Although the American Board of Medical Specialties reports dermatology has only two subspecialties – dermatopathology and pediatric dermatology -- the American Academy of Dermatology notes two more: cosmetic dermatology and Mohs surgery. Dermatologists diagnose and treat more than skin problems, as they also specialize in hair, nails and mucous membranes, such as the inside of the mouth. These physicians must be licensed in all states and are typically board-certified. The median annual salary for dermatologists was $411,499 in 2013, according to “Becker’s Hospital Review.”
The Basics of Education
All dermatologists begin their education in the same way. A four-year college degree is the first step, followed by four years of medical school, a one-year internship and at least three years in residency. Along the way, they learn the basics of anatomy, physiology, pharmacology, medical ethics and psychology, but during residency, the AAD notes they focus on hands-on surgical training and learn about more than 3,000 diseases that can affect the hair, skin and nails. Dermatology residents learn how to perform skin biopsies, remove skin cancers and other skin growths such as warts, and to inject Botox and fillers to help skin look younger.
Becoming a Specialist
Once out of residency, a dermatologist might open a medical practice or go on for further training. A dermatology fellowship is where she will learn to specialize. If she chooses dermatopathology, for example, she’ll spend a lot of time in the laboratory. These specialists diagnose disease by examining specimens under a microscope, much as a general pathologist diagnoses cancer. A pediatric dermatologist limits her practice to children and specific conditions more likely to affect them, so her fellowship would focus on those areas.
Dermatology is one of the medical specialties that incorporates both medical and surgical management. Mohs surgery, however, is one dermatology subspecialty that is strictly surgical. A Mohs surgeon removes very thin layers of skin cancer and examines each layer under a microscope until the skin is free of all cancer cells. The advantage of Mohs surgery is that it does not require the removal of healthy tissue or a large incision to ensure all of the skin cancer is removed. It may also have a more esthetically pleasing result, with less tissue damage and scarring. Mohs surgeons learn their skills in a specialty fellowship.
Cosmetic dermatology is the largest sub-sector of dermatology practice, according to a report from Harris Williams and Company, a market bank. In 2011, 20 percent of all dermatologists practiced only cosmetic dermatology. The baby boomer population is driving much of the demand, and 42 percent of cosmetic dermatology patients are at least 60 years old. Although all dermatologists receive basic training in cosmetic dermatology, specialists in this field focus exclusively on procedures such as laser surgery to remove age spots, wrinkles or acne scars, and other techniques that provide a more youthful appearance.