Pursuing a career in Dermatology

It is always difficult to pinpoint the exact moment at which you decide something, and I suppose that deciding to pursue a career in dermatology was no different. Looking back, I think my love of baking as a young child set the scene. When I wasn’t studying or seeing friends, I would spend hours in the kitchen, and I even set up a patisserie catering company as a teenager. I have always felt there was an overlap between baking and dermatology—the manual skill set, attention to detail, and highly visual focus are common to both.

While studying medicine, I completed a Bachelor of Arts in Genetics, examining the impact of epigenetic changes on the ability of skin cells to withstand different types of stress. Excited by the ability to help patients through a deeper understanding of fundamental science, I later completed a Master of Research in Human Tissue Repair, focusing on the development of new therapeutic approaches for rare skin diseases.

Through this work, I fell even more in love with skin cells by appreciating how meaningful change can come from truly understanding how they work. The capacity of the skin to act as a waterproof barrier, to protect us from external forces such as bacteria and ultraviolet radiation, and to adapt in response to these stresses continues to fascinate me.

My laboratory work and studies also further developed my academic curiosity. Dermatology is exciting in this respect- it is grounded in fundamental skin pathophysiology, immunology, inflammation, and tissue repair. Treatments used in dermatology, such as corticosteroids, and newer therapies including JAK inhibitors and biologics, work by modifying these core biological pathways. Skin biopsy, tissue diagnosis, and immunofluorescence imaging also form a major part of the specialty. All of this excites the “nerd” within me, as dermatology allows me to combine clinical care with fundamental pathophysiology.

I have always been interested in mental health and spent four months working in psychiatry. As doctors, we must be careful not to focus solely on the medical aspects of disease, but also to understand how a skin condition affects a patient’s life- their day-to-day activities and how they feel

We know that conditions affecting the skin can significantly influence how a person feels about themselves. Equally, how we feel can affect our skin. Research shows that many bodily systems including the skin, mind, gut, immune and hormonal system are closley linked together, so that when one system is affected it can have consequences for the others.

Because the skin is in such a visible and exposed position on the body, changes in how it looks or feels can have a profound impact. Dermatology is unique in that the changes we make do not only treat the skin condition itself, but can also help propel a person forward in their life. It is about restoring confidence and enabling patients to do things they might otherwise feel unable to do! The connection between the mind and the skin is fundamental to dermatology, and the emerging field of psychodermatology is one I am particularly excited to see develop.

As a resident doctor, I rotate frequently and have been privileged to work across a range of specialties, including Infectious Diseases, Tropical Medicine, Oncology, and Acute Medicine. In each of these roles, I have seen how systemic disease can manifest in the skin, and how the skin can sometimes provide the only clue to what is happening elsewhere in the body.

Dermatology is fascinating and unique in that, while we treat primary skin disorders such as eczema and psoriasis, we also act as detectives—identifying skin signs that point to wider systemic disease. From there, it is our role to investigate further, signpost appropriately, and refer patients to the correct specialist.

Charlotte is an aspiring dermatologist and currently a resident doctor at University College London Hospital. She completed her undergraduate medical studies at the University of Cambridge (Trinity College), where she intercalated with a BA in Genetics. She has also completed a Master’s degree in Human Tissue Repair at University College London.

Dr Charlotte Muehlschlegel
University College London

Find Charlotte on LinkedIn here.