Dermatology

What does a dermatologist do?

Dermatology is a diverse specialty that combines medical, surgical and research skills with the curiosity and visual acumen of a detective.

Dermatologists’ eyes are uniquely trained to diagnose and treat thousands of conditions that affect the skin, and they help improve the quality of life and save the lives of patients from birth to old age. Dermatologists have expertise in the diagnosis and treatment of benign and malignant disorders of the skin, adjacent mucous membranes (mouth and external genitalia), hair and nails. Dermatologists have extensive training and experience in the diagnosis and treatment of skin cancers, moles and other tumors of the skin; acne, eczema, psoriasis, rosacea, contact dermatitis, and other allergic and nonallergic inflammatory skin disorders; and a number of sexually transmitted infections. They also have extensive training and experience in dermatopathology, dermatologic surgery techniques, and the recognition of the  skin manifestations of systemic (including internal malignancy) and infectious diseases. In addition, dermatologists have expertise in the management of cosmetic issues.

Many dermatologists see patients (either directly or through physician referrals) who have all types of skin concerns ranging from mild to debilitating to life-threatening. Dermatologists practice in private office, group and academic clinical settings, and many dermatologists are involved in research and education. In general, a work-life balance is possible.

Dermatologists perform many specialized diagnostic procedures, including microscopic examination of skin biopsy specimens, dermoscopy, cytological smears, patch tests, photo tests, potassium  hydroxide (KOH) preparations, fungal cultures, and other microbiologic examination of skin scrapings and secretions. Treatment methods used by dermatologists include externally applied, injected and internal medications; selected X-ray and ultraviolet light therapy; and a range of dermatologic surgical procedures. The training and experience of dermatologists in dermatologic surgery include electrosurgery, cryosurgery with the use of freezing surgical units, laser surgery, nail surgery, biopsy techniques, Mohs micrographic surgery, and excisional surgery with appropriate closures, including flaps and grafts. Some of the techniques used by dermatologists for the correction of cosmetic concerns are tumescent liposuction, filler and toxin injections, chemical peels, hair transplants, injections of materials into the skin for scar revision, sclerosis of veins, laser hair removal, and laser and light therapies to treat a variety of skin conditions ranging from aging skin to vitiligo.

Pediatric dermatologists have additional training and expertise in the evaluation and management of skin diseases that occur more commonly or exclusively in children (e.g., all types of birthmarks, neonatal dermatology, genodermatoses, pediatric infections or inflammatory processes, and pediatric skin diseases with complex medical conditions requiring coordinated multispecialty care).

Dermatopathologists are experts in the microscopic diagnosis of diseases of the skin, including infectious, immunologic, degenerative and neoplastic diseases, through examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of light microscopy, electron microscopy and fluorescence microscopy.

How to become a dermatologist?

Specialty training required prior to certification: Four years

To become board-certified in dermatology, physicians must fulfill the requirements of the American Board of Dermatology (ABD) or the American Osteopathic Board of Dermatology (AOBD). Board certification in dermatology is a prerequisite to subspecialty certification. After ABD certification, physicians enter Maintenance of Certification–Dermatology, a program of lifelong learning and self-reflection.