Dermatology

**Dermatology** is the branch of medicine dealing with the skin, nails, hair, and its diseases. It is a specialty with both medical and surgical aspects. A dermatologist treats diseases, in the widest sense, and some cosmetic problems of the skin, scalp, hair, and nails.

## Training

After earning a medical degree, the length of training in the United States for a general dermatologist to be eligible for Board Certification by the American Academy of Dermatology, American Board of Dermatology, or the American Osteopathic Board of Dermatology is a total of four years. This training consist of an initial medical, transitional, surgical, or pediatric intern year followed by a three-year dermatology residency. Following this training, one or two-year post-residency fellowships are available in immunodermatology, phototherapy, laser medicine, Mohs micrographic surgery, cosmetic surgery, dermatopathology, or pediatric dermatology. For the past several years, dermatology residency positions in the United States have been one of the most competitive to obtain.

## Subspecialties

### Cosmetic dermatology

Dermatologists have been leaders in the field of cosmetic surgery. Some dermatologists complete fellowships in surgical dermatology. Many are trained in their residency on the use of botulinum toxin, fillers, and laser surgery. Some dermatologists perform cosmetic procedures including liposuction, blepharoplasty, and face lifts. Most dermatologists limit their cosmetic practice to minimally invasive procedures. Despite an absence of formal guidelines from the American Board of Dermatology, many cosmetic fellowships are offered in both surgeyr and laser medicine.

### Dermatopathology

A dermatopathologist is a pathologist or dermatologist who specializes in the pathology of the skin. This field is shared by dermatologists and pathologists. Usually, a dermatologist or pathologist will complete one year of dermatopathology fellowship. This usually includes six months of general pathology and six months of dermatopathology. Alumni of both specialties can qualify as dermatopathologists. At the completion of a standard residency in dermatology, many dermatologists are also competent at dermatopathology. Some dermatopathologists qualify to sit for their examinations by completing a residency in dermatology and one in pathology.

### Immunodermatology

This field specializes in the treatment of immune-mediated skin diseases such as lupus, bullous pemphigoid, pemphigus vulgaris, and other immune-mediated skin disorders. Specialists in this field often run their own immunopathology labs.

### Mohs surgery

The dermatologic subspecialty called Mohs surgery focuses on the excision of skin cancers using a tissue-sparing technique that allows intraoperative assessment of 100% of the peripheral and deep tumor margins developed in the 1930s by Dr. Frederic E. Mohs.

### Pediatric dermatology

Physicians can qualify for this specialization by completing both a pediatric residency and a dermatology residency. They may also elect to complete a post-residency fellowship. This field encompasses the complex diseases of the neonates, hereditary skin diseases or genodermatoses, and the many difficulties of working with the pediatric population.

### Teledermatology

Teledermatology is a form of dermatology where telecommunication technologies are used to exchange medical information via all kinds of media usually made by non-dermatologists for evaluation off-site by dermatologists. This subspecialty deals with options to view skin conditions over a large distance to provide knowledge exchange, to establish second-opinion services for experts or to use this for follow-up individuals with chronic skin conditions. Teledermatology can reduce follow-up of individuals with chronic skin conditions. Teledermatology can reduce wait times by allowing dermatologists to treat minor conditions online while serious conditions requiring immediate care are given priority for appointments.

### Dermatoepidemiology

Dermatoepidemiology is the study of skin disease at the population level. One aspect of dermatoepidemiology is the determination of the global burden of skin diseases.

## Therapies

Therapies provided by dermatologists include, but are not restricted to, the following:

* Excision and treatment of skin cancer
* Cryosurgery for the treatment of warts, skin cancers, and other dermatoses
* Cosmetic filler injections
* Hair removal with laser or other modalities
* Hair transplantation, a cosmetic procedure practiced by many dermatologists
* Intralesional treatment with steroids or chemotherapy
* Laser therapy for both the management of birth marks, skin disorders, tattoo removal, and cosmetic resurfacing and rejuvenation
* Chemical peels for the treatment of acne, melasma, and sun damage
* Photodynamic therapy for the treatment of skin cancer and precancerous growths
* Phototherapy, including the use of narrowband UVB, broadband UVB, psoralen, and UVB
* Tattoo removal with lasers
* Tumescent liposuction
* Radiation therapy
* Vitiligo therapy, including procedures like autologous melanocyte transplant, suction blister grafting and punch grafting
* Allergy testing
* Systemic therapies, including antibiotics, immunomodulators, and novel injectable products
* Topical therapies