All good medical treatments begin with a thorough evaluation, and this is certainly true for quality dermatology care. The skin is the body’s largest organ, and healthy skin is important for overall health and well-being. Skin doctors perform medical dermatology evaluations to examine patients’ skin and develop treatment plans for a wide variety of skin conditions, skin infections, and diseases.
Many skin conditions can look and feel very similar, which makes some skin problems difficult to evaluate and diagnose. Dermatologists use a variety of techniques and tools to look for skin problems, evaluate their severity, and develop treatment plans.
During a medical dermatology evaluation, the dermatologist will examine the patient’s skin carefully. The location, appearance, and pattern of a rash or other skin problem provide the dermatologist with important information about its causes. The dermatologist may ask questions about the symptoms, such as when the symptoms appeared, what parts of the body they affect, and whether the symptoms are persistent or come and go.
The doctor may ask if there are any noticeable patterns about when the symptoms appear, such as during certain weather, when the patient uses certain perfumes or products, or after exposure to certain fabrics or metals.
The dermatologist may discuss the patient’s family history to determine if a relative has been diagnosed with an inherited skin condition, such as skin cancer, lupus, acne, psoriasis, hives, warts, and carbuncles.
Skin doctors may also ask patients about any personal hygiene products they use. Many cosmetics, soaps, and moisturizers contain irritating ingredients that can cause certain skin conditions, such as dermatitis and eczema. Dermatologists can also recommend non-irritating, fragrance-free products that contain low levels of preservatives that can irritate skin.
There are no special preparations for a dermatology evaluation, except the patient should not wear makeup or fingernail polish. Patients should wear their hair loose, as a full-body dermatology evaluation includes an examination of the scalp.
For a full body evaluation, the patient will remove all their clothing, but they can wear a gown. Those who feel uncomfortable being undressed in front of their provider may request that a nurse be in the room during the exam.
The dermatologist will examine the patient’s skin from head to toe, including the scalp, behind your ears, fingers, buttocks, toes, and genitals. While some patients may feel embarrassed during the exam, it is important to check all of the skin, as skin cancer can occur anywhere on your skin. The skin doctor may use a special magnifying glass with a light to look at certain areas of skin. The entire exam should take only 10-15 minutes.
If the dermatologist finds a mole or other mark on your skin that looks like it might be a sign of cancer, the skin doctor may recommend a biopsy to help make a diagnosis. A skin biopsy is a procedure in which the dermatologist removes a small sample of skin to send to the laboratory for testing. There, technicians will look at the skin sample under a microscope to check for cancer cells. If the skin shows signs of benign cancer, which is a type of cancer that can grow but not spread to the rest of the body, the dermatologist may discuss the removal of benign skin cancer.
Dermatologists can evaluate specific areas of the skin too. They can perform evaluations of scars, for example, to determine the cause and treatment of scars resulting from acne, trauma, or other causes. Skin doctors use scar assessment scales and measurements to evaluate scars and develop treatments to prevent excessive scarring, inadequate scar formation, and exaggeration of the edges of the scar, such as those that often form after burn injuries.
Dermatologists also assess rashes and skin allergies. The skin doctor may recommend a patch test to evaluate rashes and allergies. The patch test involves the placement of small patches, which look like adhesive bandages, on the skin. The patch contains tiny amounts of substances that cause allergies, known as allergens. The patient will wear the patch for 48 to 96 hours, at which time the dermatologist will remove the patch and examine the skin for skin reactions that indicate allergies. Rash evaluation may also include a skin biopsy and/or a blood test.
Dermatologists are experts in evaluating hair loss. During the exam, the dermatologist will check the scalp for inflammation, sores, redness, or scarring. The doctor looks closely at the patient’s hair to evaluate how much hair the patient is losing, the pattern of the hair loss, and determine whether the hair is breaking.
The skin doctor may also perform tests to learn more about the health of the patient’s hair, such as the pull test and tug test. In the pull test, the dermatologist tugs at a section of about 40 hairs and counts how many hairs fall out. In the tug test, the skin doctor uses both hands to grasp a section of hair, with one hand at the scalp and the other at the tip; the dermatologist then tugs at the strands to see if they break in the middle. They can also run tests that look for fungus in the hair or scalp, or perform biopsies on hair follicles or the scalp to evaluate hair loss.
For more information on medical dermatology evaluations, consult with a dermatologist.