Dermatologist
Photo by Raphael Lovaski on Unsplash

A strong doctor-patient relationship can make all the difference when skin concerns pop up. If you feel comfortable with your dermatologist, you’re more likely to be honest with them about your issues, which can help them provide you with better care. This sort of trust can be especially helpful when it comes to chronic conditions that can also take a toll on your mental health, such as eczema or acne.

“You’re going to be seeing a lot of your dermatologist when you’re dealing with these types of ongoing issues, which tend to require a certain level of maintenance and regular appointments,” Corey Hartman, MD, an assistant clinical professor of dermatology at the University of Alabama School of Medicine, tells SELF. With all that face-time, it’s important that you feel at ease with your doctor.

“We know that conditions such as psoriasis and eczema can be correlated with increased anxiety and depression, making it more important than ever to have a relationship with your dermatologist,” Mona Gohara, MD, an associate clinical professor of dermatology at the Yale School of Medicine, tells SELF. 1,2 “You [should] feel like you’re not only getting a medical solution, but also some type of emotional comfort.

All that said, finding a dermatologist who you click with and who can also deliver the empathetic treatment you deserve may be easier said than done. For starters, there really aren’t that many skin doctors out there. Dermatologists account for only about 1% of physicians in the US; it’s an extremely competitive field because the number of residency spots is limited to only about 500 per year, Tiffany J. Libby, MD, a clinical assistant professor of dermatology at Brown University, tells SELF.

Dermatologists tend to be concentrated in larger metropolitan areas as well, making the pickings even slimmer for people who live in smaller cities or rural towns, Dr. Hartman says. Still, no matter where you are or what type of access to medical care you have, you have options. Here are some of the most important things to consider as you start the search for a dermatologist you love.

1. Start with word-of-mouth recommendations.

According to Dr. Libby, getting a referral from a friend, family member, or even your primary care physician is the best place to start your hunt for the right dermatologist. “You’ll know that you can trust their opinion, unlike simply reading online reviews, which aren’t always entirely transparent,” she points out. Googling can provide you with basic information about a doctor, but turning to your PCP or other people you trust first is almost like using a matchmaker; they’ll have a better understanding of what you’re looking for and can provide more nuanced recommendations, Dr. Gohara says.

2. Take advantage of large organizations.

If you don’t have a PCP, another doctor, or anyone else you can ask for a referral, hit the internet—but be strategic. Major dermatologic societies, such as the American Academy of Dermatology and the American Society of Dermatologic Surgeons, typically offer directories of their members, with filters that allow you to search according to geographic location or specialty, Dr. Hartman says. (That’s an especially helpful feature if you want someone with expertise in your particular skin condition. Not to mention that these directories are a foolproof way to make sure that any derm you find is credible and board-certified.)

You can also look for societies associated with certain skin diseases, Dr. Gohara suggests. There’s one for almost all of the major ones—the National Eczema Association, the National Psoriasis Foundation, the American Acne and Rosacea Society, and the list goes on. Many of these organizations have online directories, and you can also call or email them via their posted contact info to get a list of dermatologists who specialize in the particular issue you’re dealing with, she points out.

Once you have the name(s) of a dermatologist you’re considering, simply scoping out their online bio can tell you a lot about them, Dr. Gohara says. This includes their education and training, areas they specialize in, societies they’re a part of, as well as any other interests they may have, Dr. Gohara adds. A bio will also often have a photo, which can sometimes be helpful for this next tip….

3. Consider cultural competence.

“We know that racially concordant visits, where the patient works with a doctor who shares their racial identity, result in better health outcomes across the board, and that can be especially true in dermatology,” Dr. Gohara says.3 “Racial concordance helps you relate to more than just what’s happening in the exam room because you can literally see yourself in that person.” Patients often feel more heard and better taken care of when they can connect to their doctor in this way, Dr. Libby says, adding that many of her AAPI patients have told her they chose her because they felt she’d better know how to take care of their skin since she’s Asian American.

Cultural competence is incredibly important, too, because you want a dermatologist who understands how certain cultural practices may affect treatments and protocols, Dr. Libby says. She cites hair loss in Black women as a common situation where this comes up. “If the dermatologist is debating between prescribing a topical cream versus an ointment, there has to be an understanding of the type of hair the patient has, how often they’re washing it, and if they’re wearing a wig, for example,” she explains. A doctor’s awareness of these kinds of factors may not only influence whether or not someone sticks with a treatment plan, but it can also create a more supportive environment; people may feel more comfortable opening up to a dermatologist who better understands their identity.

Perhaps the biggest barrier to culturally competent care? Diversity among dermatologists is lacking—dramatically. “Only about 3% of dermatologists are Black, as compared to over 13% of the general population, and only about 4% are Hispanic, compared to over 18% of the population,” Dr. Libby says.

There’s also a diversity deficit when it comes to the training dermatologists receive, although Dr. Hartman notes that there is a promising movement toward correcting this problem—by making educational texts and images more inclusive and representative, for example. This is really important because it’s not so much that skin conditions are inherently different in people of different races, but that they may not show up in the same way. “With diseases such as psoriasis and eczema, the presentation is different. They don’t look the same in someone with darker skin as they do in people with lighter skin,” he says. “If the dermatologist isn’t tuned into that, they can easily miss a diagnosis or misdiagnose something.

The hopeful news: Though it may require a little more leg work, there are resources to help you find a doctor who shares your racial identity and/or understands your cultural practices. Dr. Hartman recommends the Black Derm Directory and the Skin of Color Society, both of which offer a national database of dermatologists that you can search by both geographic area and specialty. Once you hone in on a particular doctor or practice, you can always call to inquire further about their cultural competency or how well-versed they are in skin of color.

If you can’t find a doctor you can relate to—which might be tricky if you live somewhere where there aren’t a ton of dermatologists to begin with—you may want to consider looking for someone who shares your gender identity, Dr. Gohara says. (Research suggests that women, in particular, tend to be more satisfied with their care if their doctor is also a woman.)

4. Look into teledermatology.

It’s certainly not a magic solution for every scenario, but teledermatology has increased accessibility to dermatologists for a lot of people. “There are many instances where a teledermatology consult will be useful. For example, if you’ve already been diagnosed with acne and it’s worsening, a virtual visit can be good for exploring alternative treatment options,” Dr. Libby says. “And they’re also good for assessing issues that pop up suddenly.” (Think: You woke up with eyelid eczema or some other unexplained rash.)

But there are a lot of limitations too; even though dermatology is a visual field, a photo or video often doesn’t cut it for diagnosing certain conditions, as doctors want to be able to feel the skin, Dr. Libby cautions. (FYI, teledermatology definitely can’t be used to diagnose skin cancer.) The cost per visit will vary, too, as some teledermatology providers offer memberships (where you pay a flat monthly or annual rate), others take insurance, etc. In related news…

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5. Think outside the box if you don’t have insurance.

You can always ask the dermatologist’s office if they accept self-pay patients. “Many derms will be willing to accommodate your financial situation if you don’t have insurance,” Dr. Gohara says. “They may even reduce the cost of services or offer some type of payment plan.” You can also look for free health clinics or pop-ups. These can be community-based, and many universities also offer them and set up satellite offices once or twice per month, Dr. Hartman says. (To find one, start by calling any college or university in your area, asking your PCP or another doctor, or even contacting a local urgent care center.) Just keep in mind that these types of clinics are usually in very high demand and hard to get into—not an ideal situation if you’re going to need continued follow-ups, Dr. Libby says.

6. Make the most of any appointment.

No matter which route you take to find your dream derm, you’ll want to maximize your time with them by getting a sense of their personality and treatment style. “The general ‘vibe’ you feel and if you like them is important, but you’ll also want to make sure that everything is thoroughly explained to you,” Dr. Gohara says. “At the end of the visit, they should ask you if all of your questions have been answered and if you have any more. The goal is to leave not only feeling like you’ve been heard, but also that you have a good understanding of what happened during the appointment and what comes next.

At the end of the day, there needs to be some wiggle room between simply liking your doctor as a person and knowing that they’re going to adequately address your concerns. “It’s great if your personalities completely jibe and it’s someone you feel like you could hang out with, but you also need to make sure that they’re going to be the best person to treat your skin issues,” Dr. Gohara says. ‘Liking’ someone can mean that you think they’re a great human, or it can mean that you ‘like’ them because they’re great at clearing up your skin, she adds. In the ideal scenario, you’ll find the right balance where you get the best of both worlds—a derm whom you click with personally and whose professional expertise can help solve your skin woes.

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