A dermatologist is a physician specializing in the diagnosis and treatment of conditions affecting the skin, hair, and nails. This medical specialty addresses a wide spectrum of complex diseases, cancers, and cosmetic concerns. The field has become highly specialized, leading to distinct areas of practice. The type of dermatologist needed depends on whether the concern is a chronic medical condition, a need for surgical intervention, or an aesthetic goal.
Medical and General Dermatology
The general or medical dermatologist forms the foundation of the specialty, focusing on the identification and management of acute and long-term diseases of the skin. They handle the majority of patient visits, dealing with common inflammatory conditions like eczema, psoriasis, and rosacea. These specialists diagnose and create treatment plans for complex rashes, fungal infections, and various forms of hair loss (alopecia).
They also perform routine full-body skin examinations to check for suspicious moles or early signs of skin cancer. For chronic disorders, such as psoriasis, they utilize targeted biologic medications, topical steroids, and phototherapy. This preventative screening allows for the early detection and management of potentially serious conditions.
Surgical Dermatology
Surgical dermatology is the branch dedicated to the procedural removal of growths, lesions, and malignancies of the skin. The primary focus is skin cancer treatment, which includes standard excisions for both cancerous and non-cancerous masses like cysts and lipomas. These specialists perform complex closures and reconstructive procedures to minimize scarring after removal.
A prominent technique is Mohs Micrographic Surgery, a highly precise, tissue-sparing method for removing skin cancers like basal cell carcinoma and squamous cell carcinoma. During the Mohs procedure, the surgeon removes thin layers of tissue and immediately examines the margins under a microscope. This layer-by-layer approach continues until 100% of the margins are clear of cancer cells, which preserves the maximum amount of healthy tissue.
Cosmetic and Aesthetic Dermatology
Cosmetic and aesthetic dermatology focuses on procedures aimed at improving the appearance of the skin and addressing signs of aging. These specialists utilize non-surgical and minimally invasive techniques to enhance skin texture, tone, and contour. Injectables are a common offering, including neurotoxins like botulinum toxin to temporarily smooth dynamic wrinkles and dermal fillers to restore lost facial volume.
Surface treatments are used to rejuvenate the skin’s outer layers and stimulate collagen production. These include chemical peels, which use acidic solutions to exfoliate the skin, and laser treatments for tasks like resurfacing, reducing scarring, or correcting pigmentation issues. Body contouring techniques, such as non-surgical fat reduction, also fall within this scope.
Specialized Patient Populations and Diagnostics
Dermatology also involves highly specialized areas that focus on specific patient groups or critical diagnostic functions.
Pediatric Dermatology
Pediatric dermatology specializes in skin conditions affecting infants, children, and adolescents. They manage conditions unique to younger patients, such as complex congenital birthmarks, genetic skin disorders, and severe cases of atopic dermatitis (eczema). Their focus is on diseases that are not simply smaller versions of adult ailments.
Dermatopathology
The diagnostic backbone for all specialties is dermatopathology, which combines dermatology with pathology. A dermatopathologist examines tissue samples, or biopsies, under a microscope to confirm a definitive diagnosis. This microscopic analysis is essential for accurately identifying the type of skin cancer and classifying inflammatory diseases, guiding the overall treatment strategy for the patient.