A dermatologist is a doctor that specializes in treating skin, hair, nail, and mucous membrane disorders and diseases.
They can also address cosmetic issues, helping to revitalize the appearance of the skin, hair, and nails.
The Centers for Disease Control and Prevention (CDC) estimate that, in the United States, there were 39 million visits to office-based dermatologists, who were not federally employed, in 2010.
Below, we explore common issues that dermatologists encounter, the treatments they offer, and the qualifications involved.
Dermatology is an area of medicine that focuses on health issues affecting the skin, hair, nails, and mucous membranes.
The skin is the largest organ of the body. It is also the first line of defense against pathogens and injury, and it can be a good indicator of overall health.
It is important to know that a dermatologist has a full license or certification before visiting them. Some practitioners in spas and beauty clinics call themselves dermatologists but do not have the necessary accreditation.
In the U.S., a qualified dermatologist will be certified by the American Board of Dermatology, the American Osteopathic Board of Dermatology, or the Royal College of Physicians and Surgeons of Canada.
The American Academy of Dermatology (AAD) is the largest membership dermatology group in the United States, with more than 20,000 members.
To qualify for registration with the AAD, a dermatologist has to finish both college and medical school as either a medical doctor (MD) or a doctor of osteopathic medicine (DO). They will also have completed a residency involving 1 year of hands-on work.
Some dermatologists have the initials FAAD after their names. This abbreviation stands for: Fellow of the American Academy of Dermatology. It indicates that the dermatologist:
- has a license to practice medicine
- has passed exams given by either the American Board of Dermatology or the Royal College of Physicians and Surgeons of Canada
- is a member of the AAD
The AAD provide a search tool to help people with skin, hair, or nail conditions find a nearby dermatologist.
Being a dermatologist requires a great depth of clinical knowledge, including, for example, the various internal health problems that can cause skin symptoms.
Dermatologists can treat more than 3,000 conditions. Below are some examples of those that they see most commonly:
Dermatitis and eczema: Dermatitis is inflammation of the skin, and it typically leads to swelling with an itchy rash. There are various forms, including atopic dermatitis, which is the most common type of eczema.
Fungal infections: These are common and sometimes involve the skin, nails, and hair. A group of yeasts called Candida can cause a wide range of fungal infections, including oral thrush, ringworm, athlete’s foot, and balanitis.
Hair loss: About 80 million people in the U.S. have hereditary hair loss. A range of health issues can also cause hair loss, including head lice, which affects around 6–12 million children aged 3–11 years in the U.S. annually.
Nail problems: Dermatologists also treat health issues that damage the skin around and under the nails. Ingrown nails, fungal infections, and various other conditions can cause this damage.
Vitiligo: This involves the skin losing melanin, a pigment. As a result, some patches of skin are lighter in color than others.
Psoriasis: This chronic autoimmune disorder speeds up the growth of skin cells, resulting in patches of skin that may be thick, red, purple, or silvery and scaly. There are several types of psoriasis.
Rosacea: This causes redness in the face, sometimes with pus-filled bumps, visible blood vessels, and swelling of the eyelids. Symptoms can spread from the nose and cheeks to the forehead, chin, ears, chest, and back.
Shingles, or herpes zoster: This viral infection causes a rash that may be painful. It may clear in a few weeks without treatment, but medical intervention can help speed recovery and prevent complications, which can be severe.
Dermatologists use a range of medical and cosmetic procedures to manage issues affecting the skin, nails, and hair.
Medications and noninvasive therapies can treat many skin conditions, while others require more invasive approaches. These procedures can take place in an outpatient setting, such as the doctor’s office, or in a hospital.
This involves applying a chemical solution that causes a layer of skin to peel off, revealing regenerated skin beneath that is typically smoother.
Dermatologists use this procedure to treat sun-damaged skin and some types of acne. It can also address cosmetic complaints, such as age spots and lines under the eyes.
Results tend to last for a few months, and maintaining the effects requires regular injections. However, some people develop antibodies to Botox that make the injections ineffective.
The procedure involves freezing skin lesions — often with liquid nitrogen — to destroy the affected cells.
Dermabrasion can help reduce scar tissue, the appearance of fine wrinkles and tattoos, and potentially precancerous areas of skin.
Using a high-speed rotating brush, a dermatologist removes the top layer of skin.
Excision of lesions
Dermatologists excise skin lesions for several reasons. They may cut away these lesions:
- to prevent a disease from spreading
- for cosmetic reasons
- to prevent reoccurring infection
- to alleviate symptoms
- to diagnose an underlying issue
Depending on the size of the lesion, the person may receive a local or general anesthetic before the removal.
Hair removal or restoration
Dermatologists can also use laser surgery to treat a variety of skin issues or cosmetic complaints, including:
- unwanted tattoos
Superficial leg veins are small, dilated surface veins. People sometimes call them spider veins and may request their removal.
Sclerotherapy tends to be the spider vein treatment of choice. It involves injecting either foam or a special solution into the vein, which irritates the lining, causing the vein to shut, then become less distinct or disappear.
Tumescent liposuction is not a treatment for obesity — it is a cosmetic procedure for body contouring.
Dermatologists can also use lasers to selectively burst fat cells.
Skin grafts and flaps
Dermatologists can restore missing skin using skin from elsewhere on the body.
Or, they may repair skin loss by creating a flap of skin from a nearby area and using it to cover the damaged patch.
- Shave biopsies remove small sections of the top layer of skin.
- Punch biopsies remove small, circular sections of skin, including deeper layers.
- Excision biopsies remove entire areas of skin that seem to be unhealthy.
PUVA stands for: psoralen combined with ultraviolet A radiation.Psoralen is a drug that makes the skin more sensitive to the radiation treatment.
Dermatologists use PUVA to treat skin diseases, such as psoriasis, dermatitis, and vitiligo.
Mohs surgery is a treatment for skin cancer.
First, the dermatologist removes layers of skin to get rid of cancerous cells, then examines them under a microscope.
They then remove successive layers until there are no more cancerous cells. Performing this surgery requires specialized training.
If skin, hair, or nail symptoms are not responding to home treatment, it may be time to seek professional attention.
If concerns are cosmetic, a person can seek out a specialized cosmetic dermatologist.
It is important for people to discuss any upcoming dermatological treatments with their insurance providers, who often do not fund cosmetic procedures.
Be sure to obtain copies of any medical reports, consultation notes, and diagnostic test results to assure the insurer of the medical necessity of the treatment.