Many people assume that dermatologists only focus on prescribing creams, recommending skincare routines, or offering non-invasive treatments such as chemical peels, facials, and laser therapies. While these services certainly make up a large part of a dermatologist’s day-to-day work, the reality is far more extensive and impressive. Dermatologists are not just “skin doctors” who deal with rashes or acne they are fully qualified medical doctors who have undergone years of rigorous training in both medicine and surgery. Their education equips them to diagnose, treat, and even operate on a wide range of skin, hair, and nail conditions.
In fact, surgery is an integral part of modern dermatology. Dermatologists are uniquely trained to combine deep medical knowledge with precise surgical techniques, which allows them to treat conditions that range from small, harmless growths to serious skin cancers. Their surgical procedures can be as simple as removing a bothersome mole or skin tag during a quick in-office appointment, or as complex as performing a delicate skin cancer excision that requires careful reconstruction to minimise scarring and preserve appearance. Unlike many other medical specialists, dermatologists often manage both the diagnosis and the treatment, which means patients can receive comprehensive care from start to finish without needing to see multiple doctors.
What surprises many people is the sheer variety of surgical procedures a dermatologist can perform. These include excisions of cysts, lipomas, and suspicious moles, biopsies to diagnose skin diseases, laser surgeries to remove growths or improve scars, and specialised techniques such as Mohs micrographic surgery for treating certain types of skin cancer with extreme precision. Cosmetic procedures like removing benign bumps, tightening sagging skin, or improving the appearance of scars also fall within their expertise. This combination of medical and aesthetic skills makes dermatologists uniquely equipped to handle both health-related and appearance-related concerns.
In this article, I’ll explore the wide range of surgical procedures dermatologists perform, explain when they typically operate themselves, and highlight situations where they might refer patients to other specialists such as plastic surgeons. By understanding the full scope of what dermatologists can do, you’ll have a clearer picture of when to see a dermatologist for a surgical procedure and feel more confident about the care you receive.
Minor Skin Procedures
Dermatologists often carry out a variety of minor skin procedures within the clinic, allowing patients to receive effective treatment without the need for hospital admission. These procedures are usually performed under local anaesthesia, making them quick, relatively painless, and convenient for those with busy schedules. They address a wide range of concerns, from cosmetic issues to the early detection of serious conditions.
Mole and cyst removal:
Small growths such as moles, skin tags, or cysts can be carefully excised in a controlled environment. This is done to remove bothersome or unsightly lesions, prevent irritation from clothing or shaving, or rule out any risk of skin cancer. Dermatologists use precise techniques to minimise scarring and ensure the best cosmetic outcome. Local anaesthesia is typically applied to numb the area, so patients remain comfortable throughout the procedure.
Skin biopsies:
A skin biopsy involves taking a small sample of tissue for laboratory analysis. This simple yet vital procedure helps diagnose unusual rashes, persistent lesions, or suspicious moles that may require further treatment. Depending on the area and type of concern, dermatologists may use different biopsy methods such as punch, shave, or excisional biopsy. Early diagnosis through a biopsy can be life-saving, particularly for conditions like melanoma.
Cryotherapy:
Cryotherapy is a treatment where liquid nitrogen is used to freeze and destroy abnormal skin tissue. It is commonly employed to treat warts, actinic keratoses (precancerous sunspots), and other small lesions. The freezing process causes the targeted cells to die and naturally shed over time, leaving healthier skin behind. The procedure is quick and usually requires little to no downtime, with only mild redness or blistering that heals within days.
Overall, these minor dermatological procedures are designed to be minimally invasive, with a fast recovery period and minimal disruption to daily life. Aftercare typically involves keeping the treated area clean, applying prescribed ointments, and following your dermatologist’s instructions to promote smooth healing. Because these treatments are performed by trained specialists, patients can expect both safe medical care and results that prioritise comfort and appearance.
Cosmetic Procedures
In addition to treating medical skin conditions, dermatologists also perform a wide range of cosmetic procedures aimed at improving appearance and boosting confidence. These treatments focus on enhancing the skin’s look and feel, addressing concerns such as unwanted growths, uneven texture, or signs of ageing. Cosmetic dermatology combines medical knowledge with aesthetic precision, ensuring that every treatment is both safe and effective.
Excision of benign lesions:
Many people develop harmless skin growths such as moles, skin tags, or small cysts that may cause irritation or affect appearance. Dermatologists can carefully remove these lesions using minor surgical techniques. Removal may be recommended to prevent rubbing from clothing or to create a smoother, more even skin surface. Local anaesthesia is used to keep the procedure comfortable, and modern techniques help reduce scarring for a natural finish.
Scar revision surgeries:
Scars from acne, injuries, or previous surgeries can sometimes remain raised, uneven, or discoloured. Dermatologists perform scar revision to soften their appearance and blend them more smoothly with the surrounding skin. Depending on the type of scar, treatments may include surgical excision, laser resurfacing, or a combination of methods. While no procedure can completely erase a scar, revision can make it far less noticeable and improve overall skin texture.
Laser-assisted procedures:
Advanced laser technology allows dermatologists to treat a variety of cosmetic concerns with great precision. Lasers can reduce pigmentation such as sunspots or freckles, shrink visible blood vessels, and stimulate collagen production for firmer, smoother skin. Some treatments target specific issues like vascular lesions, while others focus on overall rejuvenation to achieve a more youthful appearance.
Cosmetic procedures are usually elective, meaning patients choose them to meet personal goals rather than medical necessity. Every treatment is customised to suit the individual’s skin type, concerns, and expectations. Whether removing a bothersome mole, softening a scar, or brightening uneven skin tone, dermatologists combine artistry with medical expertise to deliver safe results that look natural and balanced.
Skin Cancer Surgeries
Dermatologists are highly trained in both the diagnosis and surgical treatment of skin cancers, making them the first-line specialists for managing these conditions. Early detection is critical, and dermatologists play a key role in identifying suspicious moles or lesions through regular skin checks and biopsies. When cancer is confirmed, surgery is often the most effective way to remove the tumour and prevent it from spreading.
Excision of basal cell carcinoma and squamous cell carcinoma:
Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the two most common types of skin cancer. Although they are generally less aggressive than melanoma, prompt treatment is essential to avoid tissue damage and reduce the risk of recurrence. Dermatologists perform surgical excision to carefully remove the cancerous growth along with a margin of healthy tissue. This ensures that no cancer cells remain while preserving the appearance and function of the surrounding skin. Local anaesthesia is typically used, and the procedure is usually performed as an outpatient treatment, allowing patients to return home the same day.
Mohs micrographic surgery:
For certain cancers especially those on the face, ears, or other delicate areas dermatologists may recommend Mohs surgery, a highly precise method that offers the best balance between complete cancer removal and tissue preservation. During Mohs surgery, the visible tumour is removed in very thin layers. Each layer is immediately examined under a microscope to check for cancer cells. The process continues layer by layer until no abnormal cells remain. This meticulous technique allows for the highest cure rates while sparing as much healthy skin as possible, making it ideal for areas where cosmetic and functional outcomes are important.
Dermatologists’ dual expertise in medical diagnosis and surgical skill makes them uniquely qualified to perform these procedures. They not only remove the cancer but also plan the closure of the wound to achieve the best possible cosmetic result. After surgery, patients receive personalised aftercare instructions to promote healing and monitor for any signs of recurrence.
Skin cancer surgeries performed by dermatologists are typically outpatient procedures with high success rates and minimal downtime. Whether it involves a straightforward excision or the more detailed Mohs technique, early treatment by a specialist offers the best chance for complete recovery while preserving the health and appearance of the skin.
When Are Referrals Needed?
Although dermatologists are highly trained to diagnose and treat a wide range of skin conditions, there are situations where referral to other medical or surgical specialists becomes necessary. Referrals ensure that patients receive the most appropriate care for complex cases that go beyond standard dermatological procedures. Far from being a limitation, this collaborative approach ensures patient safety, optimises outcomes, and provides access to specialised expertise when needed.
Extensive reconstructive surgery after major skin cancer removal:
In certain cases of advanced skin cancer, particularly aggressive melanomas or large basal and squamous cell carcinomas, surgical removal may leave a significant tissue defect. Reconstructive surgery is often necessary to restore the appearance, structure, and function of the affected area. Dermatologists frequently collaborate with plastic or reconstructive surgeons to plan these procedures. For instance, a patient who has had a large facial lesion removed may benefit from a flap or graft procedure performed by a plastic surgeon to ensure the face heals naturally and symmetrically. Throughout this process, the dermatologist remains actively involved, monitoring healing and managing skin care to reduce the risk of complications.
Combined procedures requiring other surgical disciplines:
Some skin conditions or injuries may involve deeper tissues or adjacent anatomical structures. For example, complex facial skin cancers, traumatic injuries, or congenital deformities might require joint procedures involving maxillofacial surgeons, otolaryngologists, or even ophthalmic surgeons. By coordinating care across multiple specialties, dermatologists ensure that treatments are performed efficiently, safely, and with minimal disruption to the patient’s recovery. This collaborative approach often allows multiple procedures to be completed simultaneously or in a planned sequence, reducing overall recovery time and enhancing outcomes.
Ongoing coordination and follow-up:
Even when other specialists are involved, dermatologists play a central role in patient care, ensuring continuity throughout the treatment journey. They monitor the healing process, provide tailored skin care guidance, and follow up on the long-term management of skin health. This coordinated approach ensures that no aspect of the patient’s care is overlooked, whether it involves cosmetic appearance, functional restoration, or prevention of recurrence.
Holistic and patient-centred care:
Referrals also allow dermatologists to offer a holistic, patient-centred approach. By leveraging the expertise of other specialists while maintaining oversight of the patient’s skin health, dermatologists can address complex needs comprehensively. Patients benefit from a treatment plan that balances medical necessity, cosmetic outcome, and overall well-being, ensuring optimal results even in challenging cases.
In summary, while dermatologists are capable of managing most skin conditions independently, referrals to other specialists are sometimes necessary for advanced reconstructive work, combined surgical procedures, or cases involving multiple medical disciplines. By coordinating care and maintaining continuous involvement, dermatologists ensure that patients receive the safest, most effective, and personalised treatment possible.
Why Dermatologist Expertise Matters
Surgical dermatology is a specialised field that combines medical knowledge, technical skill, and aesthetic judgement. Choosing a dermatologist for skin procedures ensures that patients receive safe, precise, and effective care. Their expertise is particularly important because even minor procedures can have lasting effects on appearance, function, and overall skin health.
Precision and steady technique:
Many dermatological procedures are performed on delicate areas such as the face, neck, hands, or other sensitive parts of the body. Performing surgery in these regions requires a steady hand, careful planning, and meticulous technique. For example, removing a mole or performing a scar revision near the eyes or lips demands exact precision to avoid damaging surrounding structures while achieving a smooth, natural-looking result.
Ability to recognise normal versus abnormal tissue:
One of the key skills of a dermatologist is the ability to distinguish healthy skin from abnormal tissue. This is critical when removing growths, performing biopsies, or excising skin cancers. Accurate identification ensures that all affected tissue is removed while preserving as much healthy skin as possible, reducing the risk of recurrence or complications. Misidentification could result in incomplete treatment or unnecessary removal of healthy tissue, impacting both medical outcomes and appearance.
Understanding of healing and cosmetic outcomes:
Dermatologists are trained not only to perform surgical procedures but also to anticipate how the skin will heal over time. They consider factors such as skin type, location of the procedure, and individual healing tendencies to minimise scarring and maintain natural contours. Techniques such as layered closures, careful suturing, or combining procedures with laser therapy can optimise cosmetic results while supporting fast and safe recovery.
Comprehensive patient care:
Beyond technical skills, dermatologists provide holistic care, guiding patients through the procedure, recovery, and follow-up. They offer personalised advice on wound care, sun protection, and lifestyle adjustments to support optimal healing. This comprehensive approach ensures that the patient’s skin remains healthy and that results are long-lasting and aesthetically pleasing.
In summary, the expertise of a dermatologist matters because it combines medical knowledge, surgical skill, and aesthetic judgement. This ensures that procedures are performed safely, precisely, and with the best possible outcome, giving patients confidence in both their health and appearance.
Final Thoughts: Why Dermatologists Are Your Go-To for Skin Surgery
Yes dermatologists do perform surgery. From minor mole removals to advanced skin cancer excisions like Mohs, they combine medical knowledge with surgical skill to provide comprehensive care. Knowing what dermatologists can do ensures patients choose the right professional for both medical and cosmetic skin concerns.
If you’re seeking expert advice or treatment, you can book a consultation with a Dermatologist in London at The London Dermatology Centre, where experienced specialists provide personalised care and advanced skin procedures.
References:
- Skin Therapy Letter. (2023). Review of Dermato-Surgery Peri-Procedure Care.
Available at: https://www.skintherapyletter.com/supplement/dermato-surgery-peri-procedure-wound-healing/ - UC Davis Health. (2024). Dermatologic Surgery Treatments.
Available at: https://health.ucdavis.edu/dermatology/specialties/surgery/treatments.html - Passby, L., et al. (2023). Skin surgery training: a literature review of methods and outcomes. Journal of Dermatological Surgery, 49(3), 123-130.
Available at: https://pubmed.ncbi.nlm.nih.gov/36785521 - Mehta, N. (2023). Procedural dermatology and its unmet need. Indian Journal of Dermatology, Venereology and Leprology, 89(2), 123-128.
Available at: https://ijdvl.com/procedural-dermatology-and-its-unmet-need/