Dermatology: the complete story

What is dermatology?

Dermatology is the study, research, and diagnosis of conditions of the skin, fat, hair and nails. It relates most to those parts of the body that are attached to the skin and rarely involve investigations that go beyond the fat layer. However, the insides of the mouth and other bodily cavities may be involved.

What is a dermatologist?

A dermatologist will be able to diagnose and treat conditions such as skin cancer, skin rashes, growths and tumors that involve the skin with a variety of methods from removal to medications and surgery. A dermatologist is a trained doctor that has chosen to specialize in conditions of the skin. It can take upwards of 10 years to become fully trained in this discipline, so they are extremely knowledgeable in their subject.

A dermatologist will be able to help with the following:

The identification of any skin issues, rashes, acne, cancers, and inflammation.

• The treatment of any skin disease that is found including removal of suspect moles.
• The clinical diagnosis of skin problems via biopsy.
• Help with the appearance of skin by improving acne, scarring, wrinkles and age spots.
• Perform skin surgery including the removal of cysts and moles.

Skin conditions that might send you to a dermatologist

Many of these following skin conditions will come under the remit of a dermatologist, however, some could be dealt with by your doctor. It is always wise to see your doctor first and they will usually refer you to a dermatologist if required. Bear in mind that there are more than 3,000 possible skin diseases that a dermatologist might be able to treat.

• Skin cancer – including unusual moles that require investigation
• Warts that have failed to respond to over the counter treatment
• Fungal infections such as athlete’s foot
• Psoriasis that has become out of control and is not responding to usual medications
• Acne that is severe and requires particular treatment or antibiotics
• Dermatitis or other rashes caused by sensitivities. A dermatologist may be able to pinpoint the cause of the rash.
• Eczema
• Herpes or cold sores

Dermatology in the digital world

In the past, a patient would approach a dermatologist with something they thought to be a skin issue. In the case of possible cancerous moles, this might be because the patient had noticed a change in the appearance, size or behavior of the mole. With the advent of digital apps, it is now possible for the patient to establish a good timeline of the events leading to their visit and to give much more information to aid their diagnosis.

An app such as SkinVision allows you to take photos of your moles and to track them over time. Once it is clear that a mole is changing shape or size, you can take that information (including photos) to the dermatologist and they can see for themselves what the changes are and the time frame. It doesn’t remove the need for biopsy and investigation, but it does offer a clear picture and can mean earlier diagnosis and better outcomes.

When checking your moles it is important to take into account the following points:

• The size of the mole: Is it more than 5mm across?
• The shape of the mole: Is it symmetrical?
• The color of the mole: Is it more than one color or mottled?
• The behavior of the mole: Has it changed recently or is it itchy or bleeding?

An app may be able to help you identify these factors before taking that information to your dermatologist.

What is the future of dermatology?

It has recently been identified in the UK that there is a deficit of 200 consultant dermatologists despite more than 50% of the population being affected by skin issues that need medical care. The Royal College of Physicians recommends that there should be one dermatologist per 62,500 members of the public – currently, this stands at just over 1 per 100,000.

It is certainly possible that in the future, the role of the dermatologist will become even more hands-off. With apps being able to accurately diagnose skin cancers and other skin conditions, the dermatologist may have more of a treatment role. This could also mean fewer people using precious resources and the time of professionals.

Clearly, there is a role for more self-diagnosis to ensure that those people who really need to see a specialist can do so. With skin cancers, in particular, becoming one of the most common forms of cancer, it is vital that services are used efficiently. A simple app that tracks changes in moles can help achieve this. Furthermore, general health apps that track overall health can improve all areas of access to healthcare.