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How to know when it's necessary to see a dermatologist.

Image: iStock.

We all have a pretty good idea of when it’s time to see the doctor — the appearance of unusual symptoms or feeling generally unwell are obvious indicators.

Knowing when to arrange an appointment with a dermatologist, on the other hand, might seem less straightforward. Are there any telltale signs a dermatologist is required? Do you just book straight in? Should you see a doctor first?

To answer those questions, it’s worth knowing exactly what a dermatologist does — and how their expertise differs from a doctor’s.

What does a dermatologist do?

“Dermatologists are skin specialists, and we specialise in everything to do with the skin, hair and nails. So we are the group that understands that part of the body the best,” explains Dr Michael Freeman, a dermatologist from The Skin Centre.

That said, patients in the Australian healthcare system are encouraged to have a referral from their general practitioner in order to have a consultation with a dermatologist because they’ll then get a rebate through Medicare.

Commonly, a GP will know exactly how to treat a skin symptom or “eruption” — a simple rash, for instance — and there won’t be the need for a dermatologist. But not all cases will be so straightforward.

Watch: Mia Freedman answers reader questions about having pigmentation laser treatment. (Post continues after video.)

“It’ll be in those situations where the GP is perplexed because they haven’t seen this rash or know what to do, and it would be appropriate for them to refer to the dermatologist,” Dr Freeman says. “We’re talking rashes, skin cancer concerns, and cosmetic concerns like acne that’s not settling, for example.”

A GP might also suggest their patient sees a dermatologist is when they’ve made several attempts to fix the skin symptom, to no avail.

Another example of when a dermatologist’s opinion would be valuable is when a patient has skin cancer concerns — particularly if they’ve consulted with a skin cancer clinic and have been told they might need to cut out an affected area.

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“In that situation the dermatologist could be very helpful because we may be able to give a clinical opinion that might be able to avoid cutting in those areas, which means avoiding pain,” Dr Freeman says, adding that staff in these clinics don’t have the same training as dermatologists.

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Experiencing an unusual skin symptom? See your doctor first. (iStock)

Is a dermatologist always the go-to for skin conditions?

One of the main areas of confusion for patients is realising exactly when a dermatologist is needed — especially as there are some areas of overlap.

"A lot of people know they might need to see a specialist if they're not getting better with a GP, but they might not know the dermatologist is the skin specialist," Dr Freeman explains.

For instance, he says, plastic surgeons often cut out skin cancers — but this doesn't mean they have the training to determine whether or not that procedure is necessary in the first place.

In situations where they've consulted a GP regarding a skin condition, patients might also be unaware that there's a next step available.

"If you've had a rash or an eruption and the GP has given you a cream but it hasn't worked, you could consider making a polite suggestion... say to your GP, 'Do you think that given these two creams have not worked, it would be appropriate now to have a referral to a dermatologist?'" Dr Freeman suggests. (Post continues after gallery.)

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Should you ever go straight to a dermatologist?

In some instances, it can be necessary to consult with a dermatologist in the first instance.

Dr Freeman explains that babies with vascular birthmarks sometimes require urgent, early treatment with a laser — and only a dermatologist with the appropriate laser would be able to do this. Some GPs mightn't be aware that this is an option.

"They're expected to be experts in every field, and to be honest it's not very fair because there's so much knowledge in medicine now that there might be a gap in the GP's knowledge," he says.

"They might [have] been taught that a strawberry birthmark will go away so you don't bother treating them."

Skin signs of a health condition
Some dermatologists have the laser equipment to treat acne scars. (iStock)

Similarly, if you have acne scars or other cosmetic concerns that can be treated with a laser, a dermatologist trained in that treatment might be the best expert to talk to.

"Often it may not be neccessary for the cosmetic consultation to have a referral from a GP, because those [laser] treatments would be outside of Medicare," Dr Freeman explains.

How do you find a dermatologist?

The Australasian College of Dermatology website has a function that allows you to locate dermatologists by locality or specialty.

Dr Freeman warns that some skin cancer doctors label themselves as dermatologists, but don't have the required qualification.

"They do it because they have a 'special interest' in dermatology, and if you read closely usually the words are couched that way. But the reality is they're not specialists," Dr Freeman says.

"Usually the best way to ascertain whether you are with a true specialist is to say, 'Are you regarded by the Government as a medical specialist?'"

Have you ever seen a dermatologist?

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