Sometimes Skin-Care Products Just Aren’t Enough—Here’s When To See a Dermatologist
"A good analogy is like your hair color. You can certainly color your hair at home," she says. But if you have high expectations, you'd go to a professional. If you're someone who's a little more meticulous or who is genetically is suffering from conditions like acne or rosacea, you need more than the over-the-counter stuff. It's no pressure—it's just like, who are you as a person and what's important to you?"
- Caren Campbell, MD, board-certified dermatologist in Northern California
- Mona Gohara, MD, board-certified dermatologist at Dermatology Physicians of Connecticut and associate clinical professor in dermatology at Yale School of Medicine
If you're wondering when to see a dermatologist, Dr. Campbell says if you're dealing with something from the list below (which is by no means exhaustive), you should definitely consider making an appointment.
When to see a dermatologist
1. Rosacea and perioral dermatitis
"Rosacea is an inflammatory condition of the skin that's common in people of Northern European descent," says Dr. Campbell. "Some present with acne-looking bumps on the skin, on particularly nose and chin, or there's a related condition which some people lumped together called perioral dermatitis, which is kind of in the rosacea-y inflammatory skin category. And with all the mask-wearing, there's been a huge rise in that. It's concentrated around the mouth."
Both rosacea and perioral dermatitis respond well to anti-inflammatory agents like oral antibiotics. And some types of rosacea respond well to a pulsed dye laser, which is called VBeam. While she says prescription sulfur washes, anti-inflammatory vitamin C, and a mineral sunscreen can help with rosacea, they work best when used along with more targeted treatments. "A lot of those broken blood vessels, there's nothing you can do topically that's really going to get rid of those," says Dr. Campbell. You've got to destroy them with a laser.
Here, a dermatologist shares more about rosacea:
2. Eczema and rashes
"It sucks because a lot of the products out there are being marketed for eczema and rashes. And I can't tell you how many patients come in and whatever they're using is just keeping it going, making it worse," says Dr. Campbell. "If you've got an itchy red rash, you're buying different eczema or anti-itch cream over the counter, it's burning, stinging, it's lasting beyond a week or two, you really should probably get in to see a dermatologist."
3. Hair loss
"With COVID, there's been a huge uptick in people seeing me for hair loss," says Dr. Campbell. "Because honestly, there's a lot of people with stress-related hair loss right now. It's called telogen effluvium. But there's other forms of hair loss, like scarring ones and autoimmune ones, and they all have different patterns."
Dr. Campbell says she often sees patients who are trying to self-treat hair loss with supplements or topicals that don't really work.
"Hair loss is a situation where it's easier to get one visit in, get some sense of what kind of hair loss you have, so you can appropriately treat it," she says. You also want to ensure you don't have iron deficiency or thyroid issues that could be causing your hair loss. "For the autoimmune kind, you might do steroid injections into the scalp every month until it gets better, or there are new oral medications you can ask your dermatologist about that help control the immune system. Or for the stress-related hair loss, there's natural alternatives like taking melatonin at night or using men's Rogaine foam ($23)."
Dr. Campbell says platelet-rich plasma, what's used in vampire facials, can be helpful for hair loss.
"That's where we draw your blood, spin it down in a centrifuge, and then sort of harness the power of the growth factors in platelet-rich plasma to stimulate new hair growth," she says. "That's a really good one for male pattern hair loss, and then also women who are suffering from female pattern hair loss and other forms of hair loss, even the stress-related one."
4. Acne
"Anyone that's suffering from acne can benefit from a consultation with a dermatologist," says Dr. Campbell. "Any dermatologist should be able to get your skin kind of pretty free of acne within three to six months of starting to see you."
She says this is especially the case if your acne is particularly irritating and you're experiencing scarring.
"Getting in to see a dermatologist if you have big cystic acne is really important," says Dr. Campbell. "It's going to save you a world of heartache later if you can clear up the acne quicker and get less scarring."
And if you do have acne scars, no topical or at-home microneedling device is really going to get rid of them, according to Dr. Campbell. "You've got to come in for chemical peels or laser treatments or microneedling," she says.
Learn more about adult acne here:
5. Dark under-eye circles
"You can use PRP, that platelet-rich plasma, for under-eye circles. Fillers are helpful for restoring the volume. Lasers are helpful as the skin thins and you can get more darkened blood vessels under the eyes and it can make you look tired," she says. "Your under eye cream is usually not going to get that job done. It can be helpful because it has things like peptides that help stimulate collagen and caffeine which helps kind of temporarily restrict the blood vessels so the eyes look a little bit better." This treatment can also help with broken blood vessels on your face in general.
6. Hyperpigmentation, or sunspots, brown spots, and melasma
"Topical things can be helpful, like vitamin C, mineral sunscreen, AHAs, BHAs, retinoids. But oftentimes you need laser to kind of break up the pigmentation," says Dr. Campbell. Chemical peels can also be really good for these conditions. "Chemical peels can be somewhat unpredictable. It's really important you go to someone who understands different ethnicities and skin types and what works for one and not the other."
She also says the oral medication tranexamic acid, can be helpful for discoloration.
"It's a medication that historically has been used for abnormal uterine bleeding for women. But at much lower doses, it's shown to be helpful for melasma and some other disorders of hyperpigmentation," says Dr. Campbell. She says that's because there's a vascular component to hyperpigmentation disorders.
7. Wrinkles
"For anti-aging, there just comes a point where you're never going to be able to improve skin laxity," says Dr. Campbell. "As you age, you lose that muscle and bone in your face, and you've got to restore that lost volume with fillers. And over time, you're contracting the muscles under your skin and that creates lines and folds in your skin that you're never going to be able to get rid of with anything at home. You've got to relax the muscle contraction with wrinkle relaxers and botox."
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