Surgical Dermatology by Toby Nelson

What is surgical dermatology?

Surgical dermatology, also called dermatologic or derm surgery, is the diagnosis and surgical management of skin lesions including skin cancers.

What is a dermatologic surgeon? Are they plastic surgeons?

A dermatologist surgeon or dermatologic surgeon is a consultant dermatologist who has undergone additional training to perform skin surgery under local anaesthesia. Dr Nelson has trained and worked in areas of the UK and New Zealand which have some of the world’s highest incidence of skin cancer, gaining extensive experience in the surgical management of skin cancer. Dr Nelson has performed thousands of dermatological procedures.

A plastic surgeon has had far greater training in advanced skin reconstruction. Plastic surgeons are able to operate under general anaesthetic as well as local anaesthetic. Unlike dermatologic surgeons though they typically have not undergone as much training or have the same experience in skin lesion recognition. Dermoscopy, for instance, is used by all dermatologic surgeons and is mandated by national guidelines when examining skin lesions. Dr Nelson works closely with senior plastic and reconstructive surgeons and is aware when his patients are best cared for by one of these colleagues. Dr Nelson receives referrals from plastic surgeons especially around tricky facial skin cancers where Mohs micrographic surgery is needed.

If you are having a skin lesion removed by a doctor, ensure they have undergone extensive skin lesion recognition and have also had formal surgical training. Ensure they look at your lesion with a dermatoscope. If they do not, ask them why not