A PA-C in dermatology is a physician assistant-certified who specializes in diagnosing and treating skin conditions. The “PA-C” designation means the provider graduated from an accredited physician assistant program, passed a national certifying exam, and maintains active board certification. In a dermatology office, this person examines skin lesions, performs biopsies, prescribes medications, and often handles cosmetic procedures, all under a collaborative relationship with a supervising dermatologist.
What the PA-C Credential Means
PA-C stands for Physician Assistant-Certified. It’s a legally protected title issued by the National Commission on Certification of Physician Assistants (NCCPA). To earn it, a PA must graduate from a program accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) and then pass the Physician Assistant National Certifying Examination, known as PANCE. PA programs average 27 months and include roughly 2,000 supervised clinical hours across multiple medical specialties.
Once certified, PAs must maintain their credential through continuing education and recertification cycles every two years. If certification lapses, they can no longer use the PA-C title. This ongoing requirement is designed to ensure their medical knowledge stays current.
How a PA-C Specializes in Dermatology
PA programs train generalists. Dermatology specialization happens after graduation, typically through on-the-job training with a supervising dermatologist. Some PAs pursue additional formal education through the Society of Dermatology Physician Associates (SDPA), which offers a Diplomate Fellowship program: 22 modules covering 64.75 hours of accredited continuing medical education. The curriculum spans everything from basic diagnostic procedures and skin pathology to pigmentary disorders, autoimmune skin diseases, aesthetic medicine, and dermoscopy.
The modules are case-based, meaning participants work through clinical scenarios and decision-making exercises rather than just reading textbooks. Topics include skin cancers and other growths, psoriasis and eczema-type conditions, acne and rosacea, infections, hair and nail disorders, blistering diseases, and vascular conditions. This breadth reflects what a dermatology PA actually encounters day to day.
What a Dermatology PA-C Does in Practice
If you see a PA-C at a dermatology office, your visit will look similar to one with a dermatologist. They’ll examine your skin, take a medical history, and make a diagnosis or order further testing. The specific procedures they perform are extensive:
- Biopsies: Shave, punch, and excisional biopsies to evaluate suspicious moles or rashes
- Skin cancer treatment: Freezing precancerous spots with liquid nitrogen, performing excisions, and assisting in Mohs surgery (a precise technique for removing skin cancer layer by layer)
- Wound repairs: Closing surgical sites with stitches, and in advanced cases, performing complex closures using skin flaps and grafts
- Cosmetic procedures: Botox injections, dermal fillers, chemical peels, and laser or light-based therapies
- Medical management: Prescribing topical and oral medications for chronic conditions like psoriasis, eczema, acne, and rosacea
Advanced surgical skills are often taught directly by the supervising dermatologist. A PA-C who has worked in dermatology for several years may handle a wide range of surgical repairs independently, though complex or unusual cases are referred to the physician.
Prescribing Authority
Dermatology PA-Cs can prescribe medications, including topical steroids, retinoids, antibiotics, and immunosuppressants used for inflammatory skin diseases. In most states, they can also prescribe controlled substances (Schedules II through V), though a few states place restrictions. Georgia and Texas, for example, prohibit PAs from prescribing Schedule II drugs. States like Arizona, Illinois, and North Carolina limit Schedule II prescriptions to a 30-day supply. For most dermatology patients, these restrictions rarely come into play since the majority of skin-related prescriptions are non-controlled.
Training Compared to a Dermatologist
A board-certified dermatologist completes four years of medical school (5,000 to 6,000 supervised clinical hours), followed by a residency in dermatology lasting three to four years. A PA-C completes about 27 months of PA school with approximately 2,000 clinical hours, then gains dermatology-specific training on the job or through fellowship programs. The total supervised clinical training for a physician is more than double that of a PA before either one enters specialty practice.
This difference matters most for rare or complex conditions. For routine skin checks, acne management, straightforward biopsies, and common rashes, a dermatology PA-C with experience handles these with the same approach a dermatologist would. The supervising physician is available for cases that fall outside the PA’s comfort zone or require subspecialty expertise.
Growth and Compensation
Dermatology is one of the faster-growing specialties for PAs. The number of certified PAs practicing in dermatology grew from 4,350 in 2020 to 4,580 in 2021, a growth rate of about 4.1 percent annually. Long-term projections estimate 30 percent growth over a decade, driven largely by demand for skin cancer screenings and cosmetic procedures that outpaces the supply of dermatologists.
Compensation reflects the specialty’s demand. The median salary range for dermatology PAs falls between $125,000 and $162,500, which tends to be higher than PA salaries in primary care or many other specialties. Factors like geographic location, years of experience, and whether the practice includes cosmetic services all influence where a given PA falls in that range.
What to Expect at Your Appointment
When your dermatology appointment is with a PA-C, the clinical experience is largely the same as seeing a physician. You’ll be examined, you may have a biopsy taken if something looks concerning, and you’ll leave with a treatment plan or prescription if needed. The PA-C works under a collaborative agreement with a dermatologist, which means the physician reviews charts, is available for questions during your visit, and steps in for cases that need their direct involvement. In many busy practices, seeing a PA-C means shorter wait times for an appointment, sometimes by weeks, since dermatologist schedules tend to book out further in advance.