Overview

The skin is an amazing organ. It serves as your first line of defense against disease, protects your other organs, heats and cools you, and transmits signals about how healthy you are on the inside. Dermatologists are highly skilled medical doctors and skin surgeons with the knowledge and expertise to provide the finest possible treatment for the organ that cares for you.

Dermatology is the discipline of medicine that deals with skin problems. It is a specialization that encompasses both medical and surgical components. A dermatologist is a doctor that specializes in the diagnosis and medical/surgical treatment of skin, hair, nail, and mucous membrane illnesses.

What is a Dermatologist?

A dermatologist is a doctor who specializes in skin, hair, and nail disorders. A dermatologist can diagnose and treat over 3,000 ailments. These disorders include, among others, eczema, psoriasis, and skin cancer.

Dermatologists have significant training, attending school for 12 years or more to learn to diagnose and treat over 3,000 skin, hair, and nail illnesses, as well as aesthetic problems. Dermatologists are consulted by patients for problems that go beyond the surface of the skin. Skin problems can impair patients' self-esteem, cause discomfort that makes daily tasks difficult, and, in severe cases, endanger their lives.

If you were to see a dermatologist at work on any given day, you may notice the following:

• Treat a baby's prominent birthmark that is endangering the child's vision.
• Remove a mother's fatal melanoma while it is still in its early, curable stage.
• Provide assistance to a student whose persistent eczema makes sleeping difficult.
• Determine the life-threatening liver ailment causing a grandfather's excruciating itching.
• Treat a young woman's hair loss, allowing her to obtain the confidence she needs to finish a job hunt.

Dermatology Specialties 

Cosmetic Dermatology

Cosmetic dermatology is a subspecialty of dermatology that focuses on procedures that enhance the look of the skin, especially on the face and neck. Aesthetic dermatology or aesthetic medicine are other terms for it. Aesthetic dermatology extends beyond cosmetic skin care and includes minimally invasive treatments such as injections. To achieve the greatest effects, these activities might be supplemented with medical therapy.

Dermatologists are doctors who have completed further training in the study of skin. Dermatologists can provide unique, specialized treatments that your normal skin therapist cannot. Your treatment plan is developed in consultation with your dermatologist based on your specific needs and aesthetic objectives.

A cosmetic dermatological procedure can be used to improve the appearance of:

• Wrinkles
• Premature ageing
• Fine lines
• Skin pigmentation
• Scars
• Moles and other lesions
  
  

Procedures used in cosmetic dermatology include:

• BOTOX® injections - is a lot cheaper and quicker than surgery to improve skin tone
• Dermal fillers (hyaluronic acid) - can give fuller lips and plumper, softer skin
• Microdermabrasion - rejuvenates skin especially where there is scarring, stretch marks or sun damage
• Chemical peels - can improve skin tone and texture, especially for acne scars and freckles
• Laser hair removal - to remove excessive fine hairs 

Dermatopathology

The study of diseases is known as pathology. It entails researching the disease's origins, course and development, as well as the consequences that may emerge. The study and description of structural and compositional changes that occur in skin illness is known as dermatopathology.

Dermatopathology, in practice, entails the microscopic inspection, description, and interpretation of biopsy specimens collected from the skin. This is often performed by a general pathologist or a dermatopathologist (a doctor trained specifically in dermatopathology, but who may not have fully trained in anatomic pathology).

Because many different inflammatory skin illnesses have the same fundamental inflammatory process or pattern, interpreting skin specimens can be convoluted and challenging. Clinical input and clinicopathological linkage are required for the final diagnosis.

A dermatolopathologist is a dermatologist or pathologist who specializes in skin pathology. Dermatopathology fellowship will last one year and will be completed by a dermatologist or pathologist. Six months of general pathology and six months of dermatopathology are frequently included.

Because of this highly specialized pathology, a dermatopathologist should be the first port of call if your doctor detects any of the following skin conditions. Melanoma and other skin illnesses, immunologic, infectious, and pediatric diseases are examples of dermatopathology cases. Because misinterpretation of some skin conditions can be deadly, it is critical that you and your doctor obtain the most accurate and early diagnosis possible.

Trichology

Trichology is the study of human hair structure, function, and illness. Clinical trichology involves the diagnosis and treatment of hair and scalp illnesses and abnormalities.

Trichology is derived from the Greek word trichos, which means 'hair,' and the suffix 'ology,' which means 'the study of.' Trichologists use a holistic approach to therapy, taking into consideration a variety of aspects such as lifestyle, food, and overall well-being, as well as the signs and symptoms present.

Reasons to Consult a Trichologist

Trichologists can assist customers with issues ranging from female and male pattern hair loss to alopecia areata symptoms. Many hair and scalp problems are frequently observed at Trichology Clinics.

• Hair Loss

Hair loss may cause a great deal of concern and grief, and there are many misconceptions about its causes and treatments. With few professional practitioners that specialize in the hair and scalp, a Trichologist is unusual in that their whole specialty focuses solely on the hair and scalp.

Alopecia is the clinical name for any sort of hair loss, particularly on the scalp. It can be diffuse (all over the scalp), in a pattern, temporary, or permanent. It is critical to identify the type of Alopecia you may have in order to treat it effectively and obtain the best results possible.

Androgenetic Alopecia, often known as Male Pattern or Female Pattern hair loss, is the most frequent kind of hair loss. Treatment alternatives include treatments such as Platelet Rich Plasma (PRP), cosmetic options such as hair fibers and additional hair solutions, and, of course, hair transplant surgery. A Trichologist will advise you on all of your options so that you may determine what is the best course of action for your specific circumstances.

Excessive hair loss may be a terrifying condition to have, making you concerned and unsure of what to do. In many cases of excessive shedding, there are a number of underlying causal causes that, once found and addressed, can have life-changing and hair-changing consequences.

• Problems of the scalp

Scalp problems range from dandruff to more inflammatory disorders including seborrheic dermatitis and psoriasis. A Trichologist will not only correctly identify your disease, but will also be able to advise you on therapeutic shampoos other Trichological treatments that can help you manage it efficiently. Stress, nutrition, allergies, family heredity, and medicines are all variables that can cause scalp issues, and a Trichologist is well-positioned to detect the triggers and reasons and give holistic guidance to you.

These issues, like the hair, may be symptoms of another metabolic abnormality. Stress, poor nutrition, and even food allergies can all contribute to the accumulation and shedding of dead skin cells.

Another area where a skilled trichologist's guidance is frequently sought is the management of extremely oily hair and scalp. In this case, advice on the best shampoo for each individual, as well as the frequency with which it should be used, may be very useful.

• Hair texture problems

Hair texture issues can be caused by overexposure to heat or harsh chemicals, as well as a variety of other stressors and strains that we submit our hair to.

Cooperation with the hairdresser is certainly crucial in such circumstances, indicating that trichologists' training covers both medical and cosmetic domains in areas not generally addressed by either doctors or hairdressers.

Hair texture issues typically respond quite well to adequate counsel and treatment, since the underlying reason, if identified, may frequently be minimized or eradicated entirely.

Immunodermatology

This specialty treats immune-mediated skin illnesses such lupus, bullous pemphigoid, pemphigus vulgaris, and other immune-mediated skin disorders. Immunopathology specialists frequently run their own labs.

The purpose of this lab is to learn how the immune system operates within the skin. The skin is much more than a passive covering that wraps around the body. It is one among the body's most important immunological organs. It is continually attacked by all kinds of foreign materials – bugs, chemicals, microorganisms – and in order for those external substances in the environment to not enter the skin and cause injury, the body need an intact immune system that reaches all the way to the skin's surface. The skin serves as the initial line of defense.

The Immunodermatology Laboratory is committed to learning in depth how the immune system in the most external portion of the body functions to defend us on a daily basis.

The laboratory is specifically involved in:

• Understanding the precise mechanisms by which the skin immune system operates in normal and diseased states
• Vaccine development via topical patches to develop immunity to bacteria, viruses, and tumors
• Understanding how environmental variables, such as light, interact with the skin, impact the immune system, and may initiate or change illness. Leveraging autoimmune diabetes as an example, researchers are investigating methods of using the skin to modify systemic illness.
• Understanding the method by which cytotoxic T lymphocytes are first activated against the pancreas in juvenile onset diabetes mellitus is important since this event eventually leads to the disease's start. 

Pediatric Dermatology

Dermatologists can earn this specialty by completing both a pediatric and a dermatology residency, or by completing a post-residency fellowship. This topic includes complicated neonatal disorders, genetic skin diseases or genodermatoses, and the numerous challenges of working with the pediatric population.

Teledermatology

Teledermatology is a branch of dermatology in which telecommunication technologies are utilized to share medical information via various media, typically created by non-dermatologists for examination by dermatologists off-site. This specialty deals with possibilities for seeing skin disorders from afar in order to exchange information, develop second-opinion services for specialists, or use this for chronic skin condition follow-up.

Common Procedures Performed in Dermatology

There are many factors influencing the choice of treatment:

• Type of skin cancer or noncancerous or precancerous growth
• Location, size, number, and aggressiveness of the tumor
• Patient’s general health
• Side effects, possible complications, benefits, and cure rate of a procedure
• Dermatologist’s experience and familiarity with a particular procedure

Each case is unique. Your dermatologist will choose the best treatment option for you.

During your office appointment, your dermatologist will go over your medical history with you, check and diagnose your skin growth, explain what might happen if left untreated, and then go through treatment choices and follow-up care. In most circumstances, your dermatologist will select and conduct the most appropriate procedure during this session. If the examination reveals the presence of skin cancer, your dermatologist may perform a biopsy and schedule you for surgery at a later date.

Skin Biopsy

A skin biopsy is a straightforward procedure that your dermatologist will conduct under local anesthetic. Your dermatologist will initially administer a local anesthetic to the affected region. After numbing the region, your dermatologist will remove either a portion or the complete tumor. A dermatopathologist will then examine the growth under a microscope in a pathology lab (a pathologist or dermatologist specialized in the microscopic examination of skin disease).

Following the biopsy, a bandage will be applied over the wound region, and your doctor will discuss the postoperative wound care recommendations to you. The biopsy findings, which may take a few days, will tell you whether you have skin cancer and what sort of skin cancer you have. A skin biopsy can be performed using a variety of methods. Depending on the location of the treated region and the type of skin growth to be evaluated, your dermatologist will use one of the following techniques:

• Shave biopsy: A surgical blade is used to cut a shallow slice of the growth or the complete growth. This biopsy procedure often does not require stitching, and the incision heals on its own in 1 to 3 weeks, resulting in a small scar. If the shave biopsy penetrates deeper into the skin, the ensuing scar will be more apparent, and its shape will be the same as the shape of the skin sample.
• Punch biopsy: A tiny cylindrical tool is used to cut either a portion or the full growth. The ensuing wound is generally sewn together. The punch biopsy approach provides for a more thorough examination of the tumor. The scar is generally linear since the incision is stitched. Nondissolvable sutures will be removed 1 to 2 weeks following the biopsy, depending on the location of the treated region.
• Excisional biopsy: To thoroughly remove the growth, a surgical blade is utilized. The ensuing wound is generally sewn together. The resultant scar, like the punch biopsy, is linear. Nondissolvable sutures will be removed 1 to 2 weeks following the biopsy, depending on the location of the treated region.

Cryosurgery

Liquid nitrogen is typically utilized in cryosurgery to freeze and kill single or many growths. A specific canister is frequently utilized to spray the liquid nitrogen directly onto the growth; however, the liquid nitrogen can also be sprayed directly using a cotton tip applicator. The process requires no numbing of the skin, is painless, and may be completed in the office in a matter of minutes. After the growth has been frozen, it will develop a scab that will come off in 1 to 3 weeks. A black blister at the treatment location may appear a few days following the surgery.

The blister is normally left alone and eventually dries up or ruptures. When the freezing is only superficial, the scar is modest to non-existent. The resultant scar may be more apparent and look as a white blotch if the freezing is deeper. Following the surgery, your dermatologist will go through postoperative wound care recommendations with you and plan a follow-up consultation to evaluate your treatment results. 

Topical Chemotherapy

Topical chemotherapy entails the application of a chemotherapeutic drug to the afflicted region, which kills precancerous and cancerous growths. 5-fluorouracil, diclofenac, and imiquimod are examples of chemotherapeutic agents. Each agent functions differently and is administered to the patient at home. Treatment duration ranges from a few weeks to many months, depending on the chemical employed, the illness being treated, and the treatment strategy chosen.

Your dermatologist will carefully teach you on how and for how long to use the medication. Typically, the treated region becomes irritable and crusts throughout the course of the therapy. Your dermatologist will check the treated region to ensure that there is no excessive or insufficient response to the agent. Some agents are more annoying than others, while others are more effective. Your dermatologist will go through the best chemotherapeutic medicines for your case with you.

Photodynamic Therapy

In photodynamic treatment, a chemical (aminolevulinic acid or methyl aminolevulinate) is administered to the precancerous or cancerous development. After a few hours, the treated region is exposed to a light source, which photoactivates the chemical, eliminating the precancerous or cancerous cells. Different photosensitizing compounds are exposed to different light sources.

Depending on the chemical, you may apply it at home or at your doctor's office. Your doctor will use a light source to activate the photoactivation a few hours after the chemical application. When exposed to the light source, there is generally little discomfort. After the treatment is done, your doctor will go through the postoperative wound care recommendations with you.

Crusting of the treated region occurs the day following treatment, and sun protection and avoidance are required. A follow-up appointment will be planned to check that the precancerous or cancerous growth has been entirely treated and that the healing process is proceeding normally; nevertheless, the operation may need to be repeated in certain cases to ensure that the growth has been totally cured.

Electrodessication and curettage (ED&C) 

Electrodessication and curettage (ED&C) is a straightforward treatment done under local anesthetic by your dermatologist. ED&C entails scraping the tumor away with a curette, a sharp surgical tool. An electrosurgical machine may then be used to control the bleeding and remove a small piece of normal skin around the wound. Some malignant growths, such as basal cell carcinoma and squamous cell carcinoma, are removed with a few cycles of burning and scraping.

After the surgery, a bandage will be applied to the wound and you will be given postoperative wound care instructions. There is no stitching, and the wound heals on its own in 1 to 3 weeks, depending on the location of the treated region and the depth of the ED&C. Scars from ED&C are typically circular in form and somewhat larger than the treated growth. After the incision has healed, the scar may seem pink and elevated, although it normally improves over many months to a year.

Mohs micrographic surgery

Mohs micrographic surgery is a very accurate surgical procedure for removing skin cancer. It is often conducted by a dermatologist who has received further training in the necessary surgical and laboratory skills. This method allows your surgeon to thoroughly remove the skin cancer while conserving as much normal skin as possible and getting the maximum cure percentage possible. Skin cancer is removed in layers during Mohs micrographic surgery.

Before removing further tissue, each layer of tissue is inspected under a microscope to establish the location and extent of the skin cancer. While the technique is time-consuming, it results in a very high cure rate with minimal loss of normal tissue. Skin cancers such as basal cell carcinoma and squamous cell carcinoma are treated using Mohs micrographic surgery. It is not often used to treat malignant melanoma.

This process has several benefits, including the most exact and thorough eradication of skin cancer, the greatest cure rate for skin cancer therapy, maximal preservation of normal skin, and preservation of vital structures.

Conclusion 

Dermatology is a broad field that includes illnesses and diseases of the skin, mucous membranes, hair and nails, as well as a variety of sexually transmitted diseases. Acne, warts, various inflammatory dermatoses, skin malignancies, autoimmune illnesses, occupational dermatoses, and contact dermatitis are just a few of the ailments that dermatologists treat.

The treatment includes everything from excisions, sclerotherapy, laser surgery, liposuction, hair transplants, and tissue augmentation treatments to routine skin care, prevention of skin illnesses and malignancies, and treatment of photoaging skin.