A Dermatologist is a Board-Certified Doctor who provides preventive care and treatment for disorders of the skin, hair and nails. Dermatologists care for people of all ages and are trained to handle more than 3,000 different skin conditions. Since many health disorders also have associated cutaneous findings, the dermatologist plays a key role in early detection and recognition of potential coexisting health conditions, also known as comorbidities.
When looking for a Dermatologist, it is very important that you choose a physician that you feel comfortable with, and are able to easily communicate with. Your primary healthcare physician (Internal Medicine, Family Medicine, Pediatrics, or OB/GYN) can facilitate a referral to a dermatologist, and you can also do your diligence and check the credentials and practice style of the doctor with the help of your family and friends. At myDoqter, you have access to patients’ feedback about doctors, and you can also see the professional recommendations given by other physicians who have witnessed first-hand the expertise and professional competency of your doctor.
Dermatologists are doctors (M.D. or D.O.) with advanced medical degrees and training. The following is a representation of the years of education and training that a dermatologist has:
DERMATO from the Greek word ‘Dermatos’ for ‘Skin’ + LOGY from the Greek word ‘logia’ which means ‘logic’ or ‘the study of’.
Dermatologists treat a comprehensive list of conditions affecting the skin, nails and hair, including:
Acne vulgaris: Acne is a skin condition that results when hair follicles are plugged with oil and dead skin cells due to excessive production of oil, bacteria overgrowth, and a rise in hormones (which in fact leads to excess oil production). Acne is most commonly seen during the teenage years, but can affect people of all ages. Acne mostly affects the skin in areas with the highest number of oil glands, such as the face, upper back, and chest. Acne is one of the most common skin disorders, affecting 80-90% of people worldwide at some point during their lives.
Rosacea: This is a common skin condition that causes redness and visible blood vessel formation on the face. Rosacea is most common in patients with fair skin and is characterized by facial redness and flushing. Rosacea can also have an acne-like or acneiform component, given by pimple-like lesions, pustules and cysts. This condition can also be accompanied by dry and irritated eyes, and at times an enlargement of the nose, called rhinophyma. Rosacea is known to be exacerbated by many triggers including: hot and spicy foods, caffeine, red wine, chocolate, temperature fluctuations, emotions and exercise.
Dermatitis: This is a general term that describes any skin irritation or inflammation. Dermatitis is a very common condition and usually involves red, itchy, dry skin that may also blister or ooze. Atopic dermatitis (eczema) is a form of dermatitis that usually develops in childhood and may be associated with asthma and hay fever. Other forms of dermatitis include seborrheic dermatitis (greasy scale on face and dandruff in scalp) and contact dermatitis (a skin rash caused by an allergic reaction or due to a local irritant reaction).
Hives: This condition is also known as urticaria, and consists of a skin rash reaction to either a medication, food, or some other environmental irritant. Hives present as raised, red, swollen spots anywhere on the skin or soft mucosa (the mouth, for example). Hives or Urticaria may be acute (present for less than six weeks) or chronic (lasting more than six weeks). Acute hives are most often due to an allergy (to food, medication, or other agent), but chronic hives may not have a clearly identified agent that causes it in many cases.
Alopecia: This is a partial or complete loss of hair from areas of the body where it usually grows, particularly the scalp. Male- and female-pattern baldness, alopecia areata (circular patches of hair loss), and telogen effluvium (hair loss following stressful events) are the most common forms of alopecia.
Psoriasis: This is an immune-mediated chronic skin disorder where the skin cells’ lifecycle is accelerated, causing skin cells to accumulate or build up at a rate greater than normal. This results in red plaques with prominent silvery scales. Psoriasis is a relatively common skin condition that usually appears in early adulthood and is characterized by red plaques on the knees, elbows, ears, back and scalp. The exact cause of psoriasis is unknown but it is believed to be a combination of immune system malfunction and a genetic predisposition. There are many treatments for psoriasis and they include: topical corticosteroid preparations, ultraviolet light therapy, Vitamin D-derivative creams, methotrexate, as well as a variety of biologic agents that work by blocking the body’s immune system with the goal to decrease inflammation.
Vitiligo: This is an acquired pigmentary disorder that involves the loss of pigment in patches in some areas of the body. Vitiligo occurs when the pigment-producing cells, called melanocytes, are destroyed. In this case, the skin cells are destroyed by the body’s own immune system, which develops an immune response against the melanocytes. This condition may affect the skin, hair or mucous membranes. Vitiligo is an autoimmune disorder and people with this condition may be predisposed to develop other autoimmune diseases concomitantly. Although vitiligo cannot be cured, medical treatments are directed at controlling the abnormal immune response, while surgical treatment options involve transplanting melanocytes from healthy skin areas to the affected areas that have loss of pigment.
Nail Problems: Fingernails and toenails protect the underlying skin and are made of keratin, a hardened protein. The health of the nails can be an indicator of one’s overall health status. Specific changes in the color and growth patterns of nails can indicate abnormalities of the heart, lung, or liver. The most common conditions associated with the nails include injury, infection (bacterial and fungal), tumors, and warts.
Fungal Infections of the Skin and Nails: These infections are common in the skin, hair or nails and are caused by a variety of species of fungi. These infections can occur anywhere on the body but the feet and groin are most commonly affected. Athlete’s foot (tinea pedis), jock itch (tinea cruris), ringworm (tinea corporis) and a variety of yeast infections are included in this group of diseases. Fungal infection of the nails is given by thickened, yellowish nails, typically with significant amount of debris under the nail plate. Topical or local anti-fungal creams may be recommended for early cases, but a dermatologist may choose to prescribe an oral anti-fungal agent if the infection is too extensive or deep.
Shingles: This condition is also known as Herpes Zoster, and is due to the reactivation of the chickenpox virus (varicella) in the body, causing a painful rash with grouped blisters. This virus normally lies dormant near the spinal cord and brain after the original (primary) varicella infection, and can be later on reactivated at different stages throughout life, mostly due to stress or to a dramatic impairment of the immune system. It presents as a painful, blistering rash along the course of a nerve, *only on one side of the body. Although most people with Herpes Zoster experience mostly a painful rash, some may also experience systemic symptoms such as fever, chills or a headache. Potentially serious complications associated with Zoster include: loss of hearing, eye damage, secondary bacterial infections, or encephalitis (inflammation of the brain). Herpes Zoster most commonly presents in older individuals, those with a weakened immune system, patients undergoing surgery, or people going through significant emotional distress.
Common Warts: These common skin lesions, also known as verruca vulgaris, are given by excess skin cell growth in the top layer of the skin caused by one of multiple common strains of the human papilloma virus (HPV). Warts are extremely common, especially in children, and can be spread easily to other body parts and from person to person. Warts are most often found on the hands and feet and are diagnosed clinically by their characteristic appearance, with a grayish color and a rough, scaly surface.
Genital Warts: These skin lesions, also known as Condyloma Acuminata, are given by excess skin cell growth in the top layer of the skin caused by specific strains of the human papilloma virus (HPV). A single genital wart is called Condyloma Acuminatum, a term widely used for these warts. Every year in the U.S. approximately 3 million new encounters or cases of genital warts are diagnosed. They are transmitted from person to person during intercourse, and are most commonly found on the genitalia and mouth areas. Condyloma are diagnosed clinically by their characteristic appearance, with a grayish color and soft texture. Multiple treatments are available to successfully treat genital warts. It is important to discuss the best treatment for you with your Dermatologist, as well as ways to avoid future infection and new lesions. The human papillomavirus that causes condyloma has been linked to cancer and, therefore, it is important to discuss this condition with your dermatologist. Other physicians that can diagnose and treat this condition include: Gynecologists (for female patients), Urologists (for male patients) and Family Medicine doctors.
Sunburn: This condition refers to skin irritation or damage due to prolonged sun exposure without adequate protection. Sunburns are painful, and are accompanied by skin inflammation and, at times, blisters. Sunburns, particularly during childhood and young adulthood, may be associated with skin cancer development and signs of advanced aging such as brown spots and coarse wrinkles. Acute management of sunburns involves the use of pain relievers, and cool emollients and creams to reduce itching and inflammation.
Skin Cancer: Abnormal growth of cells, most commonly in the top layer of the skin called epidermis, caused by faulty DNA or damaged DNA that has not been detected or repaired by the body’s natural protective response of the immune system. This leads to mutations in skin cells that then rapidly multiply and form malignant (cancerous) tumors. The main types of skin cancer are: basal cell carcinoma (BCC), squamous cell carcinoma (SCC), malignant melanoma (MM) and Merkel cell carcinoma (MCC).
Dermatologists are also trained in dermatologic cosmetic procedures and are experts in the following treatments:
Skin Care: Dermatologists are the skin experts and are highly qualified to advise patients on a wide range of skin care products, with various objectives: skin rejuvenation, evening out of skin tone, hydration, sun protection, sensitive skin care, among many others.
Botulinum toxin for Cosmetic Use (Botox, Daxi, Dysport and Xeomin): Helps to reduce the movement of the muscles that are under the skin (which would normally cause expression lines or wrinkles). As a result, botulinum is able to soften expression lines and wrinkles in areas such as the frown (glabella), forehead and/or crows’ feet (periorbital skin).
Fillers (Juvederm, Restylane and Radiesse, among others): These are substances that help fill in deep lines and wrinkles, as well as create a lifting effect when injected in specific areas of the face.
Resurfacing lasers, such as Fraxel: These are lasers that help remove superficial layers of damaged skin and stimulate the development of new skin in these areas, with better texture, more collagen and a smoother complexion. The skin resurfacing treatments may be done in areas such as the face and neck, among others.
Laser Hair Removal and other light-assisted hair removal procedures: These are treatments performed at the dermatologist’s office for the safe and permanent reduction of unwanted hair. A consultation is important in order to determine the safe and effective laser type and laser parameters to be used in each skin type.
IPL or PhotoFacial: This is an Intense Pulse Light (IPL) source that allows the gentle removal of blood vessels and reduces redness on the face, neck and other body areas.
Non-Invasive Fat Removal with CoolSculpting: With over 5 million treatments performed worldwide, CoolSulpting has been proven to be a safe and effective method for non-invasive fat removal, without needles, and minimal to zero downtime. Specialized CoolSculpting Technicians typically carry out this treatment at the dermatologist’s office.
Muscle Toning, with devices such as the CoolTone and EMSculpt: Dermatologists can help patients achieve not only non-invasive fat reduction with CoolSculpting, but also the toning and definition of abdominal and gluteal muscles using the CoolTone or EMSculpt devices. Several sessions are required to achieve results, and the treatment is non-invasive. Specialized CoolTone or EMSculpt Technicians typically carry out this treatment at the dermatologist’s office.
Cellulite Reduction, with Fractional Radiofrequency (Profound System): This treatment is able to stimulate a significant amount of new collagen and elastin in the areas treated, therefore reducing the appearance of cellulite and improving the overall skin texture.
Ultimately, following an appropriate skin care routine and avoiding excessive sun exposure or sunburns are key measures to maintaining your skin healthy. An annual full body skin exam, head-to-toe, is also important for the early detection of skin cancer or pre-cancerous lesions, as well as atypical moles that could be precursors to malignant melanoma. You may follow up with your dermatologist annually for a full body skin exam, or your dermatologist may elect to bring you back for less frequent follow-ups (every 2 years) if you have no personal or family history of skin cancer, or other risk factors. The American Academy of Dermatology recommends every person to use sunscreen that provides broad-spectrum protection (protects against UVA and UVB sun rays) with an SPF 30 or higher, and that is water resistant, in order to help prevent skin cancer. The most effective sunscreen agents include zinc oxide and titanium dioxide, and they should be present in your sunscreen.
Topics discussed with your Dermatologist during your visit may include:
Your Dermatologist may offer you a wide range of treatment choices for the specific condition that is afflicting you, and will work with you to find the best approach for you. Make sure to discuss all these options and other preventive measures with your dermatologist.
You can read more about Dermatology in the following links:
https://www.aad.org/public/fad/what-is-a-derm
https://www.aad.org/public/diseases
https://www.skincancer.org/skin-cancer-information/
https://www.aad.org/public/everyday-care/sun-protection/sunscreen-patients/sunscreen-faqs
https://www.aad.org/public/diseases/skin-cancer/prevent/how