by Anne Lee, DMSc, MSPAS, MPH, PA-C
Affiliations. Anna Lee is with El Segundo Dermatology in El Segundo, California.
Funding: Support provided by Arcutis Biotherapeutics.
Introduction
What does it mean to be truly versatile in dermatology today? I think about this question often, and the more I do, the more excited I become about what it means for our profession. We are practicing at a genuinely remarkable moment, one where the scope of what a skilled nurse practitioner (NP) or physician assistant (PA) can offer has never been greater and the opportunity to make a lasting difference in patients’ lives has never been more within reach.
For a long time, medical, surgical, and aesthetic care each occupied their own distinct space in dermatology, but that structure no longer reflects how patients actually experience their skin. The patients who walk through your door don’t think about their skin in categories, but as one continuous story. The care you offer and provide to them should reflect that. The person being treated for plaque psoriasis is often the same person asking about postinflammatory hyperpigmentation or presenting with concerns of their hair thinning. The patient managing chronic acne doesn’t see scarring and pigmentation as separate issues requiring separate providers. Patients want one trusted clinician who understands the whole picture of their care, and as the demand for dermatologic services continues to grow, that role is increasingly filled by NPs and PAs.
Versatility in Care Can Grow Trust
The need for versatility in NP and PA experience is important now more than ever. Patients don’t experience their skin in isolated concerns and complaints, and the best care considers all aspects holistically. Consider the patient living with atopic dermatitis who also struggles with postinflammatory hyperpigmentation, or the patient with acne desperate to address the scarring that remains long after the breakouts have cleared. The clinician who can treat the disease, recognize when a lesion warrants a closer look, and meet that same patient on the cosmetic concerns it leaves behind isn’t just covering more ground; they are delivering care that feels complete, builds genuine trust, and keeps patients engaged in their own health in a way that a fragmented approach never could. That kind of integrated practice, grounded in both medical and aesthetic fluency, is what defines the most impactful NPs and PAs in dermatology today.
Competence Across Care Supports Better HealthCare and Safer Outcomes
There is something that happens when you train broadly in dermatology that is genuinely hard to describe until you experience it yourself, which is that the medical, surgical, and aesthetic sides of your knowledge and experiences start to inform each other in ways that quietly make you better at everything you do. The clinician who has worked through complex inflammatory cases can bring a different kind of attentiveness and conversation to a cosmetic consultation. The clinician who has developed aesthetic fluency can bring a sharper anatomical eye to their medical and surgical care. Rather than distinct and independent skill sets, this diverse and integrated experience and care fosters a holistic understanding of the patient and their skin, resulting in better judgment, fewer complications, and a quality of care that patients feel and appreciate.
The Business Case for Versatility
Versatility and integrated patient care can also support the long-term health of your practice. The realities of declining reimbursement and growing administrative demands can be mitigated by a clinician who contributes meaningfully across both medical and cash-pay aesthetic service lines, creating a real source of stability for any practice. With versatility in competencies and experience, the NPs and PAs might be able to support patient retention rather than referring elsewhere. This also protects the patient relationship, builds trust, and can support practice revenue in meaningful ways in the long term. Benefits can include improved scheduling efficiency, expanded range of services a practice can offer, and in settings where physician time is stretched, the ability to provide the kind of broad clinical coverage that allows a practice to care for more patients without compromising on quality. When your skill set grows, the practice grows with you, and that kind of contribution is something to feel genuinely proud of.
Patient Desire for Holistic Care
One of the greatest privileges of this work is addressing not just what is happening in a patient’s skin, but what that condition is doing to their sense of self. Acne scars, melasma, vitiligo, and hair loss are not vanity concerns, but conditions that shape how people move through the world, affect their confidence and relationships, and can impact major life milestones in ways that are genuinely profound. Conditions like psoriasis, melasma, vitiligo, and hair loss can deeply reshape how patients see themselves and how they connect with others, and because these conditions are so often stigmatized, the burden patients carry might extend deeper than what is visible on the skin. When we address the clinical, aesthetic, and emotional dimensions of that experience together, we are not simply treating a diagnosis, but changing the quality of someone’s life.
A Call to Action
The dermatology NP and PA of today has access to more training, more tools, and more opportunity to shape this specialty than any generation before them, and the path to becoming a truly versatile clinician does not require having everything mapped out from the start. It just requires a genuine commitment to keep growing, which means seeking out conferences where medical dermatology sits alongside aesthetic sessions, and surgical technique is discussed in the same room as laser and energy-based devices. Seek out opportunities where you have access to hands-on procedural workshops that can build confidence and skills. Say yes to the cases that feel slightly outside your comfort zone, and seek guidance where needed to build confidence in the care you provide. Do this because stretching beyond what is familiar is how the most capable clinicians grow. For the dermatology NP and PA, versatility might provide a career advantage, but it also could be the very thing that redefines you as a clinician and allows you to provide the kind of care your patients never forget.