Even a brief stroll through the aisles of a pharmacy or department store will confirm that skin care is a big business. Unfortunately, not all skin conditions respond to over-the-counter treatments, which is why there are dermatologists. They're fully-trained physicians who care for diseases and medical conditions that affect the skin, hair, nails and mucous membranes. Many of these illnesses are minor, but some can be painful or life-threatening.
Scope of Practice
Skin is the human body's largest organ, covering its entire surface. It serves a number of vital purposes, including retaining moisture and helping the body regulate its temperature. The dermatologist's areas of practice include not only the skin itself but conditions affecting the finger and toenails, or the scalp and hair. The delicate mucous membranes lining the mouth, nose and eyelids are also part of a dermatologist's practice, as are sexually-transmitted diseases and some autoimmune conditions such as psoriasis. Dermatologists also diagnose and treat several forms of skin cancer.
Diagnosis and Treatment
One of a dermatologist's primary responsibilities is diagnosis. Many conditions can cause symptoms such as a rash or an area of flaky skin, and family doctors who are uncertain of their origin will refer patients to a dermatologist. So will doctors who suspect skin cancer or other serious conditions. The dermatologist has the specialized knowledge needed to differentiate between similar conditions, and to construct a treatment plan. Some skin conditions can be treated by topical medications, such as corticosteroids for relief of eczema or psoriasis. In other cases the dermatologist might prescribe a course of pills or injections, or perform a physical procedure such as dermabrasion.
Dermatopathology, the detection of skin conditions through analyzing specimens, is the only formal subspecialty within dermatology. However, dermatologists can choose to focus their practice on any number of conditions. For example, some might choose to primarily treat hair loss. Others might prefer to focus on patients with chronic acne and other cosmetic issues, or to conduct research into autoimmune disorders such as psoriasis. Skin cancers are another possible area of focus, and some dermatologists specialize solely in a procedure called Moh's surgery for their removal. Dermatologists might also collaborate with other caregivers, including plastic surgeons, oncologists and immunologists, on a specific patient's treatment.
Dermatologists begin their careers like other doctors, with a four-year bachelor's degree followed by four years in medical or osteopathic college. At graduation, the new doctor spends one year practicing general medicine in an internship, then three more in a dermatologic residency. After the residency, dermatologists who want to be board-certfied must pass a set of examinations administered by the American Board of Dermatology or the American Osteopathic Association. Many cancers and other skin conditions become more common with age, so the demographically significant baby boomer generation should provide steady demand for dermatologists over the next two decades.
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