A dermatologist is a doctor who specializes in the prevention, diagnosis, and treatment of conditions affecting skin, hair, nails, sweat and oil glands, mucus membranes (inside the mouth, nose, and eyelids) which can include cancer. The skin is the largest and most visible organ of the body, and reflects the health of the body. It acts as a barrier to injury and bacteria.
It is possible to specialize in particular areas of dermatology. One is cosmetic dermatology. Another, pediatric dermatology, concerns children and the conditions associated with them such as birthmarks, atopic dermatitis and hemangiomas. Immunodermatologists specialize in the treatment of skin diseases caused by an altered immune system such as the rare disease pemphigus, where antibodies attack skin cells.
Dermatology patients can be of any age, from babies to people who are more than 100 years old. Out of 3,000 different dermatology conditions that might be treated, 20 of these account for around 80 percent of a dermatologist's workload.
In Australia, dermatologists spend much of their time treating conditions resulting from exposure to the sun, such as malignant melanoma, squamous cell carcinoma, and basal cell carcinoma. In other regions, dermatologists are more likely to encounter cosmetic problems; moles, hair and nail disorders, occupational dermatitis, psoriasis, skin infections, eczema, acne, rosacea, and hand dermatitis. Rosacea is a common skin condition that can cause redness and swelling. Hand dermatitis results from contact with household chemical and affects most women with children. The cosmetic problems for which dermatologists can provide assistance include wrinkles, age spots and other signs of aging, hair loss, and scars. Some dermatologists perform minor cosmetic procedures such as face lifts, liposuction, and blepheroplasy, a surgical modification of the eyelid.
Cosmetics, industrial compounds, and pesticides continually present new dermatological problems. The increased outdoor work and leisure time of people today have increased their exposure to the sun and other hazards that can cause skin problems. It takes years of training and experience to learn how to distinguish the subtle differences in skin problems. Different conditions often share similar symptoms. There is therefore a growing need for more doctors to understand dermatology.
Family doctors might refer a patient to a dermatologist only after their treatment has failed, or if an unsuccessful treatment has caused complications. Because of this, it is often cost-effective to see a dermatologist in the first instance. Dermatologists are also better able to make an early diagnosis. Dermatology was once considered a "lightweight" specialty, but is now recognized as being critical to people's well-being.
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Dermatologists must train as a general doctor before undertaking postgraduate education in dermatology. Then, it is likely that they must work in an internship for a year and a residency program for at least three years. Training positions are generally based in university teaching hospitals with periods at a general hospital. The competition for residency programs is intense. In the United States, completing a residency program qualifies a person as a Fellow of the American Academy of Dermatology, while completing a long and arduous examination is required to become a Board Certified Dermatologist. Any physician who has completed medical school can claim to be a dermatologist, and this is often the case with the doctors in skin cancer clinics. If a patient wishes to see a skin expert whose training is of the highest level, they should look for one with further qualifications. Full training takes 13 years in the United States; in Australia, it takes a minimum of 11 years.
Most skin conditions can be treated with topical therapy such as lotions and creams. The surgical procedures dermatologists must learn include the injection of fillers and botulinium toxin (botox) to give a patient a more youthful appearance at the expense of facial mobility, cryotherapy and other procedures to remove common skin growths such as warts, excision, and skin and nail biopsies where the patient is awake and small amounts of tissue are removed to facilitate diagnosis.
Skin conditions are often associated with internal conditions and other external factors. Therefore, dermatologists should be knowledgeable in fields such as genetics, oncology, mycology, immunology, histology, bacteriology and others.
Because of the increasing rate of skin-related diseases in recent years, dermatological therapies have been revolutionized by new drugs, laser treatment, photodynamic therapy, and ultraviolet light therapy. That notwithstanding, dermatologists are still in high demand and their work environment can be very busy. At the hospital, they offer general consultation and treat in-patients who have various skin-related diseases.
Dermatologists can decide to work in private practice or public hospitals. They can also provide training for general medical practitioners, teach at a university or run clinical trials in a research lab. Dermatologists can decide to lead campaigns aimed at the community and even offer their services to spas and other beauty therapy institutions.