There’s no grey area when it comes to the eruption of pimple-popping videos floating around the internet. People either “pore” over them, or burst out in horror just seeing the links.
I happen to like them. They’re incredibly grotesque, I admit, but also inexplicably gratifying to me – and many others. That’s why they’re all over YouTube, bubbling up on Facebook feeds, and popping up in news stories.
“Watch a man's giant pimple get popped (Video).”
I’m clicking on that link.
“OMG Popping Huge Zit on the Back, Pimple Popping at Home.”
Yeah, consider that clicked too.
Some of my colleagues and I don’t see eye to eye on this. “Oh, God. I dry-heave just thinking about those videos,” said one colleague. “Yuck. Also, yuck,” another said.
I get it. It’s not everyone’s thing.
First off, most of these videos aren’t of pimples. Yes, some are pimples, boils or lipomas, but generally, said Temitayo A. Ogunleye, MD, an assistant professor of Clinical Dermatology, the star of those clips are “epidermoid cysts.”
“These are the ones people tend to find the most satisfying to watch because of the material that comes out,” she said. “It’s typically not pus; it’s keratin, a material within the cyst.”
Epidermoid cysts develop just under the skin layer, which is constantly shedding cells. Sometimes those cells don’t escape and build up under the skin to form a pocket down into a deeper layer. A protective wall of cells forms and secretes the protein keratin into the cyst, filling it up – sometimes quickly, sometimes very slowly – and making it swell. Puncture it, and out comes all that ooze.
Cysts don’t get all the clicks. Some videos show boils, which are skin infections that start in a hair follicle or oil gland that fill up with pus. Others feature the severe form of acne known as cystic acne or blackheads, which are clogged hair follicles generally on the face.
“For me, people fall into two categories: the ‘pickers and poppers’ and the ‘non-pickers and non-poppers’,” Ogunleye said. “I don’t find those videos entertaining, and I don’t get any type of satisfaction from popping or watching. But there are people who do; they get that immediate gratification from seeing the effects of their work.
“And some people just like gross things.”
The goo may be a big draw, but there’s something else about these videos, something relatable, said David A. Yusko, PsyD, an associate director at Penn’s Center for the Treatment and Study of Anxiety.
“Everybody, for the most part, goes through that phase, where they develop pimples. And we’ve all popped them before,” Yusko said. “People identify and relate to it in some way. Everybody knows what it’s like to have this, so there’s something familiar and gratifying – as well as gross and disgusting – about watching that process.”
It’s like popping by proxy.
“There’s also a factor of, ‘Look how bad it could be’,” he said. And they can get pretty bad.
Yusko also likened all the videos to the popular food consumption challenges, such as those hot dog eating contestants or drinking a gallon of milk in 30 seconds, which lead to another type of finale: vomiting.
“That seems to be another reason why people are watching these things,” he said. “They are waiting to see the consequences.”
Or, he suggested, people may be looking for better or more effective ways to pop their own problems.
The last one I saw was, frankly, alien. It looked like a volleyball growing under a man's skin on the back of his neck. This one was a lipoma, a growth of fat cells in a fibrous pouch just below the skin. There’s not much discharge, mostly just fatty tissue to cut away.
Lipomas typically don’t require treatment because they’re harmless and almost always benign. However, in some cases, when they grow very large, removal is necessary. It’s exceptionally rare for a lipoma to become cancerous, Ogunleye said.
It’s not clear what causes cysts and lipomas, but some research suggests there may be a genetic predisposition, particularly in people who have multiple cysts at once.
Most of the time, draining a cyst at home is safe, but remember this, Ogunleye said: Sticking needles and other objects into cysts increases the risk of infection. And it’s just a quick fix. They are not removing the lining that is producing that cheesy-like material, she said.
Permanent removal requires a local anesthetic and a small incision on the surface on the skin by a medical professional to cut around the outside of the lining to remove it. Then it needs to be stitched up.
“Otherwise, it will just keep coming back. And maybe even bigger and bigger,” said Ogunleye, who treats epidermoid cysts regularly.
They are actually fairly common. About one percent of the population in the United States at any given time has one. Think about that. Right now, there are three million of them out there – from the gum-balled-sized to the softball-ball-sized ones – waiting to go viral on the internet.