Why Seeing a Dermatologist matters? 3 gripping questions answered

Seeing A Dermatologist – Who is Considered One?

A dermatologist (skin specialist) is a qualified medical specialist who has obtained qualifications to specialise in the diagnosis, treatment and prevention of skin, nail and hair diseases. Dermatologists are trained in cosmetic skin problems and aesthetic procedures. Only doctors listed as dermatologists by the Ministry of Health are recognised dermatologists. Cosmetic lasers, treatments, botulinum toxin and filler injections were developed by dermatologists. Aesthetic doctors are not skin specialists, they are family practitioners (GPs) who need to be accredited by the Dermatological Society of Singapore to carry out these procedures. Having a diploma in dermatology (Dip Derm) or a diploma in family practice dermatology (Dip FP Dermatology) does not qualify a doctor to be a dermatologist.

— Dermatological Society of Singapore

In this article, we break down some common FAQ, tips that have helped our patients and media friends navigate their way in their skincare journey with us. We hope it can help you to make the right decision about the health of your skin.  Find an accredited dermatologist here.

1. What can seeing a dermatologist tell you that an “aesthetic doctor” can’t about your skin?

There are a few layers to answering this question actually. Firstly, there is actually no such thing as an aesthetic doctor. There is either seeing a dermatologist, plastic surgeon or a general practitioner, as aesthetic medicine is not considered a medical speciality.

The public should refer to the Singapore Medical Council guidelines with regards to the “aesthetic doctor” label, which actually is not an approved qualification or title. The practice of “aesthetic medicine” is actually the realm of specialist dermatologists and plastic surgeons. Procedures such as chemical peels and lasers, botulinum toxin and fillers re developed and used by dermatologists, but are increasingly practised by non-dermatologists such as general practitioners (GP, family practice doctors).

Having a diploma in dermatology (Dip Derm) or a diploma in family practice dermatology (Dip FP Dermatology) does not qualify a doctor to be a dermatologist. In Singapore, GPs require additional Certifications of Competency (COC) to carry out such treatments in Singapore, which is administered by the Dermatological Society of Singapore.(Source: Dermatological Society of Singapore)

So the real question should be…what a GP who offers treatment for dermatological conditions can’t tell you, compared to a dermatologist.

A dermatologist (skin specialist) is a qualified medical specialist who, through additional years of special training, has obtained qualifications to specialise in the diagnosis, treatment and prevention of skin, nail and hair diseases affecting persons of all ages. Dermatologists are also trained in cosmetic skin problems and aesthetic procedures.

In Singapore, to qualify as a dermatologist, a doctor needs to obtain a post-graduate degree in general internal medicine or paediatrics which may take up to 5 years before acceptance into a full-time dermatology training programme in a recognised dermatological institute lasting minimum 3 years. At the end of this training, the Ministry of Health certifies the doctor as a dermatologist. Only doctors listed as dermatologists by the Ministry of Health are recognised dermatologists.

Dermatologists are experts in the treatment of skin conditions such as acne, eczema, psoriasis, skin infections, skin allergy, skin cancers and hair loss. Seeing a dermatologists also entails treatment all kinds of cosmetic problems of the skin and provide advice on skin health. Special treatments such as surgery for skin cancers and pre-cancerous skin conditions, the use of ultraviolet light therapy, laser therapy, intense pulsed light (IPL), radio-frequency therapy, botulinum toxin and filler injections and hair transplantations are also carried out by dermatologists. In fact, many cosmetic lasers and treatments were initially developed by dermatologists.

At the end of the day, be it in skin or other specialities, the public should just be discerning as to the qualifications of the doctor, and what a medical specialist accredited by the Ministry of Health is trained to do for specialised conditions. This is so that they are not misled to believe that they are seeing a dermatologist, a skin or an aesthetic specialist when they are seeing a general practitioner.

2. Seeing a Dermatologist or an Aesthetic Doctor (General practitioners) offers the same treatments?

The practice of medicine is really as much an art as well as a science, meaning that while many general practitioners would say they have experience treating say dermatological conditions in the family practice setting, there is a real difference in training, knowledge and experience of a dermatologist.

A specialist dermatologist takes additional years (at least 5 years) and goes through specialist accreditation managing complex medical and cosmetic dermatology conditions as well as complications associated with treatment. Certainly, for straightforward cases of any medical condition, family practice doctors are able to treat but would not be able to distinguish or diagnose conditions as accurately as seeing a dermatologist specialist.

3. Tell me about an example where it mattered seeing a dermatologist

 A case study in point: Adult Patient with pimples

If you are an adult and still struggle with pimples, then be warned your case would not be as simple as the on-off breakouts that teenagers have, which is physiological acne. Both would respond to some degree to conventional acne medication such as topical and oral antibiotics but would have a limited effectiveness if the true underlying cause is not considered. There may be a much more serious underlying medical condition, for example.

When acne persists into adulthood, dermatologists are trained to consider and work with specialist gynaecologists. This is to diagnose and rule out secondary factors such as Polycystic Ovarian Syndrome, which is associated with irregularities of the menstrual cycle, excess facial hair growth, weight gain as well as acne. Acne in such a circumstance is actually treated most effectively with a hormonal contraceptive pill.

Dermatologists would also perform adjunctive treatments like chemical peels for a quick response, to remove existing blackheads (open comedones)  and whiteheads (closed comedones) and reduce the appearance of scars. While one may wonder if the beautician or aesthetic doctor could perform the same peel, be warned that if you struggle with sensitive dry yet acne prone skin, your condition could get much worse when it is not managed by an accredited dermatologist. The choice and duration of the chemical peel (concentration, composition and source) are operator dependent.

In addition, seeing a dermatologist could suggest that chemical peels may not be suitable for you at all if you have underlying facial eczema, and may treat your eczema at the same time as acne. Anecdotally, I have had experience with patients who attended my clinic and were purportedly recommended with “oxygen facials” by “aesthetic doctors” for their sensitive skin for years. They actually were diagnosed with facial eczema, which is a medical condition managed by dermatologists. There is no evidence for using oxygen facials or any type of “facials” to treat facial eczema and in fact, could worsen the condition. If left untreated and without seeing a dermatologist, it could spread and lead to severe infections and scarring.

© 2017 TWL Specialist Skin and Laser Centre. All rights reserved.

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Meet with Dr. Teo Wan Lin, an accredited dermatologist at TWL Specialist Skin & Laser Centre, for a thorough consultation to determine the most suitable treatment for your skin.

To book an appointment with Dr. Teo, call us at +65 6355 0522, or email appt@twlskin.com. Alternatively, you may fill up our contact form here.