Dermatologists are medical doctors specializing in the diagnosis and treatment of conditions affecting the skin, hair, nails, and mucous membranes. Their practice is broad, encompassing the management of common and complex diseases, infectious disorders, cancer, and cosmetic enhancements. Since the skin is the body’s largest organ, dermatologists play an important role in maintaining a patient’s overall health.
General Medical Dermatology
Dermatologists primarily focus on the non-surgical diagnosis and management of skin, hair, and nail diseases. This requires detailed physical examinations and specialized medical knowledge to identify acute and chronic conditions.
Common conditions like acne are managed using topical treatments, systemic antibiotics, or hormonal therapies aimed at controlling inflammation and oil production.
Chronic inflammatory conditions like atopic dermatitis (eczema) and psoriasis are often managed with medicated creams, ointments, or injectable biological medications that target specific immune pathways. Psoriasis management may also include phototherapy, which uses controlled ultraviolet light exposure to slow skin cell growth. Rosacea, characterized by facial redness, is treated with oral and topical medications to reduce inflammation.
Fungal infections (e.g., ringworm or nail fungus) and bacterial infections (e.g., impetigo) require specific antifungal or antibiotic medications. Dermatologists also diagnose systemic diseases that manifest on the skin, recognizing that skin changes can indicate internal health issues. Treatment plans often include counseling on lifestyle adjustments, such as dietary modifications and sun protection, alongside prescription medications.
Surgical and Diagnostic Procedures
Dermatologists perform minor to complex surgical interventions for diagnosis or the removal of abnormal growths. A common diagnostic procedure is the skin biopsy, where a small tissue sample is taken for microscopic examination to confirm a diagnosis, such as skin cancer or an inflammatory disease. Biopsies may be performed as a shave, punch, or excisional method.
For the removal of benign, pre-cancerous, or cancerous lesions, several destructive techniques are employed. Cryosurgery uses liquid nitrogen to freeze and destroy abnormal tissue, frequently used for actinic keratoses and warts. Electrodesiccation and curettage involves scraping off the lesion and then burning the base with an electric current to stop bleeding and destroy remaining cells. Standard excisions involve cutting out a mole, cyst, or tumor and suturing the wound closed, ensuring the entire growth is removed with a margin of healthy tissue.
Mohs Micrographic Surgery
Mohs Micrographic Surgery is a specialized procedure used primarily for high-risk or recurrent skin cancers, such as basal cell carcinoma and squamous cell carcinoma. This technique involves removing the cancerous tissue layer by layer. The surgeon immediately examines each layer under a microscope to check for cancer cells at the margins. The process continues until no cancer cells are detected, allowing for complete tumor removal while preserving surrounding healthy tissue. This precision makes Mohs surgery beneficial for cancers located in cosmetically sensitive areas like the face, ears, and hands.
Aesthetic and Cosmetic Treatments
Dermatologists offer a wide range of elective procedures focused on improving the skin’s appearance, texture, and signs of aging. These treatments address cosmetic concerns like fine lines, wrinkles, scarring, and pigmentation irregularities.
One common procedure involves neurotoxins, such as botulinum toxin, which are injected into specific muscles to temporarily relax them and smooth dynamic wrinkles. Dermal fillers, often composed of hyaluronic acid, are injected beneath the skin to restore lost volume and soften static wrinkles and folds. Fillers are frequently used to enhance lips, cheeks, and nasolabial folds.
Chemical peels involve applying an acidic solution to the skin to exfoliate the outer layers. This stimulates tissue renewal and can improve issues like sun damage, pigment spots, and acne scarring.
Laser and light therapies use focused light energy to target specific components in the skin. Lasers are used for hair removal, treating vascular lesions, or addressing pigment issues such as sunspots and melasma. Laser skin resurfacing refines skin texture, reduces wrinkles, and minimizes scars by creating controlled injury to encourage new collagen production. Mechanical resurfacing techniques, like microdermabrasion, gently slough away dead skin cells, improving skin tone.