THE BLOG

What Makes a Skin Expert?

04/07/2016 10:57

In the past week alone, I have already lost count how many times I have seen "expert" comments in the popular press by self-proclaimed skin specialists.

I am just going to put this out there. Dermatologists, as a group of individuals, have the highest training possible in skin. They complete on average 6 years at medical school followed by several years of general medical training and exams. Only then are they allowed to apply for one of the most competitive specialties in medicine. If they manage to get through years of CV building and a rigorous selection process, they are then granted specialist training in dermatology. This takes many more years, exams, and finally they come out the other side gaining entry on the UK specialist register.

The General Medical Council register is surprisingly easy to check. You can check any UK doctor's registration status online via their website. I am actually surprised that when skin stories are written, more often than not, no one has bothered to check the credibility of the "expert". In the case of a UK trained dermatologist, the date of entry onto the specialist register can be viewed. And the key here is the specialist register. Any qualified doctor will be on the main register. A fully qualified GP will be on the main and GP register. A fully qualified specialist will be on the main and specialist register. In theory, it's simple.

The skin is a forgiving organ. Mistakes with skin will rarely kill you unlike mistakes with the heart or the brain. The skin is also a lucrative organ. It is tied closely with beauty, outward appearance, and anti-ageing. This is where things start to go wrong. An organ that is resilient to mistakes AND makes good money. Before you know it, everyone wants a piece of it and everyone thinks they are a dermatologist. It surely can't be that hard? All us dermatologists do is prescribe creams, right?

Wrong.

Doing a weekend course does not make a specialist. One needs to understand the skin in health and disease. The skin needs to be looked at in context with the rest of the human body and how it interacts with other organs. Years of experience and training give a dermatologist the edge in differentiating skin conditions that can look similar to each other. Only a dermatologist that has access to every skincare drug available can help you make the right choice on how to treat your skin problem.

I am going to give you acne as an example. There are lots of way to treat this effectively - creams, tablets, isotretinoin, light and laser devices. Any dermatologist knows that once you see scarring, certain treatments are better than others. Yet I have lost count of how many patients come to me 12 months after being seen elsewhere being sold chemical peels and light therapies that simply do not provide long term control. They have been frightened off using oral medications because of side effects. Except, conveniently, the people often doing the scare-mongering are the people that have little or no experience in prescribing these medicines that can be used in a safe manner under true expert guidance.

Our job as dermatologists is not to sell treatments. Our skill comes from a deep understanding of skin and the ability to have a meaningful discussion regarding all treatment options, not just the new laser device that has received good PR in last night's tabloid.

When it comes to skin, why mess about? It makes me upset and angry in equal measures to see patients present to clinic with delayed treatment as they have been badly advised.

Checking the register is easy. If you want genuine, quality skincare advice, then a dermatologist is who you need. And don't assume that fancy titles and fancy websites mean your specialist is who they say they are. Look your doctor up and if you cant find them on the register, then ask why. Is it for a simple reason such as training abroad? Or is it because they never formally trained in skin the first place?

Knowledge is power. Look your doctor up and beware of misleading titles that say very little. And back to where I started, don't assume everyone that is quoted in the media truly is a specialist.

And why does it matter to me? Firstly, it is a probity issue. It is a privilege to treat people and I like to think that most people in caring professions are honest. It is not sufficient to leave medical training, do a day "learning skin" and then market yourself as an expert. We all know expertise comes from training and experience. Secondly, it is dangerous. I hear of patients coming to NHS cancer clinics having had moles removed by laser for aesthetic reasons in private high street clinics without a dermatologist. How does the practitioner know they are not burning away a melanoma, the most serious type of skin cancer? People that treat skin must learn to work within their remits, and have an understanding of the potentially grave consequences of their mistakes.

So my advice is learn to question your doctor or specialist. Be satisfied that they are indeed qualified to treat what they say they are. A good starting point before agreeing to expensive treatments, particularly on the high street or in the private sector, is to check the General Medical Council Register. All doctors that have completed specialist training in the UK will appear on this. It is easily available online and all that is required is the name of the individual performing treatment. And the moral of the story? Beware of anyone doing anything to your skin without asking them if they are indeed qualified to do so.

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