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What started out as a single video of a blackhead extraction posted on Instagram four years ago quickly turned Dr. Sandra Lee, better known as Dr. Pimple Popper, into a viral sensation.

With over 2.4 million follows on Instagram and 4.1 million subscribers on YouTube, Dr. Lee has amassed a cult following of people who just can’t get enough of her graphic pimple popping videos. (Consider yourself warned.)

The fascination with Dr. Lee’s work has turned her into a cultural phenomenon, complete with her own skincare line, a new TV show on TLC, a forthcoming book, and even a game called Pimple Pete that lets you perfect your own pimple-popping skills.

Dr. Lee shared with Fox News some of her most memorable cases, what actually grosses her out — it isn’t what you might think — and what to do if you just can’t resist popping your own pimples.

Fox News: Are there any conditions under which someone absolutely should not pop a pimple?

Dr. Lee: If you have tried to pop something and it doesn’t pop after 30 seconds, you need to stop. You need to put your hands down and forget about it. Certainly, if you have deeper, cystic pimples, those are not something you should pop. If you feel something coming up, it is not going to pop if you squeeze it at that point. It’s actually going to get more inflamed and cause you more problems. Over time it will likely pop on its own. Your body is extruding these contents and they will eventually come out on their own if you leave them alone.

What are your thoughts on regular people popping pimples at home?

Well, I’m going to be like any other dermatologist and tell you NOT to pop your pimples, but I know that it’s really hard for people to keep their hands to themselves.

What’s the one thing they do wrong?

They don’t know when to stop — it’s addicting.

This kind of stuff doesn’t seem to gross you out, but what does? What does it take to “gross out” Dr. Pimple Popper?

It’s very important to me that my patients feel comfortable and that they trust me, so I definitely don’t ever react in a negative way to their skin conditions. Over the years, I’ve taken on a behavioral modification, to train myself to not be grossed out. I’m much more grossed out about bad toenail fungus or thick peeling feet or something like that. Those conditions are grosser to me than anything else.

What’s the strangest request you’ve ever had from a patient?

In one case, I had a liposuction patient who wanted to keep her own fat to train her cadaver dog to find other dead bodies. I had another woman who requested that she receive part of her lipoma to plant under her rose bush to act as a fertilizer — which is fine. I took a portion of it and had it shipped.

I don’t really like to give people things to take home because it’s just going to spoil — it’s an organic matter so you can’t just put it on your bookshelf or in your freezer.