An Etymological Reflection on Esthetic versus Cosmetic Dermatology

ABSTRACT

Cosmetic dermatology refers to a subspecialist area of dermatology that focuses on helping patients improve their skin, hair, and nails for cosmetic purposes, rather than for health reasons. To delineate themselves from the cosmeticians, cosmetic dermatologists have eulogized themselves to esthetic dermatologists. However, by definition, esthetics is the branch of philosophy concerned with the nature of beauty and the nature of taste and, in a broad sense, incorporates the philosophy of art. Esthetics examines the philosophy of esthetic value, which is determined by critical judgments of artistic taste; thus, the function of esthetics is the “critical reflection on art, culture, and nature.” Esthetics pertains to a subjective notion that is highly influenced by culture and evolves outside the constraints of the scientific method. Therefore, the association of the term esthetic with the term dermatology is problematic, as these represent independent concepts. Meanwhile, the term cosmetics derives from Greek kosmos, meaning “order,” kosmētikos meaning “skilled in ordering or arranging,” and kosmetikē tekhnē meaning “technique of dress and ornament.” With time and age, a state of disorder, randomness, or uncertainty develops, underlying the scientific concept of entropy. Cosmetics aims at bringing things back to a state of order and certainty. Therefore, the term cosmetic dermatology seems more appropriate than esthetic dermatology, respectively, the alternative term cosmiatry, in analogy to trichiatry for board-certified dermatologists involved with hair versus the trichologists, who are not medically qualified. The term esthetic dermatology not only fails to contribute to our understanding of many such questions but also detracts from the image this branch of our specialty has of itself, and the message we transmit to our peers and the public who reproach this subspecialty for carrying out procedures considered unnecessary, superficial, or frivolous.