A general dermatologist who sees children can diagnose and treat eczema in babies, kids and teens, and many families never need a pediatric dermatologist. A pediatric dermatologist is a dermatologist with extra training focused on children's skin. Seeing one, often at a children's hospital or academic medical center, can make sense in specific situations: a very young baby with widespread eczema, repeated skin infections, a rare or inherited skin condition, or a procedure that needs sedation. Your child's pediatrician can help you decide, and can send a referral if your insurance plan requires one.
The short answer: which fits when
- A general dermatologist who sees children is a reasonable first choice for typical eczema, including eczema that is moderate, flares often or keeps a child up at night.
- A pediatric dermatology or children's hospital clinic is worth considering when eczema is unusual, severe in a young infant, complicated by frequent infections, or comes with other conditions that need specialized care.
What a pediatric dermatologist is
HealthyChildren.org, from the American Academy of Pediatrics, describes a pediatric dermatologist as a medical doctor who completes dermatology residency training (sometimes after pediatrics residency) and then a one-year fellowship in pediatric dermatology, caring for children from birth through adolescence. The Society for Pediatric Dermatology (SPD) describes the added training as centered on skin diseases that are more common in children or occur only in children. Board certification in pediatric dermatology is a subspecialty certification, and the SPD notes that a doctor must first be board certified in general dermatology to qualify for it.
Pediatric dermatologists treat everyday problems like eczema, warts and psoriasis, along with less common ones such as certain birthmarks and inherited skin disorders. HealthyChildren.org notes that they practice in children's hospitals, university medical centers, community hospitals and private offices.
One tip if you search the SPD's online directory: the SPD notes that it lists all active physician members, and not everyone listed is a pediatric dermatologist. Check a doctor's training or board certification before assuming they have pediatric fellowship training.
What a dermatologist who sees children typically manages
Dermatologists train in conditions of the skin, hair and nails across every age group, and eczema (atopic dermatitis) is a core part of that work. A dermatologist who sees children commonly treats:
- Eczema, from mild dry patches to flares that disrupt sleep
- Rashes, including ones that look like eczema but turn out to be something else
- Warts
- Acne in preteens and teens
- Skin infections, including ones that start in scratched eczema skin
- Hair and nail problems
For eczema, that care usually means confirming the diagnosis, setting up a bathing and moisturizing routine, spotting triggers, prescribing medicine when it's needed, treating infections and adjusting the plan as your child grows. Steady routines help many children, though flares still happen, and individual results vary.
When a pediatric dermatology or children's hospital clinic may help
A specialized pediatric clinic tends to make the most sense when a child's needs go beyond typical eczema care. Examples include:
- A very young infant with widespread eczema, especially if it isn't responding to treatment
- Frequent or serious skin infections, such as repeated infected flares or a past episode of eczema herpeticum, a skin infection from the virus that causes cold sores
- A rare or inherited skin condition, or a diagnosis that still isn't clear after several visits
- Birthmarks that need specialized care; HealthyChildren.org lists laser treatment of vascular birthmarks among the procedures pediatric dermatologists perform
- Procedures that need sedation or general anesthesia, which hospitals are equipped to provide
- A child who sees several specialists, such as allergy or gastroenterology, where one hospital system may make care easier to coordinate
If you're looking for a pediatric dermatologist in Brooklyn or elsewhere in New York City, the SPD's Find a Pediatric Dermatologist tool searches by ZIP code. Your pediatrician and your insurer can tell you which hospital-based pediatric dermatology clinics are in your plan's network.
Your pediatrician's role
Your child's pediatrician is usually the first stop for a new rash. Pediatricians treat mild eczema, know your child's overall health, and can answer related questions about food allergies or asthma. They can also suggest which specialist fits and send a referral.
Referral rules come from your insurance plan, not from the dermatologist. Check your plan or call the office before the visit. Our post on whether children can see a dermatologist for eczema explains how pediatricians and dermatologists share care.
Side by side: what differs
Training
- General dermatologist: medical school, internship and dermatology residency. A board-certified dermatologist has also passed the specialty board exam.
- Pediatric dermatologist: the same path plus a pediatric dermatology fellowship, and often a subspecialty board certification.
Scope
- General dermatologist: common skin, hair and nail conditions at every age, including eczema, acne, warts and skin infections.
- Pediatric dermatologist: the same common conditions in children, plus rare, inherited and complex conditions and specialized birthmark care.
Location and travel
- General dermatologist: often in neighborhood practices, which can mean a shorter trip for follow-up visits.
- Pediatric dermatologist: frequently based at children's hospitals or academic centers, which may mean more travel.
Scheduling
- Availability varies for both. Ask each office how soon a new child patient can be seen, and whether there is a cancellation list.
Continuity
- General dermatologist: a practice that sees all ages can keep treating your child into adulthood, and can see parents and siblings too.
- Pediatric dermatologist: care centers on childhood and the teen years, so older teens eventually move to an adult dermatologist.
Urgent signs that need prompt care
Whichever kind of dermatologist you choose, some eczema problems shouldn't wait for a routine appointment. Contact your child's pediatrician or dermatologist the same day, or get urgent medical care, if you notice:
- A fever along with the rash, or your child seems unwell
- Painful blisters or open sores that spread quickly, which the American Academy of Dermatology (AAD) notes can be a sign of eczema herpeticum
- Oozing with yellow or honey-colored crusts, or pus
- Redness, warmth or swelling that keeps spreading
For infants under 3 months old, any fever of 100.4°F (38°C) or higher means calling the pediatrician right away. If a child is struggling to breathe, is hard to wake or seems very ill, call 911.
Eczema care for children at Bay Ridge Dermatology
Bay Ridge Dermatology cares for patients from childhood through older age. Its medical dermatology care covers eczema (atopic dermatitis) in infants, children, adults and seniors. Dr. Evangeline Perez is a board-certified dermatologist with more than 20 years of experience. Mandarin and Cantonese care is available with Kerry Ly, PA-C; ask for her when booking and confirm she can see your child.
If your child's needs point toward a pediatric dermatology or hospital clinic, ask the office about next steps. The practice accepts most insurances, including Aetna, BCBS, Cigna, United, Oxford, Empire and Humana. Check your specific plan for coverage and referral rules.
When to see a dermatologist
Book a dermatology visit if your child's eczema:
- Hasn't gotten better after several weeks of gentle care plus whatever the pediatrician recommended
- Keeps them up at night, or affects school, sports or mood
- Flares often or covers large areas
- Might not be eczema at all
- Raises questions about using prescription creams safely
For babies, our guide to baby eczema and when to see a dermatologist covers what to watch for.
If you'd like help building an eczema plan for your child, 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.