A Board Certified Dermatologist is a doctor who has undergone many years of extensive scientific training to determine medical conditions that are expressing themselves through the skin, hair, and nails; treat skin conditions such as acne, rosacea or psoriasis; or determine if a mole is cancerous.
On the aesthetic side, Board Certified Dermatologists are the experts in Botox, fillers, and laser procedures; and seeing a supposed expert can result in permanent scars from wrong laser settings, as well as complications from injectable fillers, including necrosis of the skin. Even more serious, a so-called expert can perform mistreatment that might worsen a skin condition.
This article offers a comprehensive look at why you should see a Board Certified Dermatologist as opposed to other so-called experts, who are appearing all over the internet with credentials that don’t compare. The purpose of this article is to provide you with as much information as possible, so you are armed with a wealth of knowledge to make the best-informed decision for yourself.
What Is a Board Certified Dermatologist?
A Board Certified Dermatologist is a physician who has successfully completed a credited residency in dermatology in the United States and has passed the board certification exam, explained Dr. Paul Yamauchi, Ph.D, who’s in private practice at the Dermatology Institute and Skin Care Center in Santa Monica, California.
“A board-eligible dermatologist is a physician who has successfully completed a credited residency in dermatology but has not taken or not passed the board certification exam – there are physicians who are neither, but pass themselves off as being a dermatologist,” added Dr. Yamauchi, who is also the founder of the Clinical Science Institute in Southern California.
Dr. Lauren L. Levy, a Board Certified Dermatologist at Loucas Dermatology in New York City, further explained that a Board Certified Dermatologist is a Ddoctor who has undergone dermatology residency and training, and is certified by the American Board of Dermatology to practice dermatology.
“This board maintains our credentials and credibility as dermatologists,” Dr. Levy said.
Additional factors include that the physician must also complete certain requirements during the residency, for example, over 100 surgical excisions and closures, dozens of laser procedures, and management of systemic medications in order to graduate from the residency program. Also, after graduating, the dermatologist must participate in the maintenance of certification, which requires attending tens of hours of courses to obtain continuing medical education credit yearly, take a re-certification exam every 10 years, and participate in quality improvement programs.
“Think that’s a lot?” Dr. Levy noted. “Some board-certified dermatologists have completed a Ph.D. during their medical school – an extra four to six years – to get a Doctorate in research/science. Others have done an additional one to two years of post-residency training in pathology, Mohs surgery (a precise surgical technique used to treat skin cancer), pediatric dermatology, and cosmetic dermatology. Why do we do all this work? To provide the best, comprehensive, and safest skin care for our patients.”
Dermatologist vs. Board Certified Dermatologist
All dermatologists “should” have completed a three-year residency approved by the Accreditation Council for Graduate Medical Education, or the American Osteopathic Association in Dermatology, said Dr. Matthew Elias, a Board Certified Dermatologist at Elias Dermatology in Florida.
“A Board Certified Dermatologist is one who has, after completing their three-year residency spending over 15,000 hours training, also completed and passed a board examination covering all aspects of dermatology,” Dr. Elias further explained.
Board Certified Dermatologists practice medicine following four years of scientific training and skills in a dermatology residency, and must continue to demonstrate competence in dermatology, unlike other providers who associate themselves with skin, said Dr. Cheryl Burgess, a Board Certified Dermatologist at the Center for Dermatology and Dermatologic Surgery in Washington, DC.
“There is a board certification exam after the completion of the residency and re-certification is every 10 years,” Dr. Burgess noted. “Dermatologists that have completed a dermatology residency, but have not passed the board certification exam, cannot say that they are board-certified.”
A Board Certified Dermatologist has the training and certification explained above; “however, anyone can say they are practicing ‘dermatology’ or ‘specialize in dermatology’,” warned Dr. Heidi A. Waldorf of Waldorf Dermatology Aesthetics in Nanuet, New York.
Experts Confused with Board Certified Dermatologists
Unfortunately, with the rise of social media, there are many physicians, mid-level providers like Physician's Assistants and Nurse Practitioners, aestheticians, and even laypeople “masquerading as dermatologists or skin experts,” Dr. Elias said. “Typically, this is found in the cosmetic dermatology realm, but is, unfortunately, being seen in all aspects of dermatology these days, too.”
This is becoming more and more confusing for patients, as more and more “experts” are offering medical and cosmetic procedures including surgery, injectables, and lasers, said Dr. Deanne Mraz Robinson, Co-Founder and Partner at Modern Dermatology in Westport, Connecticut; and Assistant Clinical Professor of Dermatology at Yale University of Medicine in New Haven.
“This can range from an MD or DO that is not a Board Certified Dermatologist who is essentially practicing in the field of dermatology, and other health care professionals with titles such as Registered Nurse, Nurse Practitioner, and Physician's Assistant,” Dr. Robinson explained.
According to Dr. Levy, nowadays with social media, “it is easy to become an expert – just post a few videos online, and you are one.” Aestheticians, for instance, are qualified to take care of certain procedures like facials and extractions, and recommend skin care products, “but are not certified to treat and manage surgical skin disease, or complex cosmetic procedures such as resurfacing lasers or fillers.”
Other experts like nurses are an important part of the dermatology team, “but are by no means dermatology experts or board certified in dermatology,” Dr. Levy said. “Nurses, nurse practitioners, and physician assistants are certified by their respective boards, but are not certified by the American Board of Dermatology, and have little formal dermatology training, although they do represent an important part of the dermatological care team working with dermatologists to take care of patients.”
Many people misrepresent their credentials, said Dr. Tina R. Kinsley, a Board Certified Dermatologist at Ann Arbor Dermatology in Michigan. For instance, a “skin specialist” is not a dermatologist; and a “cosmetic dermatologist” is not a board-certified dermatologist unless they have undergone the education, training, and required testing.
“Unfortunately, anyone can say they are a dermatologist even when they have had no more than a passion for the skin and a few weekend Botox training courses,” Dr. Kinsley warned.
Dr. Burgess added that her favorite hashtag is: #areyouaboardcertificeddermatologist?
“Are you a board-certified dermatologist? It is a yes or no answer,” Dr. Burgess said.
Reasons Why People Should See a Board Certified Dermatologist
According to Dr. Elias, a Board Certified Dermatologist should be seen for a disease or treatment of the skin, or for cancers and lymphomas of the skin, such as the following:
- Basal cell carcinoma
- Squamous cell carcinoma
Additionally, Dr. Elias said a person should see a Board Certified Dermatologist for any treatment of the skin including the following cosmetic procedures:
- Laser hair removal
- Skin resurfacing
- Fillers like Juvederm or Restylane
- Treatments like Coolsculpting, which works on the fat in the skin
“You should always be seen by a Board Certified Dermatologist on initial evaluation to make sure you are a proper candidate and to set up a proper treatment guideline,” Dr. Elias further advised. “This is for any procedure of the skin.”
Dr. Levy noted that patients should see a Board Certified Dermatologist “because they truly are the experts in all medical and cosmetic concerns of the skin, hair, and nails due to the extensive training.
According to Dr. Burgess, a person should see a Board Certified Dermatologist for a thorough examination of the hair, skin, and nails, because many dermatological issues are related to medical conditions that are expressing itself through the skin.
“Due to our medical and surgical background, we can swiftly diagnosis a cutaneous manifestation of an internal disease,” Dr. Burgess explained. “Some examples are systemic cancer can metastasize to the skin, or autoimmune disease may present as hair loss.”
Dr. Waldorf, who is trained to recognize skin conditions including premalignant and malignant lesions, said patients coming into her office “can be reassured that I will not treat a potential malignancy with a procedure for aesthetics if that procedure could camouflage the lesion and slow diagnosis.” Her training involved a thorough study of the pathophysiology of the skin and anatomy of the skin and underlying tissues, “which allows me to best evaluate and treat my patients and manage complications.”
Typically, Board Certified Dermatologists have undergone three years of rigorous clinical training, learning every aspect of the structure and function of the skin, Dr. Yamauchi said; adding that a residency program requires training in medical dermatology, surgical dermatology, cosmetic dermatology, pathology of the skin, pediatric dermatology, and basic science dermatology.
“A non-certified dermatologist in another field, such as internal medicine, might have taken a three-month rotation in dermatology to be exposed some of the more common skin conditions,” Dr. Yamauchi explained. “These rotations do not provide sufficient training in surgical, procedural, and cosmetic dermatology.”
Board Certified Dermatologists have proven their knowledge and competence with continued education and learning, Dr. Robinson added. “You should demand nothing less than this for your care.”
Dangers of Seeing “Experts” vs. Board Certified Dermatologists
Dr. Levy warned some potential dangers of seeing a non-board certified dermatologist include the following:
- Wrong diagnosis of conditions including skin cancer and dangerous rashes
- Permanent scars from wrong laser settings for hair removal
- Complications from injectable fillers, including necrosis of the skin
“Of course, any of these complications could potentially happen to a Board Certified Dermatologist as well, but as skin experts, we are well-versed in knowing how to manage these complications if they were to occur, and are often the ones who are managing complications from med-spas who have non-trained ‘experts’ performing procedures,” Dr. Levy said.
Many times, supposed experts in dermatology only want to do surgical and cosmetic procedures such as Botox, fillers, or lasers, Dr. Yamauchi said. And because of their lack of training, “complications and adverse events are much higher. In addition, the rate of misdiagnosis of a skin condition is much higher with non-certified dermatologists.”
According to Dr. Waldorf, the number one danger is missing a malignancy, and the number two danger is mistreatment and worsening of a skin condition.
“At the most basic, think of acne,” Dr. Waldorf further explained. “I have seen so many patients over the years whose acne was ‘managed’ solely by aestheticians until the patient saw me. Scarring could have been avoided had the patient seen a dermatologist from the start.”
Dr. Robinson warned that the lack of expertise can result in misdiagnoses, incorrect and or lack of treatment and other serious medical issues.
“In terms of cosmetic procedures, there are serious consequences that can occur, such as burns and scarring with laser and light-based devices, and blindness and/or strokes from dermal filler injections, just to highlight two of the most popular procedures,” Dr. Robinson said.
Dr. Burgess agreed that the biggest potential danger of seeing a supposed expert is a misdiagnosis of moles or melanoma, adverse events and unknown side effects with treatments and cosmetic procedures; and burns from chemical peels and laser/light devices.
Often times, these non-dermatologists who promote themselves as dermatologists have little to no training in the skin, Dr. Elias added. “They tout their experience, training, passion for dermatology or passion for aesthetics…to deceive the public into thinking they are experts in the skin. The only true expert in all things skin is a Board Certified Dermatologist.”
Red Flags an Expert Is Not a Board Certified Dermatologist
According to Dr. Burgess, the biggest red flags that could indicate a person is not a Board Certified Dermatologist include stating “board-certified” without stating the specialty. She noted that “board-certified” is commonly seen in marketing and advertisements, adding that “dermatologists have had years of training and will state Board-Certified in Dermatology.”
Unfortunately, descriptions of physician and non-physician certifications in offices, on websites and in social media blur the facts about training, Dr. Waldorf said. She offers the following rules of thumb:
If a doctor is described as “board certified” but the specific board is not specified, in particular, the American Board of Dermatology, then he/she is not a board certified dermatologist. Their board certification may well be in family practice, internal medicine, gynecology or something else.
The American Academy of Family Practice sponsors a one-year Dermatology Underserved Fellowship in Family Medicine. According to the AAFP website, this program is designed for a board-certified or board-eligible family physician that wants to develop expertise in dermatology and wants to give back to their community by providing needed skin care for underserved populations. The fellow will improve their skills in the full range and depth of medical and surgical dermatology, excluding cosmetics. Those physicians will list themselves as “board certified in family practice with a specialty in dermatology.” That is not the same as board certification in dermatology.
Non-physicians not only practice in physician offices under physician supervision but also see patients in offices and spas with an off-site MD as a “medical director” in name only. And the lines are blurring further – Physician Assistants and NPs can practice independently in many states. NPs with a Ph.D. may use the title “Dr.” despite not having an MD. PAs are fighting to be called “physician associates” instead of “physician assistants” and to be called “Dr.”
When You Should See a Board Certified Dermatologist
According to Dr. Robinson, it depends on your personal and family history of skin cancer, “however for most individuals, it is advised to have a full body skin cancer screening exam annually.”
Dr. Burgess said someone with more than 20 moles should see a Board Certified Dermatologist yearly, especially if the moles are located on the back or locations that can’t routinely be examined by the patient.
Dr. Waldorf recommends that everyone have at least one full skin examination by a Board Certified Dermatologist. Based upon that evaluation, personal and family history and other risk factors, repeated exams may be recommended several times a year to annually, to only when changes are noted.
“Patients should also see a Board Certified Dermatologist for other skin conditions such as acne, rosacea, psoriasis, eczema and any unusual rashes or new or changing growths,” Dr. Waldorf added. “A Board Certified Dermatologist specializing in cosmetic dermatology should also be the first choice for injectables, lasers, and energy based devices for the face and body.”
Dr. Levy agreed one should see a Board Certified Dermatologist at least yearly for skin cancer checks “and more often if the person has a history of skin cancer, undergoing treatment of rashes or management of acne.”
In further advice, Dr. Yamauchi recommends a person should see a Board Certified Dermatologist for a growth that doesn’t want to go away, a changing mole, a persistent rash that does not improve with over the counter medications, or for cosmetic reasons, such as looking younger, excessive hair, or removing unwanted blemishes. He added that Board Certified Dermatologists are the experts in Botox, fillers, and laser procedures.
Advice for First-Timers Seeing a Board Certified Dermatologist
It is a good idea to get a yearly skin check starting in your 20s, Dr. Levy advised, but sooner if you have a family history of melanoma or skin cancer, or heavy sun exposure or blistering sunburns. “Of course, we’ve even seen newborns and children with any rashes, acne, or concerning lesions.”
If you’ve never seen a Board Certified Dermatologist, Dr. Waldorf recommends seeing one if you have birthmarks you cannot see easily, have had sunburns, been to a tanning salon, or have a family history of melanoma or non-melanoma skin cancer. Additionally, you should see a Board Certified Dermatologist when you have a rash or a spot that is new or changing.
Dr. Robinson added it’s never too early or too late to see one, because “Board Certified Dermatologists are trained to treat all ages from infants through geriatrics.”
What to Expect During Your First Visit to a Board Certified Dermatologist
If you’re going to see a Board Certified Dermatologist for the first time, expect a review of your personal medical history, as well as your lifestyle, Dr. Robinson said. For instance, “did you use tanning beds…if so, we need to know that as it significantly impacts your likelihood of developing melanoma.” Your family medical history will also be discussed because some skin cancers have a hereditary element to them.
“Depending on the reason of your visit, what happens next may vary,” Dr. Robinson added. “For a full body exam, you will need to remove all clothing and we will examine you from head to toe.”
If the appointment is for a specific lesion or rash, history will be taken, the site evaluated, a biopsy might be taken, or the physician may diagnose based on the history and physical and prescribe topical and/or oral treatment, Dr. Waldorf said.
“It is important for the patient to arrange a follow up appointment if recommended and/or to call the dermatologists office if the condition is not improving or worsens,” Dr. Waldorf advised.
For a total body skin check, the patient will be asked to undress and put on a gown, and patients should let the doctor know if there are any spots that have changed.
“The doctor will look at the skin from head to toe including scalp, behind the ears, under underwear, between the toes, etc.,” Dr. Waldorf explained. “The doctor may stop longer at some spots that look suspicious and may even want to take a sample (biopsy). It may seem very quick – a dermatologist knows what he/she is looking for on your skin.”
Dr. Elias added, “Don’t wear makeup,” and be prepared to answer a lot of questions “and have all of your skin on your body examined, including areas such as the scalp, groin and buttocks, and bottoms of the feet.”
The cost to see a Board Certified Dermatologist varies based on insurance, geography and what is being done during the visit, Dr. Robinson said.
At Dr. Burgess’ practice, for instance, it costs $400 for the first thorough examination to address the dermatologic issues.
Dr. Yamauchi said the cost depends on the nature of the visit, whether it’s medical, surgical, or cosmetic, as well as the type of insurance the patient has.
Many Board Certified Dermatologists take insurance for medical dermatology, skin cancer management, and treatment or management of acne and rashes, Dr. Levy noted.
“This means the patient will have to pay the co-pay and whatever the deductible is,” she said. “Cosmetic procedures are never covered by insurance and cost varies based on practice, location, and what procedure is performed. Some dermatologists do not take insurance for medical dermatology and again the cost is set by the practice.”
How to Find the Best Board Certified Dermatologist
Board Certified Dermatologists can be located online at the American Academy of Dermatology Association. “It will require your zip code or the name of the physician to check the board certified status and medical degree,” Dr. Burgess noted.
Dr. Yamauchi said the American Academy of Dermatology website lists board certified dermatologists by geographic region. “If you are referred to a dermatologist or see an advertisement for a dermatologist, check the website to see if that person is listed.”
“You can also ask your primary care physicians for referrals and recommendations,” Dr. Robinson advised. “Always do your own homework on the physician you choose to see beforehand.”
Dr. Waldorf recommends looking into the American Society for Dermatologic Surgery.
Dr. Levy added that in order to be a Board Certified Dermatologist, the practitioner must be a physician, so check for MD or DO next to the name. Next, check on the website to see what credentials are listed. A Board Certified Dermatologist will have American Board of Dermatology in their biography.
“They also may have a special seal on their website which has been given to the doctor by the American Board of Dermatology. Patients can also check this website: Is My Doctor Board Certified?” Dr. Levy added. “Lastly, it never hurts to ask the physician what their training is or certification is.”
Board Certified Dermatologists are “rigorously trained” in all aspects of the skin and well equipped to handle any kind of skin emergency, Dr. Yamauchi said. “Don’t let a non-certified dermatologist perform any surgical or cosmetic procedure on your skin.”
The bottom line is the market is becoming confusing and dangerous with more and more less qualified providers administering medical and cosmetic procedures, Dr. Robinson warned, adding that Board Certified Dermatologists possess the integral education, training and credentialing to properly care for your skin, hair, and nails.
Just because someone has over 20,000 Instagram followers does not make them an expert, Dr. Levy emphasized: “Do your research before you commit to a procedure and make sure they have proper training to not only do the procedure but to manage the aftercare or any potential complications.”