Dermatology has come a long way since it hung out in the syphilis ward. A relatively new specialty, dermatology has established itself in the cultural and consumer consciousness as never before. And it was the drive for beauty that put it there.
This is new though. Up until the 1950s, dermatology’s primary focus was on venereal diseases because of the unsavory havoc they wrought on the skin. As a branch of medicine it lingered rather low on the totem pole and not something to be discussed in polite company.
Mid-century in the Western countries, dermatology as a specialty separated from venereology. Its main focus then was chronic conditions like psoriasis and acne, two of the more formidable opponents we in the skin business still face today.
As for skin cancer, sun tanning didn’t start becoming fashionable until after 1920 when Coco Chanel got accidentally sunburnt while vacationing on the French Rivera, declared it de rigueur and launched an industry. It took awhile to catch on – delayed in part by the Great Depression and World War II – but during the post-war era, tan and toasty became erroneously synonymous with happy and gorgeous. For dermatologists, of course, tanning became synonymous with an exponentially higher number of skin cancer patients.
Flash forward to a recent online blind survey published by the American Society for Dermatologic Surgery where a full 30 percent of consumers reported that they are considering a cosmetic skin procedure and named dermatologists as the greatest influence for their decision. In fact, dermatologists exhibit a greater influence on this decision than friends, physician referral or 11 other choices, they said. So what happened to bring dermatology to the forefront?
Cosmetic dermatology happened, that’s what, and with it came a major paradigm shift.
As for me, back 1989 whilst in medical school, I wavered between specializing in either internal medicine or gynecology. It was my med school roommate who suggested that dermatology would make a perfect fit because it combined both medicine and surgery. It did and I was hooked.
At the same time, three technological breakthroughs launched a stroke of good fortune that amazes me to this day because my connection with them was so instinctive. They, in turn, helped build my career. Cosmetic dermatology’s mighty triumvirate – laser and light-based technologies, injectables and topical medication breakthroughs – ushered in new, non-invasive ways to relieve previously unsolvable skin problems like birthmarks, wrinkles and persistent signs of aging. And as these various products, devices and treatments became more sophisticated, so did we.
For example, the first ruby and pulse-dye lasers were used to remove red or brown birthmarks. It didn’t take long for practitioners to notice that the laser-heated skin ended up looking firmer, smoother and younger because it triggered new collagen growth. It didn’t take long then for lasers became instruments of rejuvenation in and of themselves. Today, it is in the various combinations of devices (which now include ultrasound and radiofrequency in addition to light), injectables and topicals that give us the extraordinary breadth of available solutions we have today.
The final piece of the awareness puzzle finally got put into place by the media in the 2000s. Thanks to television programs such as Extreme Makeover and many others, consumers saw up close and personal what and how cosmetic dermatologists could work wonders on the skin. With enhanced awareness, the more people saw about dermatology, the more they wanted the improvements for themselves.
Today this translates into ASDA findings that conclude, “Consumers gave the highest overall satisfaction rates to cosmetic procedures that are performed by dermatologists more often than by other practitioners – such as injectable wrinkle treatments (92 percent) and injectable filler treatments (92 percent).”
In terms of desire and possibility, dermatology has changed the face of faces for millions of people. That’s how my personal cri de coeur came about; “Life happens, but it doesn’t have to show on your skin.”
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