In this installment of Under Your Skin, host Nicholas Brownstone, MD, sits down with Lisa Swanson, MD, to hear her commentary on what she loves most about being a dermatologist, her tips on dealing with demanding patients, and what conditions we still need better treatments for in dermatology. 

A passion for dermatology 

Dr Swanson's journey into dermatology is deeply rooted in childhood experiences growing up with her urologist father. She was exposed to the medical world early through manually organizing and filing her father's research articles and was impacted by his perspectives on medical practice, which became a driving force in her decision to become a doctor. 

Dr Swanson sees herself practicing in the "golden age of dermatology," driven by the profound impact dermatologists can have on improving patients' lives. 

Dealing with demanding patients 

Addressing the challenge of demanding patients, Dr Swanson emphasizes 2 crucial elements: listening and accessibility. 

As a pediatric dermatologist, she makes sure to allocate ample time for appointments with potentially demanding parents. This ensures that she’s able to listen thoroughly to their concerns without these extended encounters impacting her ability to stay on schedule in clinic. 

Regarding accessibility, Dr Swanson encourages email communication with her more demanding patients, establishing a connection that helps diffuse tension by offering them an easy way to ask questions. 

Drs Brownstone and Swanson acknowledge that doctors may be hesitant to share contact information in this way for fear that patients will abuse it; however, they both agree that patients are usually reassured simply by having access to this valuable outlet and thus rarely overuse it. 

Improving the treatment landscape for challenging conditions 

Dr Swanson identifies 3 conditions in need of better treatment options in dermatology. Hidradenitis suppurativa presents challenges for many patients despite existing treatments, though she anticipates more solutions in the coming years. 

She also feels alopecia areata and vitiligo need improved medication options. However, both appear to be on the cusp of a treatment revolution, particularly with the promising developments in JAK inhibitors.