Dermatologists warn non-specialists distort field as cosmetic skin care, risking patient safety

Cases of serious skin side effects caused by non-specialist healthcare providers are not uncommon.

For example, a CO2 laser treatment for freckles made them darker, or melanoma was mistaken for a simple mole and lasered, causing it to grow larger and requiring transfer to a university hospital.

Dermatologists point out that non-specialists encroaching on dermatology's domain can distort the field, making it appear to be solely about “dermatology = cosmetic skin care,” which leads to the misconception that dermatologists refuse to treat general skin diseases.

The Korean Dermatological Association held a media event on Thursday to mark the 23rd Skin Health Day, highlighting the severity of skin diseases and the role dermatologists play for the general public.

“In the field of cosmetic skin treatments, general practitioners are advertising dermatology services and providing dermatological care. Recently, even oriental medicine practitioners and non-medical personnel are encroaching on dermatology's domain,” said Dr. Ahn In-soo, the association’s director of public relations and head of Human Dermatology Clinic in Siheung, Gyeonggi Province. “This leads to delayed proper diagnosis, increases misdiagnosis rates, and significantly raises the risk of adverse effects.”

The skin is our body's largest organ and a mirror reflecting overall health, Ahn noted, adding that it must be viewed and treated as an organically interconnected system to ensure proper diagnosis and treatment.

Ahn also argued that the criticism that dermatologists avoid or refuse to treat common skin conditions stems from confusion caused by non-specialists advertising dermatology services. He explained that non-specialists, having never trained in common skin conditions, inevitably avoid or refuse to treat them.

“Dermatology specialists undergo at least four years of specialized training based on pathology, immunology, and diagnostics, but non-specialists practicing dermatology do not. Consequently, cases of adverse effects from indiscriminate procedures by non-specialists in dermatology continue to be reported,” Ahn pointed out.

Ahn also disclosed cases where patients suffered severe side effects due to misdiagnosis by non-specialists.

He advised that procedures like lasers, radiofrequency, fillers, and botulinum toxin, while highly effective, can lead to permanent scarring, pigmentation, and serious complications if side effects occur. Therefore, prioritizing the practitioner's expertise and safety management capabilities is crucial, rather than focusing solely on cost or convenience.

The problem lies in the rapid increase in clinics operating under the specialty of dermatology despite not being staffed by dermatologists.

According to clinic opening data released by Rep. Jeon Jin-sook of the Democratic Party of Korea, among the 421 new clinics opened by non-specialist physicians from January to July this year, 146 were registered under dermatology – the highest number among all specialties.

“Dermatology specialists are the only professionals who can provide patient-tailored treatments based on extensive clinical experience and scientific evidence, while preventing and managing side effects,” Director Ahn said. “Please help create a sustainable medical environment by adjusting insurance reimbursement rates to reflect reality, and regulating non-specialists' practice of dermatology to enable the public to make informed choices.”

Professor Kim Dong-hyun of the Department of Dermatology at CHA University Bundang Medical Center highlighted the realities and challenges dermatology specialists face within the healthcare system. He pointed out that structural issues, such as shortages of essential medical personnel, low insurance reimbursement rates, and the expansion of non-specialist practice, make it difficult for the public to receive safe, standardized treatment.

Professor Kim warned, “While skin diseases may appear simple on the surface, they require complex differential diagnosis and various procedures for accurate diagnosis. Therefore, indiscriminate treatment by non-specialists and distorted medical information threaten patient safety.”

“Patients can only receive accurate diagnoses and treatments when the role and expertise of dermatology specialists are guaranteed,” he said, adding, “Institutional improvements, such as insurance reimbursement rate adjustments and regulations on non-specialists, are necessary to protect the public's right to skin health.”

Dr. Kang Hoon, president of the Korean Dermatological Association, said, “Despite dermatology being an essential medical field specializing in various severe skin diseases, there are still numerous cases where the public is exposed to unnecessary side effects and risks due to diagnosis and treatment by non-specialists.”

He continued, “Dermatology specialists are experts who, through extensive education and clinical experience, can provide patients with accurate diagnoses and optimal treatment. Therefore, the Society will create an environment where the public can receive safe and proper care based on this expertise, and will continue campaigns to raise awareness about the importance of skin health.”