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Dermatologists in the US earn an average of $350,000-$400,000 per year, making it one of the highest-paid and most competitive medical specialties.
Dermatology represents the “holy grail” of medicine: top-tier income ($400,000-$700,000+), excellent work-life balance (no nights, minimal call), and interesting procedural work. The trade-off is that getting in is brutally competitive — only the top medical students match into dermatology residency.
What Dermatologists Actually Do
Dermatology work varies significantly by subspecialty and practice type:
| Area | What You Actually Do | % of Practice |
|---|---|---|
| Medical derm | Diagnose rashes, eczema, psoriasis, acne, prescribe treatments | 40-60% |
| Skin cancer | Identify and biopsy suspicious lesions, melanoma management | 20-30% |
| Cosmetic | Botox, fillers, lasers, chemical peels (often cash-pay) | 10-40% |
| Surgical | Excisions, Mohs surgery, biopsies | 10-30% |
| Pathology | Read biopsies and slides (dermatopathologists) | 100% if specializing |
Typical day for a general dermatologist:
| Hour | Activity |
|---|---|
| 8:00am-12:00pm | 15-20 patients: acne, rashes, mole checks, follow-ups |
| 12:00-1:00pm | Lunch, charts, pathology review |
| 1:00pm-5:00pm | 15-20 patients, minor procedures |
| 5:00pm | Done — rarely any after-hours work |
Production reality: Many practices see 30-50+ patients daily. The high volume, low complexity nature of most visits (acne, rosacea, mole checks) is what enables the high income with good lifestyle.
Why dermatology lifestyle is exceptional:
- No hospital call (or very rare)
- No night shifts
- No emergencies (skin issues can wait)
- Predictable hours
- Outpatient only
Quick Answer: Dermatologist Salary
| Metric | Amount |
|---|---|
| Average salary | $350,000-$400,000 |
| Entry-level salary | $280,000 |
| Experienced salary | $450,000+ |
| Mohs surgeon | $500,000-$700,000 |
| Private practice owner | $500,000-$1,000,000+ |
Dermatologist Salary by Subspecialty
| Subspecialty | Average Salary |
|---|---|
| Mohs surgery | $550,000-$700,000 |
| Cosmetic dermatology | $400,000-$600,000 |
| Dermatopathology | $400,000-$500,000 |
| Pediatric dermatology | $325,000-$375,000 |
| Medical dermatology | $300,000-$400,000 |
| Academic dermatology | $250,000-$350,000 |
Dermatologist Salary by State
| State | Average Salary |
|---|---|
| Florida | $450,000 |
| Texas | $420,000 |
| California | $400,000 |
| Arizona | $400,000 |
| Georgia | $395,000 |
| North Carolina | $385,000 |
| New York | $380,000 |
| Colorado | $375,000 |
| Illinois | $370,000 |
| Ohio | $365,000 |
| Pennsylvania | $360,000 |
| Massachusetts | $350,000 |
| Michigan | $360,000 |
| Washington | $355,000 |
Note: Higher cost-of-living states often have lower relative pay due to more competition.
Dermatologist Salary by Work Setting
| Setting | Average Salary |
|---|---|
| Private practice (owner) | $500,000-$1,000,000+ |
| Private practice (employed) | $350,000-$450,000 |
| Hospital employed | $300,000-$400,000 |
| Academic medical center | $250,000-$350,000 |
| Telehealth dermatology | $300,000-$400,000 |
| Locum tenens | $400,000-$500,000 |
Dermatologist Salary by Experience
| Experience Level | Average Salary |
|---|---|
| New attending (1-2 years) | $280,000-$320,000 |
| Early career (3-5 years) | $350,000-$400,000 |
| Mid-career (6-10 years) | $400,000-$500,000 |
| Established (11-20 years) | $450,000-$600,000 |
| Senior (20+ years) | $500,000-$750,000 |
Path to Becoming a Dermatologist
| Stage | Duration | Typical Earnings |
|---|---|---|
| College (pre-med) | 4 years | -$100,000 (debt) |
| Medical school | 4 years | -$200,000 (debt) |
| Internal medicine/transitional year | 1 year | $60,000 |
| Dermatology residency | 3 years | $70,000-$85,000 |
| Fellowship (optional) | 1-2 years | $80,000-$90,000 |
| Total training | 12-14 years |
How Competitive Is Dermatology Residency?
| Metric | Data |
|---|---|
| Residency positions per year | ~450 |
| Applicants per position | 5-7 |
| Match rate | 70-80% |
| Average Step 1 score (historical) | 245+ |
| Research requirements | High (5+ publications avg) |
Cosmetic vs Medical Dermatology
| Factor | Medical Dermatology | Cosmetic Dermatology |
|---|---|---|
| Base salary | $300,000-$400,000 | $400,000-$600,000 |
| Insurance involvement | High | Low/none |
| Patient demand | Consistent | Market-dependent |
| Lifestyle | Regular hours | Flexible |
| Cash pay | Low | High |
Dermatologist After-Tax Income
| Gross Salary | Federal Tax | FICA | State Tax (avg) | Take-Home |
|---|---|---|---|---|
| $300,000 | $65,000 | $21,400 | $18,000 | $195,600 |
| $400,000 | $98,000 | $22,600 | $24,000 | $255,400 |
| $500,000 | $133,000 | $23,800 | $30,000 | $313,200 |
| $700,000 | $203,000 | $24,600 | $42,000 | $430,400 |
Mohs Surgeon Salary Deep Dive
Mohs micrographic surgery is the highest-paid dermatology subspecialty:
| Setting | Mohs Surgeon Salary |
|---|---|
| Private practice (owner) | $700,000-$1,000,000+ |
| Employed practice | $500,000-$650,000 |
| Academic | $350,000-$450,000 |
| High-volume practice | $800,000-$1,200,000 |
Additional training: 1-2 year fellowship after dermatology residency
Dermatology Job Outlook
- Job growth: 3% (2022-2032)
- Competition: Very high for residency
- Demand: High (1.5-6 month wait times typical)
- Lifestyle: Among best in medicine
Why Dermatology Is Popular
| Factor | Rating |
|---|---|
| Salary/income | ★★★★★ |
| Work-life balance | ★★★★★ |
| Hours (no call usually) | ★★★★★ |
| Procedure variety | ★★★★☆ |
| Patient outcomes | ★★★★★ |
| Residency competitiveness | ★★★★★ |
Is Dermatology Worth It?
Advantages of a Dermatology Career
| Advantage | Details |
|---|---|
| Top-tier income | $350,000-$700,000+ average, $1M+ possible with ownership |
| Exceptional lifestyle | No call, no nights, predictable hours |
| Interesting work | Mix of medical, surgical, and cosmetic |
| High patient satisfaction | Most skin conditions treatable or manageable |
| Practice ownership viable | Solo and group practices still profitable |
| Cosmetic cash-pay option | Additional income stream outside insurance |
| Low malpractice risk | Skin conditions rarely have catastrophic outcomes |
| Geographic flexibility | Dermatologists needed everywhere |
| High professional satisfaction | Consistently ranked top specialty for satisfaction |
Disadvantages of a Dermatology Career
| Challenge | Details |
|---|---|
| Brutal residency competition | Only ~450 spots/year, top students only |
| 12-14 years of training | College, medical school, residency before earning |
| $300,000-$400,000+ debt | Medical school debt significant |
| High patient volume | 30-50+ patients/day can feel like a factory |
| Repetitive cases | Lots of acne, eczema, rashes — can become routine |
| Insurance reimbursement declining | Some procedures pay less than before |
| Cosmetic competition | Med spas, non-dermatologists offering Botox |
| Risk of burnout | High volume, short visits contribute to assembly-line feeling |
Who Should Become a Dermatologist?
Good Fit For
| Type | Why Dermatology Works |
|---|---|
| Top medical students | Required to match — top 10-20% of class |
| Visual/pattern recognition oriented | Skin conditions require visual diagnosis skills |
| Work-life balance prioritizers | Best lifestyle among high-paying specialties |
| Procedurally inclined | Enjoy biopsies, surgeries, cosmetic procedures |
| Business-minded physicians | Private practice and cosmetic work reward business skills |
| Detail-oriented individuals | Subtle skin changes matter for diagnosis |
Poor Fit For
| Type | Why Dermatology May Not Work |
|---|---|
| Average medical students | Realistic chance of matching requires top performance |
| Those seeking critical care excitement | Derm is low-acuity, outpatient |
| People who dislike repetition | Same conditions daily after mastery |
| Short-timeline planners | 12+ years before earning real income |
| Those avoiding business | Best income requires practice ownership skills |
| High-touch, long-relationship seekers | 10-15 minute visits limit patient connection |
Building Wealth as a Dermatologist
First 5 years (debt paydown phase, $320,000/year employed):
| Category | Monthly | Annual |
|---|---|---|
| After-tax take-home | $18,600 | $223,200 |
| Aggressive loan repayment | $8,000 | $96,000 |
| 401k (10%) | $2,667 | $32,000 |
| Remaining | $7,933 | $95,200 |
| Housing | $3,000 | $36,000 |
| Living expenses | $2,500 | $30,000 |
| Available for other savings | $2,433 | $29,200 |
Pay off $350,000+ in loans in 4-5 years with aggressive approach.
Years 6-15 (wealth accumulation, $450,000/year practice owner):
| Category | Monthly | Annual |
|---|---|---|
| After-tax take-home | $24,500 | $294,000 |
| SEP 401k (max) | $5,417 | $65,000 |
| Remaining | $19,083 | $229,000 |
| Housing | $4,000 | $48,000 |
| Living expenses | $4,000 | $48,000 |
| Available for savings | $11,083 | $133,000 |
Plus practice equity building (saleable for $500,000-$2,000,000+).
Peak earning years ($600,000+/year Mohs surgeon or cosmetic heavy):
| Category | Monthly | Annual |
|---|---|---|
| After-tax take-home | $32,000 | $384,000 |
| SEP 401k (max) | $5,417 | $65,000 |
| Remaining | $26,583 | $319,000 |
| Housing | $5,000 | $60,000 |
| Living expenses | $5,000 | $60,000 |
| Available for savings | $16,583 | $199,000 |
20-Year Wealth Trajectory (from residency completion):
| Career Path | Year 5 Net Worth | Year 10 Net Worth | Year 20 Net Worth |
|---|---|---|---|
| Employed, average progression | $100,000 | $800,000 | $3,000,000 |
| Practice owner | $200,000 | $1,500,000 | $5,000,000+ |
| Mohs surgeon/heavy cosmetic | $300,000 | $2,000,000 | $7,000,000+ |
Dermatologists can realistically reach eight-figure net worth by retirement with disciplined saving and practice ownership.
The Bottom Line: Is Dermatology the Best Medical Specialty?
For many metrics, yes — dermatology is the “golden ticket” of medicine.
| Question | Answer |
|---|---|
| Is $380,000 average good? | Exceptional — top 10% of all earners |
| Can you reach $500k+? | Yes, with Mohs, cosmetic, or ownership |
| Can you reach $1M? | Yes, as practice owner or high-volume Mohs surgeon |
| Is work-life balance real? | Among the best in medicine |
| Is it worth the competition? | If you can match, absolutely yes |
| Is cosmetic work ethical? | Personal decision; many derms do mix of medical + cosmetic |
Key takeaways:
-
$350,000-$400,000 is just the floor — Practice owners and subspecialists (Mohs, cosmetic) earn $500,000-$1,000,000+. The upside is enormous.
-
Lifestyle is genuinely exceptional — No call, no nights, no weekends, outpatient only. This is rare among high-paying medical specialties.
-
Matching is the hardest part — If you’re a top 10-20% medical student, dermatology is achievable. Otherwise, you need a backup plan.
-
Practice ownership multiplies income — Employed dermatologists cap around $400,000-$500,000. Owners can exceed $700,000-$1,000,000.
-
Cosmetic work is lucrative but optional — Some dermatologists do purely medical work; others are 50%+ cosmetic. Both can be very profitable.
-
The debt problem solves quickly — $350,000+ debt is intimidating, but $350,000+ annual income pays it off in 3-5 years.
-
This is a career you can do for 40+ years — Unlike surgical specialties, the physical demands are low. Many dermatologists work into their 70s.
For medical students who can match into dermatology, it offers perhaps the best combination of income and lifestyle available in medicine. The challenge is getting in.
Dermatologist Take-Home Pay After Taxes and Loans
A $400,000 gross dermatologist salary looks different after taxes, malpractice insurance, and student loan repayments. Here’s a realistic breakdown:
| Item | Annual | Monthly |
|---|---|---|
| Gross salary | $400,000 | $33,333 |
| Federal income tax (~37% effective) | -$130,000 | -$10,833 |
| State income tax (avg 5%) | -$20,000 | -$1,667 |
| Medicare surtax (0.9% over $200K) | -$1,800 | -$150 |
| Malpractice insurance | -$8,000 | -$667 |
| 401(k) / 403(b) max | -$23,500 | -$1,958 |
| Student loan payment (typical) | -$36,000 | -$3,000 |
| Estimated take-home | ~$181,000 | ~$15,100 |
Take-home pay for an employed dermatologist is roughly $14,000–$16,000/month — rising significantly once loans are paid off. Private practice owners earn more but carry additional business expenses (staff, rent, equipment). The break-even for private practice ownership typically comes 3–5 years in, after which income can substantially exceed employed salary.
Related Guides
- How much do doctors make?
- How much do surgeons make?
- How much do anesthesiologists make?
- US Income Percentile Calculator
Data sources: Medscape Physician Compensation Report, MGMA, Doximity, Bureau of Labor Statistics. Updated March 2026.
Sources
- U.S. Bureau of Labor Statistics. “Occupational Employment and Wage Statistics, May 2024.” bls.gov/oes
- Medscape. “Physician Compensation Report 2024.” medscape.com/slideshow/2024-compensation-overview-6016427
The content on Wealthvieu is for informational purposes only and should not be considered financial, tax, or investment advice. Consult a qualified professional before making financial decisions. Full disclaimer · Editorial policy