Department

A dermatologist is a medical doctor who specializes in treating diseases that affect the skin, hair, and nails. You might see a dermatologist routinely for an annual skin cancer check or for management of a chronic skin condition like psoriasis, or as needed when an issue such as a rash or skin infection arises.

Dermatologists can diagnose and treat many different conditions like acne, dandruff, eczema, and cellulitis, according to the American Academy of Dermatology.1 Aside from this, they can offer guidance on caring for and protecting your skin based on its type.

You might also see a dermatologist for a cosmetic procedure or treatment, such as to improve skin texture and tone or to minimize the appearance of wrinkles or scars.

Concentrations

Dermatologists treat a variety of skin diseases and reactions.

They can diagnose and treat skin, nail, or hair conditions such as:

Acne

Eczema

Hair loss

Psoriasis

Rosacea

Skin cancer

Dry Skin

Rashes

Hives

Dandruff

Boils

Styes

Cellulitis

Warts

Keratosis pilaris

Poison ivy, oak, or sumac

Ringworm

Scars

Nail infections

Oral diseases

Scabies

Xeroderma pigmentosum (a genetic condition that causes extreme sensitivity to sunlight)

Procedural Expertise

There are a variety of medical tests and procedures related to skin conditions and sun damage or aging that dermatologists may order and perform.

Some dermatologists may have particular specialties in one or more areas.

Medical

Procedures and surgeries performed by dermatologists for medical reasons include:

Skin patch testing for diagnosing contact dermatitis

Photodynamic therapy (PDT), a light therapy for skin that can be used to treat precancers, acne, and other skin conditions

Excision, the surgical removal of skin cancer or a benign growth, including skin cyst removal

Electrodessication and curettage (ED&C), a procedure that uses an instrument called a curette to scrape away skin tissue, followed by cautery to stop the bleeding

Mohs surgery, a procedure done in stages to remove skin cancer, with careful microscopic examination between each stage to spare as much healthy tissue as possible

Skin biopsy, which removes skin cells or tissue for microscopic examination to help diagnose conditions such as skin cancer

Intralesional injections to shrink cysts and treat other dermatologic conditions locallyCryotherapy, a procedure to freeze areas of skin with liquid nitrogen to treat conditions such as warts or seborrheic keratosis (benign, wart-like growths)

Skin graft, a procedure that takes healthy skin, often from somewhere else on a person's body, and attaches it to a damaged area, often used after a burn, a large excision, or Mohs surgery

Topical chemotherapy applied to the skin to treat actinic keratosis (precancerous growths caused by sun exposure) or skin cancers, such as basal cell carcinoma or squamous cell carcinoma

Cosmetic

Some dermatologists perform procedures to enhance appearance.

These are not considered medically necessary:

Microdermabrasion treatments to improve skin's texture and tone, or to reduce wrinkles or scars

Scar removal with subcision, resurfacing laser, or micro-needling, with or without radio-frequency

Dermaplaning, which is superficial exfoliation

Derma filler injections, which are substances put under the skin to reduce the appearance of wrinkles or scars

Botox, a treatment that uses botulinum toxin to block nerve signals to prevent wrinkles and minimize existing wrinkles (other uses: eye twitches and migraine prevention/treatment)

Chemical peel in which an acid solution is applied to the skin to cause it to shed the outer layer

Minor cosmetic surgery that can be done with local anesthesia (e.g., such as tumescent liposuction)

Laser skin resurfacing to precisely burn away damaged skin

Shave removal to take off a portion of a non-harmful skin growth for cosmetic purposes

Sclerotherapy, a treatment for minimizing the appearance of varicose veins or spider veins

Tattoo removal, often using lasers

Hair transplants, which involve implanting healthy hairs from other areas of your head into a region of hair loss

Subspecialties

All dermatologists receive training in the four branches of dermatology: medical dermatology, cosmetic dermatology, surgical dermatology, and dermatopathology.

A dermatologist might choose to specialize in one of these specific branches, making it the major or sole focus of their practice:

Medical dermatology: The dermatologist diagnoses, treats, and helps to prevent diseases that can affect the skin, hair, and nails.

Surgical dermatology: The dermatologist treats the diseases that affect the skin, hair, and nails through surgical procedures, such as the removal of skin cancer.

Cosmetic dermatology: The dermatologist uses treatments to improve the appearance of the skin, hair, and nails. Cosmetic dermatology is for aesthetic purposes and is not an essential component of maintaining good health. It encompasses procedures such as injecting fillers for a more youthful appearance, chemical peels, hair transplants, and laser surgery to diminish the appearance of skin conditions such as scars, wrinkles, and varicose veins.

Dermatopathology: The dermatologist specializes in dermatology and pathology. They examine samples of the skin, hair, and nails with a microscope to diagnose and treat diseases.

Dermatologists may continue with additional training to gain expertise in specific areas of dermatology or specific types of surgery. The three formal board-certified fellowships are procedural dermatology (Mohs/cosmetic), pediatric dermatology, and dermatopathology.

Training and Certification

A dermatologist must earn a bachelor's degree and attend medical school, after which they will become a medical doctor (M.D.) or a doctor of osteopathic medicine (D.O.). Then they will complete a medical internship and at least three years of training in an accredited dermatology residency program.

After completing an ACGME, AOA, or Royal College of Physicians and Surgeons of Canada accredited dermatology residency, a dermatologist can become board-certified by passing exams by the American Board of Dermatology, the American Osteopathic Board of Dermatology, or the Royal College of Physicians and Surgeons of Canada.

A board-certified dermatologist must retake board exams every 10 years in order to keep the title. A dermatologist is expected to keep up with industry advances by attending advanced courses and reading peer-reviewed dermatology journals.

Appointment Tips

In many cases, health insurance plans require a formal dermatology referral from a primary healthcare provider.

Common reasons for a referral:

If you find a lesion that you suspect could be skin cancer 

If you have risk factors that increase your likelihood of developing skin cancer, such as fair skin and a history of blistering sunburns or a family history of skin cancer

It's also recommended that everyone visit a dermatologist once a year for a complete skin examination to check for skin cancer.5

If you don't have health insurance, you can ask the dermatologist's office if they offer any discounts or sliding scale based on income.

During your appointment, point out any changes in moles or skin bumps and ask about any concerns, such as dry skin or blemishes. Never assume a change in your skin is too minor to mention.

To prepare for your appointment:

Jot down a list of any skin changes. This includes any irregular-shaped moles (asymmetrical or with irregular borders), new or changing bumps, or discolorations.

Bring a copy of any relevant tests results, if applicable

Bring a list of all medications and supplements you are taking since some may have side effects that can affect the skin or lead to skin reactions.

Snap photos of product ingredient lists—for skincare washes, soaps, oils, serums, and lotions—especially if you have rashes or areas of irritation. Do the same for laundry detergents.

You should also bring a list of questions so that you can ensure nothing is forgotten during your appointment.

Be prepared for a full-body skin check. You might be asked to change into a gown. The dermatologist may use a magnifying device called a dermoscope to examine certain areas closely and may ask to photograph moles and growths for your medical chart to compare size and appearance at future appointments.

To make it easier for a dermatologist to inspect your skin:

Remove nail polish so that the dermatologist can thoroughly examine your nails and nail beds, which are regions where skin cancers can occur.

Wear your hair down or in ties or clips that are easily removed so that the dermatologist can thoroughly check your scalp.5

Don't wear makeup or pack makeup remover that you can use prior to the appointment so that all areas of your face and around your eyes are clearly visible.

Don't wear jewelry since it can cover areas of skin.

A Word From GVMC

If you have health insurance, don't assume that a dermatologist accepts insurance—some don't, so it's important to ask.

If you are visiting a dermatologist for cosmetic reasons, it's important to get detailed information from their office about costs, since insurance often doesn't cover cosmetic procedures.