Study: Dermatologists most qualified for skin cancer, cosmetic procedures

Primary care physicians say dermatologists are better qualified than other specialists to perform skin cancer surgery as well as a variety of cosmetic procedures, according to a new study published in the October Dermatologic Surgeryjournal.

The study, supported by a Cutting Edge Research Grant from the American Society for Dermatologic Surgery (ASDS), found a majority of primary care physicians choose dermatologists as the best trained to do the following:

• Perform skin cancer surgery.
• Treat skin wrinkles with injectable neuromodulators such as Botox and Dysport
• Rejuvenate skin with dermal filler injections such as Restylane, Juvederm and Radiesse.
• Use lasers for cosmetic treatments as well as removal of hair and tattoos.
• Evaluate and biopsy a worrisome lesion on the skin.

“The majority of primary care physicians recognize the expertise of dermatologists in these areas because of the large volumes of these procedures they perform,” said lead author Dr. Omar A. Ibrahimi, director of the Connecticut Skin Institute in Stamford, Conn., and Visiting Assistant Professor at the Wellman Center for Photomedicine at Massachusetts General Hospital. “They also recognize the innovations that dermatologists have made in skin cancer surgery, laser procedures as well as injectable cosmetic treatments.”

The study asked 561 physicians in primary care, family medicine and internal medicine residency programs in the United States to select who are the most qualified to perform different cutaneous cosmetic and surgical procedures: dermatologists, plastic surgeons, otolaryngologists (ear, nose and throat specialists) or ophthalmologists.

As suspected, study respondents said dermatologists are the best qualified to evaluate and biopsy a worrisome lesion on the skin (95 percent) and perform skin cancer surgery (56 percent). By almost a 3-to-1 margin, respondents said dermatologists also are the best trained to perform laser treatments for cosmetic treatments, hair removal, tattoo removal and birthmarks.

Almost two-thirds of respondents also chose dermatologists over plastic surgeons as the most qualified to perform cosmetic procedures for wrinkles (e.g., Botox, Dysport) and skin rejuvenation (e.g., Restylane, Juvederm, Radiesse).

“Because primary care, family care and internal medicine physicians are trusted sources of information and referral for patients, it is important to understand their opinions on which specialist is the optimal provider for specific procedures,” said Dr. Ibrahimi. “We also wanted to see how dermatologists compare in terms of their perceived expertise for cutaneous surgery and cosmetic procedures because of the overlap with other surgical subspecialties.”