Medical dermatology diagnoses and treats conditions of the skin, hair and nails, such as acne, eczema, psoriasis, a rash or a mole that has changed, and it is usually billed to your health insurance. Cosmetic dermatology covers elective treatments that change how your skin looks, such as Botox or fillers, and insurance does not pay for them. You do not need separate doctors for each: dermatology training covers both, and many practices, including Bay Ridge Dermatology, offer both under one roof.
Below is a side-by-side look at the two, how insurance generally treats each, and an honest list of what Bay Ridge does and does not offer.
Medical dermatology: diagnosing and treating skin, hair and nail conditions
Medical dermatology is about health. The goal is to find out what is going on with your skin, hair or nails, treat it, and keep it under control. Some problems clear up in a visit or two. Others, like eczema or psoriasis, are long-term conditions that need a plan you can live with.
A medical visit might include:
- A skin exam and questions about your health history
- A biopsy, where a small sample of skin is sent to a lab
- Prescription creams, pills or injections
- Light therapy for conditions such as psoriasis or vitiligo
- Follow-up visits to see how treatment is working
Cosmetic dermatology: elective treatments for appearance
Cosmetic dermatology is about how your skin looks. These treatments are elective, which means you choose them because you want a change, not because a condition needs treating. Common goals include softening lines, restoring lost volume, refreshing skin texture or reducing unwanted hair.
Cosmetic treatments are still medical procedures. The person doing them should understand how skin heals and how it reacts across different skin tones. Results depend on your skin and the treatment, and individual results vary.
Do you need separate doctors for medical and cosmetic care?
No. Dermatologists are trained to diagnose skin disease and to perform procedures, and many dermatology practices offer medical and cosmetic care in the same office. Having both in one place has some practical advantages:
- The person treating your skin cosmetically can also recognize a medical problem, such as a spot that should be checked before anything is done to it.
- Conditions like acne or rosacea can be treated medically first, so a cosmetic treatment is not working against an active skin condition.
- Your history, medicines and allergies are in one record.
What matters more than the label on the door is who performs each treatment and what training they have. It is reasonable to ask that before any procedure, at any practice.
Where they overlap: acne, rosacea and pigment concerns
The line between medical and cosmetic is not always sharp. A few common examples:
- Acne. Active acne is a medical condition, and treating it is medical care. Marks or scars left behind after acne clears are often treated as a cosmetic concern.
- Rosacea. Rosacea is a long-term medical condition that causes flushing, redness and bumps on the face. Treating it is medical care. Some practices also use light or laser devices for leftover redness, which is usually considered cosmetic.
- Pigment. Some pigment problems, such as vitiligo or melasma, are medical conditions a dermatologist diagnoses and treats. Sun spots (also called age spots) are usually harmless, and fading them is generally considered cosmetic. A new or changing dark spot should still be checked first.
- Moles and skin tags. Removing a harmless skin tag or mole because you don't like how it looks is cosmetic. Checking a mole because it has changed is medical.
Whether something counts as medical or cosmetic usually comes down to why it is being done. That is also what drives insurance.
Insurance: how coverage generally works
In general, health insurance pays for care that is medically necessary, meaning it diagnoses or treats a condition. Your share depends on your plan, including copays, deductibles and whether a treatment needs approval ahead of time. Cosmetic treatments are not covered by insurance, and neither is hair restoration, so you pay for those yourself.
Bay Ridge Dermatology accepts most insurances, including Aetna, BCBS, Cigna, United, Medicare, Oxford, Empire and Humana. Coverage for a specific service depends on your plan, so check with your insurer or call the office before your visit. You can also read the practice's insurance information.
One example worth knowing: XTRAC, an FDA-cleared excimer laser for psoriasis, vitiligo and atopic dermatitis, is a medical treatment and is covered by most insurances. Your own plan's coverage still needs checking. Read more about XTRAC laser treatment.
If a single visit includes both a medical concern and a cosmetic request, ask how each part will be billed before any treatment starts.
What Bay Ridge offers on each side, and what it doesn't
Medical. Bay Ridge's medical dermatology care covers acne, eczema and atopic dermatitis (from infants through seniors), psoriasis, rosacea, vitiligo, hyperhidrosis (heavy sweating), warts, rashes, pigment disorders, hair and nail disorders, skin infections and autoimmune skin conditions. The practice also offers full-body skin cancer screenings, XTRAC laser treatment, and in-office procedures such as shave biopsies, cyst drainage and wart removal.
Cosmetic. Bay Ridge's cosmetic services include Botox, dermal fillers, PRP (platelet-rich plasma) for facial rejuvenation, IPL (intense pulsed light) for hair reduction, gentle chemical peels with no downtime, and cosmetic removal of skin tags and moles. If you are weighing a cosmetic treatment, you can start with a cosmetic consultation to talk through your goals and options.
What the practice does not offer:
- Laser treatment for pigmentation, including sun spots and melasma. IPL at Bay Ridge is used for hair reduction, not to fade dark spots or redness.
- Deeper TCA chemical peels. The peels offered are the gentle, no-downtime kind.
Pigment disorders are still part of Bay Ridge's medical care. Vitiligo, for example, can be treated with XTRAC. The practice simply does not offer laser treatment to fade sun spots or melasma.
When to see a dermatologist before trying a cosmetic fix
Some changes should be checked medically before you cover them, fade them or have them removed:
- A spot or mole that is new, changing, itching, bleeding, or looks different from your other spots
- A dark patch that is spreading, or patches of skin losing their color
- A rash that won't settle, or keeps coming back
- Facial redness, bumps or flushing you have been treating as "sensitive skin"
- Sudden hair shedding, bald patches, or changes in your nails
A cosmetic treatment can make a skin condition look better for a while without treating its cause, and some can irritate it. A diagnosis first means any cosmetic step that follows starts from the right plan.
Whether your question is medical, cosmetic or a bit of both, you can book online or call (347) 497-4984.
This article is general information, not medical advice. For advice about your own skin, see a dermatologist.