When you think of dermatology, your thoughts might immediately include acne or skin cancer. But a dermatologist does so much more.
What is a dermatologist?
Dermatologists specialize in the prevention, diagnosis, and treatment of skin, hair, nail, and mucous membrane disorders and diseases, as well as perform cosmetic procedures. According to the American Academy of Dermatology (AAD), a dermatologist can diagnose and treat more than 3,000 conditions. Some common skin conditions include skin cancer, moles and warts, fungal infections, rosacea, shingles, and poison ivy reactions. Dermatologists are often trained in cosmetic procedures, such as fillers, tattoo removal, and wrinkle treatment.
To become a dermatologist, a person must complete four years of college, four years of medical school, one year as an intern, and three years in a specialized residency program. Beyond those years, many physicians choose to receive additional training or certificates, such as becoming a Mohs surgeon, a physician who performs a special technique for removing cancer, or a cosmetic dermatologist, who is trailed on fillers, botox, and other cosmetic procedures.
What exactly does a dermatologist do?
Dermatologists perform many medical procedures and non-invasive therapies to treat a variety of conditions. Your doctor can complete many of them in the office. Some of these include:
- Expert diagnosis of skin conditions that may confound other providers.
- Biopsies remove small sections of skin for further testing.
- Chemical peels remove the top layer of skin to reveal regenerated skin beneath. These treat sun-damaged skin, acne, or for cosmetic reasons.
- Cosmetic injections, such as Botox or collagen fillers, are used to improve the appearance of wrinkles and increase facial fullness.
- Cryotherapy uses liquid nitrogen to remove skin lesions, such as warts.
- Dermabrasion removes the top layer of skin to reduce scar tissue, tattoos, precancerous lesions and can lessen the appearance of wrinkles.
- Hair restoration is performed through methods like medication or hair transplants.
- Laser surgery treats skin and cosmetic issues, such as scars, tumors, moles, birthmarks, and warts, tattoo removal, and excess hair.
- Lesion excision is a surgical procedure to remove a skin lesion to prevent cancer from spreading, to reduce the chance of an infection spreading, to alleviate symptoms if there is pain or bleeding, for cosmetic reasons, or biopsy.
- Liposuction removes fatty tissue for cosmetic purposes.
- Moh’s surgery removes cancerous cells.
- Sclerotherapy treats varicose and spider veins.
- Skin grafts repair damaged or missing skin.
- UV phototherapy treats psoriasis, dermatitis, and vitiligo.
When should I see a dermatologist?
One common reason people go to a dermatologist is to treat acne. A simple pimple or two usually responds to over-the-counter treatments and products or can be treated by a primary care provider, but more persistent lesions can cause permanent scarring when left untreated. A dermatologist provides tailored guidance, advice on daily skin care, and when necessary, a prescription treatment option for long-term results.
Beyond acne, there are a number of reasons you may make an appointment with a dermatologist or receive a referral to a dermatologist from your primary care provider. These include situations when you:
- are experiencing general skin problems, such as redness, itchiness, or pigment changes.
- notice a mole has changed in size, shape, or color.
- have a rash that is itchy, swollen, or bothersome.
- have dry, itchy, or irritated skin that isn’t improving with over-the-counter treatments.
- want to discuss ways to improve signs of aging, such as smooth wrinkles or tighten skin.
- have varicose veins or spider veins.
- are experiencing severe allergic reaction, such poison ivy, oak, or sumac.
- have chronic or severe acne.
- notice thinning hair or bald spots.
- have a sore or cut that isn’t healing or looks infected.
Another very important reason you should see a dermatologist is for your annual skin check. This involves the doctor checking your entire body for lesions, spots, and any mole or freckles changes from year to year.
“On your initial visit, you might be asked to change into a gown, as dermatologists often perform a thorough history and physical exam to help with diagnosis and treatment,” according to Vindhya Veerula MD, a board-certified dermatologist in Fort Wayne, Indiana, and a medical advisor for eMediHealth.
In a skin exam, your doctor looks at every inch of your body—from the top of your head to your toes—checking for spots, moles, and other abnormalities. For moles, the doctor pays attention to the shape, discoloration, size, and border, so on further visits, your doctor sees whether there are changes.
This full body check can help detect skin cancer and other chronic skin conditions early—and is why you should schedule regularly, depending on your doctor’s recommendation. “The frequency of skin checks is based on risk factors, family history of melanoma and other skin cancers, a history of sun exposure or burning, and the presence of atypical moles,” Dr. Veerula explains.
How to prepare for a dermatology appointment
Getting ready to see a new doctor can be overwhelming, especially if you have health concerns or a chronic condition. Making sure you are prepared can help ease some anxiety. Start with these steps.
Check your insurance coverage: Determine if you need a referral, and if so, contact your primary physician for it. Find out what copayments or deductible you have on your plan and, if you have a deductible, how much has been satisfied this year. If you are paying for the appointment, contact the office ahead of time to ask about their charges. An initial visit might be between $100 and $200. You might need to pay for your portion of the bill at the time of your appointment.
Bring a list of medications and prior treatments: Write down the name, strength, and how often you take each medication—or take a picture of your prescription label. Write a summary and the results of prior treatments, and the doctor who ordered each one. The more complete your information, the easier it will be for a new doctor to decide on future therapies. If you use over-the-counter products, treatments, vitamins, or supplements, it is a good idea to take pictures or note those as well.
Write down questions you have: It’s a good idea, especially if you have an ongoing condition, to keep a notebook. Write down any questions you have and use it to take notes on the information the doctor provides. The following are some general questions you might want to ask:
- What is the most important thing I should know about my condition?
- What treatments do you suggest for my condition?
- What products should I use? Which should I avoid?
- What level SPF is best for my skin type?
- How can I do an at-home self-check? And how often should I do it?
- Does my diet affect my skin disease?
- What can I do to improve my appearance?
- How can I slow down signs of aging?
- How often should I come in for follow-up visits?
Take pictures: This is helpful to show your doctor if the appearance of your condition changes. For conditions such as acne or psoriasis, the appearance can change from week to week. Pictures allow your doctor to see the difference that occurs when you aren’t in office.
Make it easy for the doctor to see your skin: Wear loose clothing, remove nail polish, and forego the makeup. Dermatologists don’t necessarily look only at a single spot on your body. They might check your face, your arms, your nails. Keep these areas easily accessible.
Resources for skin disorders and healthy skin tips:
- What it’s like living with psoriasis
- Perioral dermatitis and medications
- Acne treatment and medications
- Which eczema treatment is best for you?
- How to reduce your exposure to UV rays
- Hair loss treatments and cures
- 9 things you can do to prevent cancer