of a bean. It's squishy, and sometimes I get pain
01:47in that area.
01:48The keloid on my right ear is definitely the one that's the worst. It wraps around, and my regular ear
01:53will be right here.
01:53It feels like if you put flour in a balloon, it's very hard and very dinked.
01:59My keloids are itchy all the time. They feel really uncomfortable.
02:02When I was 13 in middle school, I started piercing my ears more, and after that, I got a bunch
02:08of keloids.
02:08I used to get bullied for my ears a lot because people would treat me like I was contagious and
02:13wouldn't even try to talk to me.
02:15It crushed my self-esteem 100%.
02:18Yes, we got the phone back.
02:20Moral of the story is, don't try to take people's stuff.
02:23I try to be as positive as I can be, but I think the positivity is like toxic positivity.
02:29Like, I have to stay positive because if I'm not, then it's like an abyss and depression.
02:33I have to present myself every day.
02:45I really always felt like I needed a way to escape, which is why I really fell in love with
02:49music.
02:51I sing and I rap, and my artist name is Tiny.
02:54Music for me kind of brings in this brightness. It just fills me up with joy.
02:59I don't perform as much as I used to. I feel very self-conscious on stage.
03:07Going into 12th grade, I got my keloids removed. It felt amazing.
03:11I felt free from feeling embarrassed about my keloids.
03:13But then over the course of three years, they slowly started to grow, and they just came right back ten
03:18times worse.
03:21I really feel, like, sad and depressed that, like, my keloids make me detach from other people.
03:27I'm a very social, outgoing person, but I do feel like I quiet my energy because I'm scared of what
03:33people will think because of my keloids.
03:40I'm so excited to go to this restaurant. I've really never been here before.
03:43In the club, yes. I need a drink. You should get some tequila. I'm gonna tempt you.
03:48Oh, no. It's very chilly, Burr.
04:04Girl, we don't have a social life. You need to get booed.
04:08It's kind of hard because, like, I want to see you happy. You know what I'm saying?
04:11I want to see myself happy, too, but, like, I don't know, kind of stuck kind of feeling because of
04:15my keloids and stuff like that.
04:16Really? Yeah.
04:18Tiara is sweet, funny, goofy. We became friends about seven years ago.
04:24She's become, like, a sister to me at this point. I feel really bad about her keloids.
04:29It's affecting her life a lot. It messes up her self-esteem.
04:33She's been struggling for a while to find a person, especially someone that would treat her well.
04:38Any guy should give Tiara the moon. You know, they should go up into space and give her the moon
04:43because that's what she deserves.
04:46You're a cocoon right now, you know, and you're waiting to blossom.
04:49You know the butterflies that we release? Yeah.
04:51You're about to be released, bro.
04:53I feel like once I feel I'm able to, like, get out of my shell, then I'll be able to
04:57do that. You know what I mean?
04:59I'm really excited to get my keloids removed, but I'm really, really, really scared that they're gonna come back.
05:05And I'm stuck. Like, I can't see ahead.
05:22The kids were just home during spring break. It was so nice to see them.
05:25But it also reminded me how hard it is to be in your 20s, really, and live.
05:31You know, you're just trying to figure out your way in the world, and you're very self-conscious about things,
05:35and people can be really critical.
05:37I think a lot of the feelings of comfort and feelings of success is really having control over your own
05:43life.
05:43You know, that's what I'm here for, too.
05:44If I can help people, in a way, feel more control over their lives, then I'm all for it.
06:07Hello. Hello.
06:09You look so cute. Thank you. What are you here for?
06:12Today I'm here about my keloid. Oh, I see it now.
06:15Wow. My goodness. That has taken over your ear.
06:19Yes, literally. They're very large.
06:22I can feel how heavy that is.
06:24Absolutely, and it's, like, mostly itchy.
06:26Okay, and then do you have it on... Okay, well, this is much easier to deal with, and it's soft,
06:30too.
06:31Yeah.
06:31Keloids don't happen to everyone. Some people are sort of more susceptible to getting keloids.
06:36It's really just a hyperactive scar. It's triggered by trauma. It can happen from something as insignificant as a bug
06:45bite or a pimple.
06:46How long have you had them?
06:48Well, when I was in middle school, I had piercings, and I started to see them keloids, so I took
06:53them out.
06:54Okay. And then I got my keloids removed. It came back from, like, the scar.
06:58Have you had any treated in any other way? No, I haven't.
07:01Okay. So you understand a little bit that trauma causes it, like an ear piercing, for example, but also surgery.
07:09It's like a form of trauma. It's, like, also injuring the tissue, and the trouble with that is that when
07:14you remove a keloid,
07:15you have to take out more tissue and make the scar longer, and then that makes a potentially bigger keloid.
07:20Yeah. The problem with keloids is the treatment option can oftentimes lead to a worse result.
07:29This has already happened, Tierra, so to really get rid of this, I got to come up with a good
07:33plan.
07:34You can see that because of its distortion, it's pulled your earlobe up, so it's like an L shape.
07:39I know we want this L gone, because, like, L is for...
07:43Losers.
07:44I'm going to try to keep the scar as small as possible, because the smaller the scar, the less potential
07:48that a keloid has to grow.
07:49So, I think what I will do is start on this ear, actually.
07:54Okay, that works.
07:55Okay.
07:55I'll see you in a little bit, okay?
07:57Okay, cool.
07:58It was really great meeting Dr. Lee.
08:00She's very cool.
08:01She's very funny.
08:02But I'm really nervous for this, because last time I went to the doctor and I grew back even bigger.
08:18Alrighty.
08:19This is just a little baby pinch, okay?
08:21Baby pinch here.
08:22My plan is to keep the top layer that's over this keloid.
08:26I want to remove that scar tissue that's underneath, which is the keloidal tissue, and then use that top skin
08:33to really create a covering.
08:35This is going to be different from three years ago when Tierra had this keloid removed.
08:39And in this case, I'm trying not to alter any normal skin.
08:44As little normal skin as possible.
08:46You make sure I'm not that hurting you, but you're going to hear me.
08:48I'm like a little mouse over here, okay?
08:49Okay.
08:49Scratching away.
08:52This one's nice and soft and pliable.
08:57You can hear it though in your head, I know, because it's in your ear.
09:01Sounds freaky.
09:03I'm able to save a lot of the normal skin that overlies the keloid, but this one is really kind
09:08of amateur hour.
09:09The big keloid on the right ear is going to be much more difficult to tackle.
09:14All right, we are finished on this side.
09:16That was the easy side though, okay?
09:19The second keloid is certainly a bigger challenge.
09:22It's very difficult to discern the difference between your regular cartilage and where this keloid begins.
09:28I need to leave enough skin that was atop this keloid to place back in the area.
09:34Make sure we're just taking off keloid.
09:37Let me take off this here first.
09:42You okay?
09:42Yeah, I'm fine.
09:44I don't really feel anything.
09:45Good, good.
09:45That's what we want.
09:47You know what this is like?
09:49If you ever gotten that block of cement, you got to like get the fake dinosaur bones in them.
09:54Oh my god.
09:55I think I did that once.
09:57I feel like it's kind of like that you're like excavating.
10:00Mm-hmm.
10:02Just got to figure out where this tissue is going to come from that I'm going to keep.
10:06That's the hard part.
10:08Now that is not her ear, right?
10:10Let's feel it overall and see.
10:11What the heck is going on here?
10:15This keloid is very complicated because I could distort the shape of Tierra's ear if I took off too little
10:22tissue or too much tissue.
10:23I mean, what do I need to do here to take that off?
10:38What the heck is going on here?
10:43I'm here with Tierra and I'm removing this really massive keloid on the back of her right ear.
10:49And it's really hard to discern where the keloid tissue stops and where the cartilage starts.
10:55They look very similar.
10:56They feel very similar.
10:57I gotta use all my skills to keep this ear intact.
11:01All right, let's take this lower part off.
11:03I think that'll help us to see.
11:06We're almost what we call debolked.
11:10Where we're taking off most of the weight of it, there's still, you know, a little bit of it left,
11:15but it's not so easy to see everything.
11:18This definitely is a challenge.
11:23I feel that was really relieving to me too, taking that off.
11:26There's a lot of keloid here.
11:28Yeah, right?
11:29That's going to be good.
11:31I have removed as much of the keloid as I safely can and maintain that skin that's overlying it.
11:37And so I'm going to be able to flap that back and close it.
11:40I tried to keep the scar in the area of where the existing keloid is to minimize traumatizing new unaltered
11:50skin.
11:51It looks pretty darn good.
11:53Do you want to see?
11:56Oh, that looks so good.
11:58It's going to look really good.
12:00See, it wants to be puffy a little bit.
12:01Yeah, because it's swelling.
12:02Because it's swelling, I put numbing underneath it, so it's fuller still.
12:05But that should smoosh down because we're going to smash it.
12:08Yes, my profile is about to eat.
12:10I'm about to look so good.
12:12Tiara, unleash.
12:13Tiara, unleash.
12:14No longer.
12:15Oh my god.
12:17Oh no, we unleashed the real.
12:20Yes.
12:20We just unleashed her.
12:23It's been a really long time since I felt myself energy.
12:26That is so cute.
12:28Oh my god.
12:29So I'm really happy right now, but I'm also a little bit anxious and nervous because I don't know what
12:34she's going to do to ensure that it doesn't come back.
12:38You did awesome.
12:39I know that wasn't easy.
12:40But we're going to do another procedure to ensure this doesn't grow back.
12:46What we're going to do is superficial radiation therapy there and irradiate those cells so that they don't overgrow again
12:52and turn into another keloid.
12:53Will I feel anything during irradiation?
12:55You should not feel anything.
12:56It only penetrates, I think, just a couple millimeters.
12:59Okay?
13:00Okay, that works.
13:00Okay.
13:01When I hear the word radiation, I really think of like something cancerous or something really, really bad, you know?
13:07But Dr. Lee explained everything to me and she was like, it's not that bad and they'll protect me against
13:12everything.
13:13But I'm really nervous.
13:15Hello.
13:16Hi.
13:16How are you?
13:16I'm doing great.
13:17How are you?
13:18Good.
13:18You are Tiara.
13:19Yes, I am.
13:20One of my best tools for helping to prevent keloids from coming back is superficial radiation treatment.
13:27And I'm bringing in Dr. Rebush, who is another dermatologist that works with me.
13:32He also happens to be my husband.
13:34And he's the one specifically trained in doing superficial radiation treatment.
13:39We are going to be putting a lot of lead kind of on your face, around your ear.
13:43We're going to have tape on your face.
13:45Okay, do you have any questions for me?
13:47I don't think I have any questions, no.
13:49Okay.
13:50Well, let's get after it then, okay?
13:52SRT is going to help inhibit quickly growing scar tissue cells from growing back.
13:59There's a lot of protection you have to have going on.
14:02Radiation can damage any of your cells in your body.
14:05We're trying to focus it just on those cells that we don't want to have grow back.
14:12We'll be back.
14:26Okay, you made it.
14:28Okay, great.
14:29You're welcome.
14:30At first, I was kind of nervous because I didn't know what to expect.
14:33But I'm really, really happy I did it.
14:35I'm leaving today with so much more hopefulness that my keywords will come back.
14:40Positivity and this amazing life-changing experience.
14:43They ask me how I shine like this.
14:45Oh, it's so good, it's miraculous.
14:49Now that I don't have them anymore, I know that my love life is going to change.
14:52My career is going to change.
14:53My music is going to change.
14:55My confidence is going to change.
14:56And I'm ready to live my best 20-year-old life and turn up.
14:59And I'm so excited to do that.
15:04New chapter, new beginning.
15:07New chapters, new beginnings.
15:09Da-da-da!
15:13Bye!
15:31My name's Ryan, I'm 33 years old.
15:34I live in New Orleans.
15:35And according to my mom, I've got a couple of gargoyle horns on my head.
15:40Sorry I called them that.
15:42You know.
15:44The bumps that are on my head, they're firm like hard rubber.
15:48But just maybe a tiny bit of give to it.
15:52I've had these bumps for at least 20 years now.
15:56And they've just been holding me back from the future I want.
16:04I'm a transgender man.
16:06Meaning that I was born female.
16:09And raised as a daughter for quite a long time.
16:14But then when I was around 25, I realized who I was meant to be.
16:20And went on that journey.
16:22And now I'm the Ryan we are today.
16:25My baby boy.
16:34In sixth grade when I first noticed the bumps, it was already a time in my life when I was
16:40starting to go through puberty.
16:42And things were happening to my body that I did not like.
16:46Compared to everything else, the bumps seemed so insignificant.
16:51But then I started growing during what a lot of people call second puberty.
16:56When I started hormone replacement therapy.
16:59I feel like the bumps are like the last little piece of the physical transition into who I am.
17:06I don't know, after this it's like only up from here, you know.
17:14Ryan?
17:14It's been a long journey to try to feel good about myself.
17:18I spent so much time putting myself in the shadows.
17:22Keeping people from seeing me.
17:24And it's time for Ryan to come out of the shadows.
17:29One step closer.
17:38My name is Dr. Zoe Indigo.
17:40I moved here to Los Angeles to do my dermatology residency at UCLA.
17:45I now have my own practice in Beverly Hills.
17:48I first met Dr. Lee when I was a medical student.
17:53And I recently reached out and I asked her,
17:55Can I learn from you as I'm exploring this whole new world?
17:59I know that working with Dr. Lee is going to expose me to like some really, really cool cases that
18:05I could only dream of.
18:07Dr. Lee.
18:08Oh, hi.
18:09How are you?
18:10So nice to see you.
18:12So good to see you again.
18:12Thank you for coming.
18:13Welcome to my office.
18:14Thanks for having me.
18:16Dr. Zoe and I met at a dermatology conference.
18:19You learn so much faster when you're actually doing something than when you just have the knowledge from the textbooks.
18:24I think this is a perfect case for her to start with because he has multiple bumps.
18:28And so it's going to give us multiple opportunities to see the art of popping.
18:33So we have an interesting case today.
18:36Okay.
18:36He's got multiple pylarsis.
18:38Multiple?
18:39Yeah.
18:39I actually haven't met him yet, but I saw a picture of him.
18:41All right.
18:42So I think he's got multiple ones.
18:43And you know, your residency, did you, you guys remove pylarsis before and things like that?
18:47I think we'd remove one.
18:48Yes.
18:49Yeah.
18:49I want to work with Dr. Lee because she has really put dermatology on the map.
18:55Many of the cases that Dr. Lee does, most dermatologists would refer out to general surgery or plastics or head
19:02and neck surgeons, and she's doing them every day.
19:04So that's the one I could learn from.
19:07Let's do it.
19:08Let's do it.
19:08All right.
19:11Hello.
19:11Hi.
19:13Hi, Ryan.
19:14Yes.
19:14Hi, how are you?
19:15I'm Dr. Lee.
19:16What is your name?
19:17Mom.
19:18Mom.
19:18Okay.
19:19Hi, Mom.
19:19If you don't mind, Dr. Zoe is a fellow dermatologist.
19:22Awesome.
19:22She's just newer in her practice and I just thought it would be nice to show her around.
19:26Great to meet you.
19:27Nice to meet you.
19:27Do you know what these are?
19:28Has anyone ever told you what they are?
19:30I mean, all I've been told is subcutaneous cysts.
19:33Yeah, it's a generic kind of term, yes.
19:35Let's take a good look here.
19:37We're both going to have our hands on you here.
19:39Oh.
19:40Yes, these are pylarsis.
19:42So what happens, which is really interesting, is that hair, it actually changed the texture of them.
19:47You'll see the hair coming out like with a little curl to it, which is also part of the reassurance
19:52to me that it's a pylarsis.
19:55We're both learning today.
19:56Yes.
19:57So I hope, because I like this kind of size to remove, hopefully we can even pop them out just
20:02very simply.
20:03Be awesome.
20:04Yeah.
20:05I'll see you in a little bit.
20:06Alrighty.
20:09I am nervous.
20:10I'm really hoping it doesn't hurt very much because I'm kind of sensitive.
20:14There's no turning back now.
20:26Okay, so I'm going to put just like a little numbing here.
20:28Okay, just a baby pinch.
20:32You okay?
20:33Oh yeah.
20:33It's going nice and slow.
20:35The pain happens with the pressure that you put on the plunger.
20:39So if you inject very quickly, it hurts more.
20:42I know that Dr. Zoe, like all dermatology residents have had some experience with pylarsis, but they don't know the
20:49little specificities that will make this procedure easier.
20:55These are like the perfect balance of a little juicy, but not too scary, and so hopefully they'll be the
21:00perfect kind of pop.
21:01Alright, so let me start with this one right here, okay?
21:04There was a little bit of a thinning of your skin right there where I was trying to poke out
21:07a little on your skin.
21:08Yeah.
21:08So I'm just going to do it really lightly because it might spit at us.
21:12Make sure I'm not hurting you, okay?
21:15Let's move around here a little bit.
21:25Nice.
21:27Did you feel that release?
21:29I mean, yeah.
21:30I know, huh?
21:32That's number one.
21:33I'm going to lay it down right here.
21:34It's like a cute little, like a little nipple.
21:40Now that I've removed the pylarsis intact and Zoe has watched me, I'm going to see how she does here.
21:45Ideally, it's great to take out a pylarsis hole because then you're not going to contaminate the wound with any
21:52skin cells, but also you're pretty sure that you got the whole thing.
21:56I'm going to make it wet enough so that you can potentially squeeze it, but then I'm going to stand
21:59back because I don't know you well enough, Zoe.
22:02It might squirt on us, okay?
22:03Okay.
22:04Okay, are you ready?
22:16Okay, are you ready?
22:21I'm here with Ryan, who has pylarsis on his head, and I'm here with Dr. Zoe, pimple popper in training.
22:28We're going to try to remove them whole.
22:30I really want Dr. Zoe to learn this technique.
22:34One side and ease it out first.
22:36If you push on both, it might pop on you.
22:38So guard your eyes.
22:41She's not coming.
22:42Let me see.
22:44I know, it's hard.
22:45Push down and get your nail like under there, and then you push the other side.
22:48Okay, let me try that.
22:53There she goes.
22:55Oh yeah, a little pop, wait.
22:56Let that go so it doesn't get all messy on there.
22:59It takes some practice to really remove one of these pylarsis eggs and not break them.
23:05I'm going to show Zoe my technique for smaller pylarsis now.
23:08Sometimes these ones that are smaller are actually harder to squeeze out.
23:17There we go.
23:18There's that one.
23:21And this one.
23:22I'm going to pass that to you.
23:27It's so tiny.
23:28Can you press on this side so we can get double pressure on both sides?
23:31Let me see for that pressure.
23:37The pimple popping technique is not taught in residency.
23:40This is an art.
23:46Be careful, we don't want to break it apart.
23:50Now you got to make sure you got it all.
23:52And there's hair in the way and all that kind of stuff, so.
23:56Ah, yes, it's not as easy as it looks.
23:58And so I think it's time for me to step in and see if I can grab it.
24:02Oh, there he goes.
24:06They're finally gone.
24:08After having this going on for 20 years, I see me, see myself the way I've always wanted
24:17to see myself before the bumps got in the way.
24:20I just feel like I can finally breathe easy.
24:25Julie, thank you so much.
24:27It was good to meet you.
24:28Really a pleasure.
24:29Take care.
24:29Bye, mama.
24:30Take care of him.
24:31Thank you so much.
24:33I can't believe it's finally over.
24:35Now the next thing I can't wait for is to take all of this off and see the real Brian.
24:46And love him.
24:58Girl, strip starts now.
25:02This would look nice on you.
25:04This would be nice on me.
25:07My name is Anne.
25:08I'm 33 years old and I have a lamellar ichthyosis skin condition and my best friend here is Molly.
25:19I was born with lamellar ichthyosis wherein the third layer of my skin did not develop when I was inside
25:26of my mom.
25:27It's all over my body from head to toe and there's no cure for it.
25:34My dad has a specific gene and also my mom has a specific gene.
25:40And when you combine them together that like turns into like add it all into me.
25:49Hi, where are we going to go?
25:53Hi.
25:54You are up to the bar.
25:55The bar.
25:57Yay.
25:59I'm getting a drink.
26:00I like this.
26:01I know.
26:02It's so fancy.
26:03Not in here.
26:04It is.
26:04It's hot in here.
26:06It is.
26:06And it's unusual for this time of the year though.
26:09But like in the Philippines, it's the same thing.
26:12I was born in the Philippines and most of the kids there picked on me.
26:17I ended up thinking why am I different to everybody.
26:21I used to cry all the times.
26:23But then I realized that I cannot be living like that.
26:28So me laughing is kind of like a defensive mechanism for me not to cry or show the true feelings
26:38that I have.
26:40Because I look different than anybody.
26:44I'm so curious.
26:46What's in that bag?
26:47What?
26:47I brought a lot of things with me.
26:49Okay.
26:50Let's see.
26:51Oh, look at that.
26:52Look at that.
26:53Oh my God.
26:54I usually tend to overheat and I do not sweat like a regular person.
26:59If my skin gets sweaty, you see like lumps or bubbles.
27:04My skin is always rough and dry.
27:07My eyes are red and puffy.
27:10And all my eyelids are going up instead of like going in.
27:14So it's just uncomfortable.
27:16Let's do a kiss.
27:19Girl strap.
27:20Girl strap.
27:22Oh, my hands are shaking still.
27:25Is it because you're nervous or...?
27:28Oh, no.
27:30Just half of it.
27:31It's just that like feels weird.
27:33You see right here?
27:35There's like fissure right here now.
27:37Ooh.
27:38It's hurting me.
27:39It's tough to be living with it because my skin tends to just like crack and then bleeds.
27:45It is painful and it's quite gross.
27:49Sometimes I'm not able to walk or to handle things with my hands.
27:54But you know what?
27:56I'm still living!
27:57What?!
28:00I've got some fissures right now and it's so hard to walk around.
28:03When I was younger, I was like kneeling myself onto the floor like this, going all the way to the
28:11washroom.
28:12No way.
28:13Yeah.
28:14I'll do this.
28:16First time I met Anne, it was her bubbly personality that just attracted me to her.
28:21We've been friends for six years now and we work together.
28:25I find that she's more upbeat and going in positive than myself.
28:30And honestly, the personality that she holds with her condition, she's a very strong woman.
28:35I know you've lived with this for so long.
28:39Imagine my dermatologist, so frustrating that she can't even give me a specific answer.
28:45So now it's been five years that I haven't seen her and even bothered seeing her.
28:50So when I was 16, we moved to Canada and I found another dermatologist.
28:57I saw my dermatologist from 16 to 27.
29:01She's been giving me creams left and right that's over the counter and nothing has been working that much.
29:08She told me that I'm able to just like see you once a year.
29:13Every single time I try to call, it always goes to the voicemail.
29:17I can't even reach my own dermatologist and I got tired of it.
29:22I'm really hoping that Dr. Lee has answered for me.
29:26Just keep positive.
29:27I got you.
29:28Aww.
29:36I've been living with the pain for 32 years.
29:40I'm so sick of like hitting dead end after dead end.
29:44I know there's no cure, but I came all this way.
29:48And because Dr. Lee is on top of her field and I want answers.
29:54What can I do to make my life better?
29:57I don't want to be disappointed and not get any answers.
30:10Hi!
30:11How are you?
30:12I'm good.
30:13Very nice to meet you.
30:14I'm Dr. Lee.
30:15Where are you from?
30:16I am from Oro, Ontario.
30:19Oro, Medante, Ontario, Canada.
30:20Okay, from another country then.
30:22Well, welcome.
30:24So I think I know why you're here in general.
30:26You have a skin condition, right?
30:28Yes.
30:28That you're probably born with.
30:29Mm-hmm.
30:30Which is lamellar ichthyosis.
30:32Yes.
30:33Lamellar ichthyosis has to do with a mutation in your genes.
30:36This is not a common condition.
30:39This is probably one of the first cases of lamellar ichthyosis that I've seen in person.
30:43But we know what they are because we study about them.
30:46Yeah.
30:46So you have this condition where you have trouble creating your skin like this.
30:53Like it's always like a dead skin.
30:56Epidermal hyperkeratosis like almost moving too fast.
30:59Yes.
30:59There's nobody else in your family that has this as far as you know?
31:03No.
31:03We got like family members who has extra fingers.
31:06Okay.
31:07And some behavioral issues.
31:09But none of them.
31:10That's so funny though.
31:12None of them has like a skin condition like me.
31:16It's pretty rare.
31:17Which is hard for you to seek treatment.
31:19Because the rarer something is, the less that drug companies or people are trying to cater to them, right?
31:27Yeah, exactly.
31:27You have to sort of find things on your own or so.
31:30Lamellar ichthyosis is a very difficult thing to live with.
31:34And skin is drying up and hardening and cracking open.
31:38It's really painful.
31:39It's really uncomfortable.
31:40It's a hard thing to have a condition like this where you know you look different and people may stare.
31:47I hope that I can use my experience to help her in some way.
31:51I mean she has such beautiful light and such great energy.
31:53I've been living with this for so long.
31:57Your whole life.
31:58Finding like answers for it.
32:01You want to find the right answers.
32:02Yeah, exactly.
32:03It's like dead end after dead end.
32:05I want something that I could be using to better my skin off.
32:10So what are the areas that bother you or what are the trouble things that you have?
32:14What are you using?
32:16Just recently I have like a fissure right here onto my feet.
32:20Oh yeah, it looks like it's really painful and it's definitely been bleeding.
32:23Yeah.
32:23Look at the scale that you have, you know?
32:26Yeah.
32:27Even when I was at the airport I had to ask for a wheelchair because like my feet are like...
32:32Crack when you're walking.
32:34Crack and also inflamed during that time.
32:36Right.
32:36I can imagine.
32:37How about your eyes too?
32:39Yeah, with my eyes it bothers me.
32:42Very sensitive.
32:43So sensitive.
32:44Do you feel like you get cracks too on your eyes itself?
32:47Yeah.
32:47Because sometimes they do bleed inside here.
32:50Oh my.
32:51Are there other main issues that you have?
32:53My hair has been starting to...
32:56Fall out?
32:57Fall out.
32:57Like even now like as you see.
33:00Yes.
33:01Yeah.
33:02But I mean I think...
33:03Will they grow again or something though?
33:05I think that...
33:07Is that gonna be like forever though?
33:08Yeah, it's tough because I think with your condition you can get what's called cicatricial
33:14alopecia.
33:15Alopecia being hair loss.
33:17Okay.
33:17But cicatricial meaning a scarring type of hair loss.
33:20Okay.
33:20So what I see here, what we call little doll's hair where you don't have the hair all consistently
33:27coming out but like kind of coming out in clumps you know when like the old baby dolls.
33:31We kind of can see that maybe with some scarring hair loss.
33:33And with scarring hair loss you have less likely to have the hair grow back.
33:37Because there's scar tissue there.
33:40Is there no like oil or cream or medication that I can use?
33:46I don't think so.
33:46Not necessarily with scarring alopecia.
33:50I feel nervous right now because I don't know what...
33:55If Dr. Lee is able to help me I don't know I'm just like anxious.
34:09Scarring hair loss, you're less likely to have the hair grow back because there's scar tissue there.
34:14But I don't want you to lose hope because somebody who is a real specialist at this,
34:18they know a lot more people that have been going through this.
34:21I'm here with Ann who has lamellar ichthyosis.
34:23It's not something that you can easily hide and it's not something that you can cure.
34:29Despite all this she's so upbeat and happy and positive.
34:33I really hope that I can do something to make her life more easy and more comfortable.
34:38There's actually an amazing dermatologist in your area.
34:41His name is Dr. Scott Walsh.
34:43He's like the expert in your area.
34:45Okay.
34:45I'm more of an expert at pimples than I am at like genodermatosis.
34:49Yes.
34:49But I feel fortunate that I can at least get that for you.
34:52You know what I mean?
34:53Because he can really help you with that.
34:55Okay.
34:55So the main areas of discomfort are the fissures on your body and in your eyes, right?
34:59Yeah.
35:00So I think I have some solutions for that.
35:02I'm going to give you a little duoderm.
35:03We use it mainly for slow healing ulcers on people.
35:07But what it does is it covers and protects that area and it gives you padding.
35:12And you can keep that on for a week on areas if it doesn't fall off.
35:15And that can help you be more comfortable to walk.
35:17You can see, if you feel it, feel that like there.
35:20See how it's like soft?
35:21That's cushioned.
35:22Duoderm or hydrocolloid dressing is going to help to protect that area and encourage
35:27it to heal.
35:28It's also going to give her a little extra padding so she can walk around comfortably.
35:32The next thing I want to try to do is put a little glue seal on your toe or liquid
35:39band.
35:39Super glue.
35:39Yes.
35:40Yes.
35:41Super glue helps to seal.
35:44It's like it becomes a liquid bandage.
35:45Super glue is actually widely used in dermatology and skin surgeries in general.
35:50It protects it from outside bacteria and it helps it to heal faster.
35:55So I just really take it and paint it over that area to help it to stay sealed.
36:00It's like a second skin almost.
36:02Yeah, yeah.
36:02You're trying to put it on there.
36:03Just trying to see if we can do little things here and there to make things more comfortable
36:08for you.
36:08Because these things are annoying and you have to sort of bear them without people even
36:13realizing you're going through them.
36:14You know?
36:15So the other thing I think I can help with are your eyes.
36:17There is an eye drop that is called Timolol.
36:21It's a beta blocker.
36:23It's used to slow down our heart rate but not in your eyes here.
36:27The eyes here can actually help with the little fissures and things like that.
36:30Okay.
36:30So Ann has ectropion which is when the skin around your eyelid exposes the inside of your
36:38eyes.
36:38In her case it's probably from all the tightness of her tissue and the scarring that it's pulling
36:43her eyes open.
36:44But we can use topical beta blockers to increase the efficiency of your skin cell turnover.
36:51And don't ask me how somebody figured that out.
36:53But it works.
36:55And the last thing that I think would be helpful for you is a medication by mouth.
36:59Isotretinoin or acetretin.
37:01It can help to regulate the high turnover of your skin.
37:06Yeah.
37:06But I think that that would be something.
37:07So I think I got a bunch of things for you.
37:09So we have potential answers for all the main issues you had.
37:13We went over eye medication.
37:15I started her on some hydrocolloid dressings.
37:18We're using super glue as sort of a sealant and a protectant.
37:22And oral medication that can help to improve the healing of her skin in general.
37:27So hopefully all those things teamed with setting her up with an excellent congenital
37:32ichthyosis specialist will help her to manage this condition well long term.
37:38So it's really nice to be able to treat somebody who loves life and to help them feel more comfortable
37:44so that they can enjoy their life.
37:45But I love your outlook.
37:47Aw, thank you.
37:47Like you just have the most positive outlook.
37:50And I do think that it's going to be good, you know, good news for you.
37:53And you're beautiful.
37:54Aw, thank you so much.
37:55Very nice to know you.
37:58Dr. Lee has done more for me in one visit than my dermatologist back home.
38:07Thank you so much.
38:08Okay, thank you for being a part of my life.
38:10Like that makes me feel really special.
38:11Dr. Lee did see me for who I am and also actually like touched my skin.
38:18Not every doctor will do that.
38:20Have a safe trip home.
38:21We'll be in touch.
38:22This is my goodbye.
38:23I'm very happy for that.
38:24The answers that she was searching for, she finally found me.
38:27She pushes through everything and then she never gives up.
38:30I'm living Dr. Lee's office feeling amazing.
38:47Sweet Ann came to me three months ago and since then she has found some tremendous relief.
38:53Thank you Dr. Lee for everything.
38:56I've seen big progress.
38:59Ann's feet don't hurt as much using those hydrocolloid pads.
39:02She's been super gluing her dry fissures for less pain.
39:05And most of all, the eye medication is really helping her eyes hurt a lot less.
39:10It is such a joy to see Ann so happy.
39:14You are a light to all of us, Ann.
39:16I actually feel so good that I took my kids to the water park.
39:20Meeting Dr. Lee, it was such a big help and it actually boosted up my self esteem.
39:29It's been three months since I saw Sweet Ryan and his many cysts.
39:33I've just been so much more confident and I've been letting the real me shine through.
39:39His head has healed up beautifully without those extra little friends.
39:43And it's so lovely to see him living his best life.
39:46Thank you so, so much for changing my life.
39:50Thank you from the bottom of my heart.
39:52Looking good, Ryan.
40:03It's been two and a half months since my procedure with Dr. Lee and my ears look amazing.
40:12Those giant keloids are gone for good.
40:15Dr. Lee was like an artist.
40:17My ears don't itch and they're very soft to the touch.
40:20And I think because of the radiation, I'm hoping that it will never happen again.
40:25So I'm really excited to see for the future.
40:27My confidence has changed 100%.
40:29I just feel like the real me.
40:35I've been going out a lot more and Ambrose is super happy for me.
40:40We can hang out with our friends.
40:41Cheers to Tiny.
40:43Oh, it's so good.
40:44You are glowing too.
40:46Now I've started dating again because I have my self esteem back and it feels so good.
40:50Please welcome Tiny.
40:54Now I'm so excited to start performing again.
41:01I was really insecure about my keloids, but now I feel at home on this stage.
41:09Dr. Lee has really changed my life.
41:11I can't thank her enough.
41:13Winner winner chicken dinner.
41:15Yes.
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