Just as a cardiologist uses a stethoscope to help differentiate a normal heart sound from something more sinister, the dermatologist’s tool when examining the skin is the dermatoscope – yes, that fancy light looking thing. I carry mine around all day, and look at every atypical looking mole with this essential device. Not surprisingly, patients will often ask me what it does – so here’s the skinny.
What is a dermatoscope?
A dermatoscope is a tool that has a magnifier as well as two different light settings – polarized and non-polarized. The light settings allow the dermatologist to review the structures of the skin without any reflection. This basically makes it so you can see what’s going on just under the top layer of the skin, and get a better understanding for what is giving a skin spot the brown, red, or yellow colors that you’re seeing with the naked eye.
Its use has been refined by dermatologists over the years, and now nearly all skin conditions have some characteristic appearances under the dermatoscope. The use of a dermatoscope is called dermoscopy, and board-certified dermatologists master this technique during training.
This is where the dermatoscope has been incredibly helpful. Melanomas are a type of skin cancer that can kill you, and they’re difficult to differentiate from normal moles. When we use the dermatoscope, we’ll look for certain patterns that are typical of melanomas – thus increasing our ability to detect this skin cancer and keeping you safe.
Other skin cancers
Skin cancers beyond melanomas also can be detected using dermoscopy. Basal cell and squamous cell carcinomas – slower growing skin cancers that often grow on the face – also have features that we can detect on dermoscopy. The better chance we have of catching something early, the easier the cure.
Skin growths and cosmetic treatments
From a cosmetic standpoint, dermoscopy is great too. There are usually many ways to remove an unsightly bump, such as cutting it out, freezing the spot, lasers, injections, and more. The dermatoscope helps figure out where and how a skin growth is behaving, and we can cater our treatments using this knowledge. This makes our treatment more effective, saving you time and money.
Not all hair loss is the same! When we look at the root of the hair with our dermatoscope we can see if there’s inflammation or certain structures that define the type of hair loss that you have. Exclamation point hairs, for example, grow in a way that makes them look like the punctuation mark, and tell us immediately that you have a type of hair loss called alopecia areata. Once we know the type of hair loss, we can direct our therapy accordingly.
Warts, Molluscum, Rashes, Nail cuticles, Scabies, and more!!
As you’d imagine, all of these have their own classic features on dermoscopy, so when you see your dermatologist they can more accurately diagnose your problem from the onset. One of the more memorable signs is the ‘stealth bomber sign’ – that’s what a tiny scabies mite looks like in the dermatoscope! Hopefully you’ll never see one in person, but if your derm finds one, a simple cream will cure your horrible itch.
The bottom line is the dermatoscope is a versatile tool, helping us identify skin cancers sooner and improving our diagnosis with rashes, hair changes, and other growths. It has been an essential part of my practice for years, and I can’t imagine doing a dermatology consultation without one.