A dermatologist can tell you about the disease in an informative way, but he can’t cure it. He can make you less uncomfortable, though.
If a dermatologist cured diseases he would be a medical miracle worker, and there wouldn’t be any job for a dermatologist at all. But his job is to make people less uncomfortable, not to cure them. A dermatologist can make you less uncomfortable by giving you pain relief or by washing off the dead skin that’s causing the itch. He can also reposition skin that has been stretched too far; if your arm or leg is stretched too far it will look worse than it really is and then you’ll feel even more self-conscious about it than you did before.
The trick is to take care of what you have—to keep your skin healthy and soft—and not to worry about what you don’t have.
In my kids’ school nurse’s office there is a board with a list of NHS doctors who will do house calls in their area. I was interested to see that the first one listed was not a GP, but a dermatologist.
Because I wanted to understand what treatments dermatologists offer, and why, I decided to call the dermatologist nearest me and ask him what he does.
It turned out that there are three types of dermatology. The first is treating skin infections and skin cancers. That’s what my dermatologist does. He sees patients in his office, or on hospital wards if they need surgery or chemotherapy.
The second type treats wrinkles, spots on the skin and so on which are caused by various things, including sun damage and hormonal changes in middle age. That’s what I asked about: how does someone get spots on the skin? Turns out that’s not how it works: “I can’t treat wrinkles.” He said he can do something called dermabrasion, which uses tiny crystals to make the skin smooth raspberries but not spots.”
“But you must be able to treat them,” I said. He explained that some people get spots when their skin gets too tight or narrow because of fat overgrowth during pregnancy;
As a dermatologist, I’m often asked to explain the disease so that people who aren’t doctors can understand it. Sometimes this isn’t hard. Many diseases have symptoms that are obviously bad and easy to describe. But more often, people have vague or contradictory views about the disease. They may misunderstand the role of what we call “contagious” versus “non-contagious” in the spread of a disease. Or they may assume that we have all the answers, when in fact our understanding is limited: new research findings frequently overturn conventional wisdom.
So if you don’t know much about a medical condition but want to get your friends and family to understand it, it’s best to avoid generalizations and jargon and try to be explicit about how you got your information. You can make your story more credible by including things like “I did some research online,” or “I talked to my doctor,” or “the Internet has lots of sites with information on this.”
If you have a skin disease, you can’t stop there. If you’re getting a dermatological exam, you need to ask about the disease in a way that will make it relevant to the patient’s particular needs.
The first thing to decide is what kind of skin problem you have. You know how to diagnose heart disease: do an electrocardiogram. When your doctor wants to know if you have heart disease, he or she brings up the ECG and asks if it looks normal.
When your doctor wants to know if you have skin cancer, he or she brings up your skin and asks if it looks normal. It isn’t as simple as that, but that’s the basic idea.
I had a conversation with my dermatologist, who asked me how I take care of my skin. I told him I use moisturizer, sunscreen, and a basic cleanser. He mentioned a few products he liked. We went into the part of the office where we keep the products, but he didn’t find any he used or recommended. So then he asked about my skin type, and I showed him my skin under the fluorescent lights in his office.
He pointed to a map of the United States on the wall that reflected his office’s lights. “What brand is this?” he asked.
“Well, there’s Neutrogena,” I said.” And then there’s this one.”
“Oh my God,” he said. “You’re not in California. You’re in East Texas.”
I laughed, feeling ridiculous for thinking that if my skin looked different from his it must be because it was California and not Texas. In fact, Californians get sun tanned like everyone else, but only after they burn their first few times out in the sun. But no one ever thinks to ask them why their tan looks odd unless they live in California or have enough money to stay indoors all day and never get sunburned. His office didn’t
Dermatology is the study of skin, hair, and nails. In the past, it was divided into diseases of the skin (scabies and lice) and diseases of the hair (nits and warts). Now these are combined in “dermatology” — but still separately from the diseases of the nails.
Dermatologists are often called to see people who have a crazy-sounding skin disease, like contact dermatitis or pityriasis rosea. But people with these diseases are not usually bothered by it. What a dermatologist really needs to know is whether it’s something that will bother them later on.
The best way to diagnose a condition is not with tests but with careful observations. A specialist in anything has to take your whole life history into account: what you’ve done to your body, how you’ve been trying to look after it, why you’re worrying about it now. It’s no good giving advice if you don’t know what’s going on.
A dermatologist (from the Greek word for skin) is a doctor who specializes in the treatment of skin conditions. Dermatology is a branch of medicine that looks at the structure and function of the skin, hair and nails.
Because dermatology is so closely related to medicine, you might think it would be obvious what a dermatologist does. But if you ask most people what a dermatologist does, they’ll say “treats skin diseases.” That’s not quite right: the American Academy of Dermatology has about 20,000 members practicing in more than 50 countries; less than 5% are general practitioners.
The rest are specialists, treating mostly skin diseases including eczema, rosacea, acne, psoriasis and other inflammatory skin disorders; acne that won’t clear up; warts and moles; birthmarks and pigmentation disorders; and scarring from burns or other injuries.
Dermatologists who specialize in these conditions have training similar to that of cardiologists or surgeons or neurologists. They learn how to use laboratory tests to diagnose diseases and make decisions about how to treat them. They learn how to perform surgery. They study how cells work, how they grow and change, how they reproduce themselves. And they learn how