The following article takes a look at the history of the area of medicine known today as dermatology, including its earliest incarnations in classical cultures.
What is Dermatology?
Before looking at the history of dermatology as a profession and as a term it is a worth briefly summarising what it actually involves. In a very basic sense dermatology is the area of medicine that relates to the skin. As a result it can cover practices which deal with diseases, cancers, infections, allergies and hormonal reactions that affect the skin, as well as purely cosmetic alterations and/or the treatment of ‘blemishes’. These practices can therefore involve areas such as surgery and pathology (diagnosis and treatment of diseases). Practitioners in the field are called dermatologists with more specific titles depending on their areas of expertise (e.g., a dermatolopathologist will specialise in dermatolopathology - the pathology of skin).
Dermatology as a defined concept really came into being around the end of the 18th and start of the 19th century despite the fact that skin conditions would have been treated and acknowledged throughout the course of human history. The coining of the term gave a formal label to a branch of medicine which included treatments and practices that would have been performed for thousands of years. In fact some of the earliest accounts of advanced skin treatment date back to the ancient Egyptians. Everyone knows the stories of Cleopatra bathing in ass’s milk, and the effects on the skin of the lactic acid in the milk are still recognised today. However, the Egyptians were known to use other substances to alter the appearance of their skin such as alabaster, oils and salt. They even applied some chemicals to the skin for medical rather than cosmetic purposes with arsenic, for example, being used in an attempt to treat skin cancers.
The forerunners of many other non-invasive dermatological practices which are still being explored today can also be traced back to the Egyptians. Techniques such as dermabrasion could be identified in the use of sandpaper to smooth down rough skin and scars, whilst they even realised the benefits of exposing skin to light (a practice which carried on through the ages), in their case natural sunlight.
The cosmetic benefits of skin treatments continued to be appreciated throughout the ancient world. The Greek and Roman cultures used a mixture of substances such as natural oils and resins (e.g., myrrh and frankincense) with pumices to smooth and exfoliate the skin. Across Asia, in India, they replaced the natural resins with urine to achieve the same results and rather drastically the ancient Turks achieved their exfoliation by actually singeing the skin.
The Birth of Modern Dermatology
The term dermatology itself Comes from the Greek for “skin” derma and “to learn” logy via first the French dermologie and subsequently the latinised term dermatologia. In fact the French were early practitioners in the modern field or dermatology, opening the first school in Paris at the Hôpital Saint-Louis in 1801. What we now consider as dermatology though can be traced back to the early 16th century in Europe and much of this early work focused on the use of chemicals from classical practices as well as sunlight on conditions such as eczema and psoriasis.
20th Century Dermatology
The start of the 20th century saw greater innovations in skin treatment using electrosurgery (treatment with electrical currents) and cryosurgery (the use of extreme cold) with subsequent developments in liposculpture (removal of fats from under the skin surface) and hair transplants taking place in the first half of the century. The early 1900s also witnessed the introduction of peels to strip away dead skin and expose new healthier skin, through the use of Phenol peels in particular.
In the 1950s, the use of light treatments evolved into the development of lasers and in turn these techniques progressed in the latter half the 20th century to deal with the removal of hair and certain cosmetic blemishes. Indeed, laser treatments are still being developed with current advances centering around the treatment of issues such as stretch marks and the tightening of the skin. The late 20th century also saw the further developments in peeling techniques to replenish the skin using trichloracetic and alpha-hydroxy acids, which hark right back to the earliest Egyptian practices.
© Stuart Mitchell 2012
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