Dermatologists: What do they do?
A dermatologist can also provide support for cosmetic issues, helping patients to revitalize the appearance of their skin, hair, and nails.
The Centers for Disease Control and Prevention (CDC) estimate there were 39 million visits to non-federally employed, office-based dermatologists in the U.S. in 2010.
- Dermatology is concerned with the health of the skin, nails, and mucous membranes.
- There are around 8,500 qualified dermatologists in the U.S.
- Dermatologists treat over 3,000 skin conditions, including acne, psoriasis, and skin cancer.
- They are trained to carry out skin grafts, laser treatments, the excision of lesions, and more.
What is dermatology?
Dermatologists are qualified to treat skin complaints.
Dermatology is an area of medicine concerned with the health of the skin and diseases of the hair, nails, and mucous membranes.
The skin is the largest organ in the body. It is the first line of defense against bacteria and injury, and often reflects overall health.
A 2013 study reported that 42.7 percent of patients visited their doctors at some point due to a skin disorder.
It is important to know that you are visiting a licensed or certified dermatologist. Some practitioners in spas and beauty clinics call themselves dermatologists, but they do not have the correct accreditation.
A qualified dermatologist will be board-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 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 a year of hands-on work.
Some dermatologists have the initials FAAD after their name, which stands for "Fellow of the American Academy of Dermatology." These initials indicate that the dermatologist:
- is licensed 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 American Academy of Dermatology
Here is a useful search tool provided by the AAD to help people with skin, hair, or nail conditions find a nearby dermatologist.
Vitiligo is just one of the over 3,000 diseases handled by dermatologists.
Dermatologists can treat over 3,000 different diseases.
The practice of dermatology requires a great depth of clinical knowledge. Dermatologists need to know the numerous internal conditions that can cause skin symptoms.
Here are some examples of the more common conditions dermatologists are trained to treat.
Vitiligo: The skin loses melanin, leading to patches of lighter colored skin.
Acne: One of the most common diseases in the U.S., acne is a disease affecting the oil glands of the skin. It has a range of causes that lead to many different kinds of pimples. Acne can result in depression, low self-esteem, and scarring.
Dermatitis and eczema: Dermatitis is inflammation of the skin. It typically leads to swelling with an itchy rash. Dermatitis takes different forms, including contact dermatitis, seborrheic dermatitis, and atopic dermatitis. Each affects the skin differently.
Fungal infections: Fungus can infect the skin, nails, and hair. Fungal infections are common, and symptoms are normally mild. They can cause more serious symptoms for people with reduced immunity. A group of yeasts called Candida can cause a wide range of infections, including oral thrush and balanitis.
Hair disorders: About 80 million people in the U.S. have hereditary hair loss. The loss of hair may be the result of an underlying condition, such as alopecia, or an isolated issue. Hair can also be affected by head lice, and around 6 to 12 million children aged between 3 and 12 years have head lice in the U.S. every year.
Nail problems: Dermatologists also treat conditions affecting the nails. These complaints often consist of fungal infections and ingrowing toenails. Nail problems can be indicative of other underlying conditions.
Psoriasis: This is a chronic, autoimmune skin disorder that speeds up the growth of skin cells. This rapid growth results in thick, red skin and silvery scales. There are several different types of psoriasis. Psoriasis can sometimes have a similar appearance to eczema.
Rosacea: Rosacea causes redness in the face, similar to blushing. Small, pus-filled bumps often appear, and rosacea can also lead to visible blood vessels and swollen eyelids. Rosacea can spread from the nose and cheeks to the forehead, chin, ears, chest, and back. Women with fair skin who are in middle aged most often experience rosacea.
Skin cancer: Almost 5 million people receive treatment for skin cancer in the U.S. every year, and one in five people in the U.S. will develop a form of skin cancer in their lifetime. The most common forms of skin cancer are basal cell carcinoma (BCC), melanoma, and squamous cell carcinoma (SCC). Early treatment can resolve most skin cancers.
Shingles, or herpes zoster: This viral infection affects the nerve endings in the skin and causes a painful rash. Although the condition clears after a few weeks without treatment, intervention is recommended to speed up recovery and prevent long-lasting pain, numbness, and itching after the disease has gone. Shingles can also potentially damage the eyes.
Warts: These are contagious, benign skin growths that appear when a virus infects the top layer of skin. Warts may indicate an underlying issue with immunity, but they often resolve without treatment. A dermatologist can use a variety of treatments to remove persistent warts.
Laser hair removal is one of many dermatological procedures.
Dermatologists use a range of medical and cosmetic surgical procedures.
Many dermatological conditions can be treated with medication and non-invasive therapy, but some require surgical intervention or more invasive treatment. Dermatological procedures can take place in an outpatient setting, such as a doctor's office, or during a hospitalization.
Biopsies: Skin biopsies are primarily carried out to diagnose or rule out certain skin conditions. There are three commonly-performed types of skin biopsy. Shave biopsies remove small sections of the top layer of skin, punch biopsies remove a small circular section including deeper layers, and excision biopsies remove entire areas of abnormal-looking skin.
Chemical peels: A chemical solution is applied to the skin. It causes a layer of skin to peel off, leaving a layer of regenerated skin underneath that is typically smoother. Dermatologists use this procedure to treat sun-damaged skin and some types of acne. It can also address complaints of a more cosmetic nature, such as age spots and lines under the eyes.
Cosmetic injections: Wrinkles, scarring, and lost facial fullness can be temporarily reduced with injections. A dermatologist can inject botulinum toxin therapy, or fillers such as collagen and fat, during an office visit. Results of this treatment tend to last for a few months, and injections need to be repeated periodically. Some people can develop antibodies to Botox that make repeat treatments ineffective.
Cryotherapy: This is a quick and common form of treatment for many benign skin conditions, such as warts. Skin lesions are frozen to destroy the affected skin cells, often using liquid nitrogen.
Dermabrasion: Using a high-speed rotating brush, a dermatologist removes the top layer of skin, surgically eroding scar tissue, fine wrinkles, tattoos, and potentially precancerous skin patches.
Excisions of lesions: Skin lesions are excised for several reasons. They are removed to prevent disease from spreading, for cosmetic reasons, to prevent repeat infection, to alleviate symptoms, and for diagnosis. Depending on the size of the lesion, local or general anesthetic can be used to numb the area before removal.
Hair removal and restoration: Hair loss can be treated with hair transplantation or surgery to the scalp. Unwanted body hair can be removed with laser hair epilation, or electrolysis that destroys hair follicles.
Laser surgery: Dermatologists can use a special light beam to treat a variety of skin complaints. These include tumors, warts, moles, tattoos, birthmarks, scars, wrinkles, and unwanted hair.
Mohs surgery: This is a specific type of surgery for skin cancer. Layers of skin are removed and examined under a microscope to get rid of cancerous cells. Successive layers are removed until the surgeon can find no more cancer cells. Mohs surgery is only performed by Mohs surgeons and requires additional medical training.
Psoralen combined with ultraviolet A (PUVA): Psoralen is a drug that makes the skin more sensitive to radiation treatment. PUVA is used to treat severe skin diseases, such as psoriasis, dermatitis, and vitiligo.
Skin grafts and flaps: Dermatologists can repair missing skin using skin from elsewhere on the body. Skin can be grafted from a free piece of tissue without its own blood supply, or a skin flap can be created from skin tissue near the area of skin loss.
Tumescent liposuction: Dermatologists use a process called tumescent liposuction to remove excess fat from the body. Large volumes of local anesthetic are injected into the fatty tissue, which is then sucked from the body. Tumescent liposuction is not a treatment for obesity but a cosmetic procedure for body contouring. Dermatologists can also use lasers to selectively burst fat cells and help remove tumescent fluid.
Vein therapy: Superficial leg veins are small, dilated surface veins. They are also known as spider veins and are often removed for cosmetic reasons. Sclerotherapy is usually the preferred treatment for spider veins. Dermatologists insert either foam or a solution into the vein. This irritates the lining, causing it to shut. The vein then becomes less distinct or disappears completely.
When to see a dermatologist
Individuals with symptoms of a disease affecting the skin, hair, nails, or mucous membranes should see a dermatologist if that condition is not responding to home treatment.
People with cosmetic concerns can also consult a specialized cosmetic dermatologist.
Those seeking skin cancer examinations should also visit a dermatologist.
Discuss any upcoming dermatological treatment with your insurer. Insurance companies often do not fund cosmetic procedures. Be sure to obtain copies of any relevant medical reports, consultation notes, and diagnostic test results to confirm to the insurer the medical necessity of the dermatology treatment.