As a branch of medicine, Dermatology is specifically focused on treating skin conditions and also covers issues with the hair and the nails. These are all classed as cutaneous (skin) conditions that affects the integumentary system, which consists of the elements involved in the body’s barrier against the external environment.
The name dermatology derives from the Greek (dermatos) for ‘of skin’, and dermatologists are practitioners of dermatology, treating both diseases and cosmetic issues.
Dermatology in Ancient Times
From a timeline perspective dermatological practices have been around since the dawn of civilization, where humans have been interested in ways of treating sickness. With the skin, hair and nails being the visible exterior of our body, this was an important area in term of treatment and consideration.
What we now would classify as dermatological practices were discovered in ancient Egypt, where Egyptians were known to use various items to treat both medical and cosmetic issues. Some examples of early dermatological practice from ancient Egypt include the use of substances such as arsenic to treat skin cancer, and in fact even today, forms of arsenic are used to treat certain kinds of blood cancers, which offers an interesting insight into the ingenuity of this ancient culture. Other issues, such as Acne, in both ancient Egypt and Greece were treated with honey. Perhaps more famously, Egyptians also looked to treat the dermatologic manifestations of leprosy, which caused notable skin disorders and used sandpaper to treat skin similar to how Microdermabrasion was created.
The treatment of the skin was also considered important in Roman times, with the ancient Roman physician Celsus mentioning the treatment of pimples and acne in his work, “De Medicina” where he recommended a combination of galbanum and vinegar.
Middle-ages Dermatology and the Renaissance
The treatment of skin conditions was first referenced in the written word via a group of books written by the Persian philosopher Avicenna in 1025, called the “Canon of Medicine.” Early references to skin conditions tended to focus on serious skin complaints. This collection of writing and knowledge was hugely influential and was used as a source of medical knowledge and insight for hundreds of years.
In 1572, Geronimo Mercuriali wrote a book called ‘De Morbis Cutaneis’ (On the diseases of the skin) and this is recognized as the first written work dedicated to the area of dermatology. Mercuriali was a physician who is perhaps best known for another work De Arte Gymnastica which details principles of physical therapy.
Dermatology through the Enlightenment and into the Modern Period
Daniel Turner’s similarly named “De Morbis Cutaneis,” which was originally published in 1714, was also notable in that it was the very first complete book about dermatology that was published in the English language, and this helped to launch the practice in the United Kingdom. One of the interesting things noted in Turner’s work was that there was evidence to suggest that externally applied medicines could enter a person’s body through the pores of their skin.
The point in history where many say that dermatology became its own branch of medicine, at least in written form was with the release of the text book “Dermatologia” written in 1799 by Francesco Bianchi and was a dedicated medical text for students of medicine. Close to the release of this book, from 1801 medical students could study dermatology, when a dedicated school was opened in Hôpital Saint-Louis in Paris.
Another notable place for dermatology education was labelled the Vienna School of Dermatology (formed around the second half of the 19th century) which consisted of a group of dermatologists from the University of Vienna and were key individuals responsible for the development of modern dermatology. Notable individuals involved with progressing dermatology in this period were Ferdinand von Hebra and Moritz Kaposi.
20th Century Dermatological Developments
In 1906, the Food and Drug Act was signed into law by US President Theodore Roosevelt to help protect consumers from unscrupulous practices. Later in 1938 this was expanded to also cover cosmetics. Today, this act continues to protect consumers, and treatments for dermatology need to be approved by the FDA to ensure that they have been thoroughly tested and are safe to use.
In the 20th century dermatological treatments progressed rapidly, and a shift in mentality also occurred with the modern movement in skin-care and preventative treatments. One such key moment relates to the chemist Eugene Schueller, founder of the company L’Oreal who is also famed for making the synthetic sun-screen called “Ambre Solaire,” which had an ingredient called benzyl salicylate which could help absorb some of the ultra-violet-ray from the sun. As with many dermatological practices the idea of skin care and protection from the sun has ancient roots with both the Greeks and Egyptians exploring ways to protect the skin from the sun.
Modern dermatology practices became into fruition in the 1960’s with the advent of laser technology to help improve skin care. The first working laser was built by Dr. T. H. Maiman and later in that decade Dr. Leon Goldman examined lasers interaction with biological systems.
By the end of the 60’s medical lasers were developed and used for the treatment in retinal diseases. Use in dermatology didn’t start to take place until much later, with the development of different forms of laser such as the pulse laser in the 1980’s which could be used in the treatment of skin disorders such as ‘port wine’ birth marks. Q-switched lasers were also introduced around this time to help remove unwanted tattoos. In the 1990’s Scanned, pulsed lasers were introduced which were used in the process of laser resurfacing on the skin. Developments in laser technology continues today (such as the Nd:Yag laser shown above), but many of the treatments carried out by lasers have their root from these earlier, pioneering days.
Other popular treatments such as the chemical peel have been used since ancient times where there is evidence that a form of peel was used by Egyptians. The goal of a chemical peel is to improve the texture of the skin, and this was pioneered by Ferdinand Hobra from the Vienna School in the 1900’s. In the 1950’s phenol peels which were used for treating acne scarring became common place. Later in the 1970’s chemical peels became more standardized and popular and have developed into the type of peels that are still available today.
Modern procedures that are commonly used in dermatology today, such as using Botox to treat fine lines and wrinkles, have their foundations in the late 1980’s and its growth of popularity in the 1990’s. The use of Botox for cosmetic treatments was first discovered by Dr Jean Carruthers and Dr Alastair Carruthers and was used initially to help treat an uncontrollable spasming around the eye area. A side effect of this treatment was that it also reduced wrinkles in the forehead.
21st Century Dermatology & Cosmetic Dermatology
Moving into the 21st century one of the key developments in cosmetic dermatology has become the trend in ‘fat freezing’, also known by its technical name “Cryolipolysis” which is a treatment that freezes fat cells, which in turns removes them from the body, with the effect that fat is reduced in the treated area. This procedure was developed in 2008 by Dr. Rox Anderson and Dr. Dieter Manstein. This was approved for use for the treatment of fat removal in 2010 using technology from the company Zeltiq, and this technology today is known by the brand name CoolSculpting.
In addition to that, other injectable fillers have also gained popularity since, such as Juvederm and Restylane. Both of these are known as “Hyaluronic Acid fillers” (HA Fillers) which were approved via the FDA in 2006. Another trend in recent years are the various types of “Radio frequency skin tightening,” which uses RF energy to heat tissue and stimulate collagen production within the skin, usually to reduce the appearance of lines/wrinkles. This modern treatment process has become a popular alternative to the “facelift” and is a non-invasive option that takes 30-45 minutes per session. The speed and ease of this has helped propel its popularity among patients in today’s fast paced world. Popular RF devices include Thermage and Exilis. Another recent trend is Plasma Rich Protein, known as PRP, which can use your own blood to rejuvenate skin as well as hair.
New treatments and technology continue to become available for the treatment for the skin, nails and hair and the overarching goals of dermatology remain the same, which is to provide long-lasting, safe, quick and effective results. With more and more women and men looking at dermatology as a key part of their overall health, skin (our largest organ) has become a priority to many.