Like many medical terms, it comes from a Greek word, “dermatologia,” a combination of “derma” (which means “skin”) and “logia” (which means “study” or “discourse”). Put the two together, and you have the noun that today refers to the branch of medicine dedicated to the diagnosis and treatment of the skin.
In the past 30 years, however, two other words have been added to the dermatology lexicon: “cosmetic” and “medical.” As the field of dermatology has advanced, there are now two distinct branches of doctors: cosmetic dermatologists and medical dermatologists. While both receive the same standard of medical training, they have different areas of focus that achieve different goals.
We asked David Bank, M.D., a board-certified cosmetic dermatologist in Mount Kisco, New York, to explain the differences between these two types of doctors and when to see each one, depending on your skin needs.
What is a medical dermatologist?
A board-certified medical dermatologist (we’ll explain in a moment what “board-certified” means) diagnoses and treats skin conditions that can affect your health and general wellbeing.
“This can be any type of skin problem, from a rash, wart, or fungal infection to a suspicious-looking mole or growth to chronic conditions such as eczema or psoriasis,” says Dr. Bank.
In addition, a medical dermatologist treats conditions related to the growth and health of hair and nails, so anything wrong in these areas falls under a medical dermatologist’s purview.
What is a cosmetic dermatologist?
A board-certified cosmetic dermatologist has the same basic training as a medical dermatologist but typically focuses their practice more on treatments that improve the skin’s appearance (though they usually treat medical skin, hair, and nail conditions, too).
Cosmetic dermatologists offer a variety of non-invasive and minimally invasive procedures to rejuvenate and revitalize the skin’s appearance. Think injectables, lasers, medical-grade peels, microdermabrasion, and more. Basically, anything that doesn’t involve a scalpel.
Patients often joke that cosmetic dermatology appointments are the only doctor visits they actually look forward to. And the only ones they’d have to reschedule because they’re sick.
What is a board-certified dermatologist?
When any dermatologist, medical or cosmetic, is board-certified, it means they’ve done additional training on top of their general medical training and specialty certification exams, as defined by each of the member boards of the American Board of Medical Specialties (ABMS). Under the ABMS, there are 24 Member Boards that certify doctors in 38 specialties and 89 subspecialties, including the American Board of Dermatology (ABD). The ABD/ABMS grants board-certification to osteopathic and medical doctors that train in U.S. dermatology residency programs and pass the board examination, and maintain their certification.
To identify dermatologists who have been certified by the ABD, you can visit the ABMS’s certificationmatters.org, and in their search tool, look up a dermatologist by name. You can also see any additional sub-specialties they may have, such as dermatopathology.
Is a cosmetic dermatologist a real doctor?
Let us assure you that yes, a cosmetic dermatologist is absolutely a living, breathing medical doctor. It’s simply that they chose a different career specialty, much like when someone with a law degree decides to go into criminal law rather than civil law.
“We all get the same standard of medical dermatologist training, followed by completing a three-year dermatology residency,” explains Dr. Bank. From there, dermatologists may elect to pursue one of several cosmetic fellowships, adding an additional year of specialized training in cosmetic dermatology to their repertoire. Because cosmetic dermatologists build on a medical dermatology foundation, some offer both disciplines in the same office.
Throughout their careers, both medical and cosmetic dermatologists pursue ongoing education and training. “As the field advances, we stay current by attending meetings, reading journal articles, interacting with our peers, taking courses, and doing a variety of additional training to keep up with the changes,” says Dr. Bank.
The key difference lies in their focus. Cosmetic dermatologists stay on the cutting edge of aesthetic treatments, while medical dermatologists track advances in diagnosing and treating skin diseases such as psoriasis, eczema, acne, and skin cancer.
One big watch-out, especially considering the way people refer to themselves on social media: “There is a subset of ‘pretenders,’ let’s call them, who call themselves ‘cosmetic dermatologists’ but who do not have prior U.S. or Canadian dermatology residency training, and this could include family medicine, emergency medicine, as well as nurse practitioners and physician assistants,” says Dr. Krathen. Always make sure your cosmetic dermatologist has an M.D. or D.O. (Doctor of Osteopathy) degree and the appropriate credentials.
When should I see a medical dermatologist?
Any change in the health of your skin, hair, or nails is reason to see a medical dermatologist. All of these are reasons to go:
You’re worried about a problem, such as a rash or infection on your skin, nails, or scalp, and would like a diagnosis
You need help managing a chronic skin condition like eczema or an autoimmune skin disease like psoriasis
You’re struggling with persistent acne that doesn’t respond to over-the-counter treatments
You have noticeable hair loss or thinning
You’re experiencing excessive sweating
You have a new mole or one that has changed shape
A cosmetic dermatologist can conduct an annual skin cancer screening as well. But if you have a history of skin cancer or it runs in your family, it may be best to see a medical dermatologist for your mole checks and skin cancer screenings. Why? While both types of dermatologists can perform biopsies and remove and treat any cancerous areas of the skin, medical dermatologists focused on skin cancer conduct such treatments more regularly.
Many treatments and screenings by a medical dermatologist are covered by insurance. Check with your healthcare insurance provider to learn what is and is not covered by your plan.
When should I see a cosmetic dermatologist?
“If there is something about the appearance of your skin that bothers you, or you feel like your skincare is no longer working as well as it used to, that’s when you see a cosmetic dermatologist,” says Dr. Bank.
These dermatologists can help you address fine lines and wrinkles, dark spots and uneven skin tone, changes in skin texture, sagging, or loss of volume, as well as the appearance of your body skin. They can help you determine the best skincare for your needs, including prescription skin care. And they offer such treatments as injectables, chemical peels, microneedling, lasers that resurface the skin or remove unwanted hair, body-contouring devices, platelet-rich plasma therapy, cosmetic cryotherapy, and more.
Some people worry that visiting a cosmetic dermatologist could become a slippery slope where they'll be pressured into doing more treatments than they intended. Since most cosmetic procedures aren’t covered by insurance unless tied to a medical condition (like neuromodulator injections, such as Botox, for chronic migraines), it’s important to be upfront about your budget and aesthetic goals from the start.
Research providers, ask friends or your primary care doctor for referrals, and book a consultation first to make sure you and the cosmetic dermatologist are aligned on what you want for your skin.
If I’m already seeing a cosmetic dermatologist, do I need a medical dermatologist too?
Unless you develop skin cancer or another serious skin health condition, there’s no need to see a medical dermatologist if you’re already seeing a cosmetic dermatologist. Many cosmetic dermatologists accept insurance for diagnosing and treating medical skin conditions (though always check with their office), and they can perform your annual skin cancer check, too.
Dr. Bank adds that if you’re a patient and your child develops, say, acne or any other condition, ask your cosmetic dermatologist if they can treat your child as well.
One reason you may want to see a cosmetic dermatologist for acne is that, in addition to helping you manage the condition, “our practices will have lasers and other technologies that can treat post-acne scarring and dark marks,” says Dr. Bank If you've been seeing a medical dermatologist for acne and feel you've tapped out on all the options, it's worth seeing a cosmetic dermatologist.
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