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The feds are turning up the heat on the tanning bed industry, with two major regulatory agencies and Congress getting into the act. Late last year, senators developing healthcare legislation dropped a proposed tax on cosmetic surgery and substituted a 10 percent tax on indoor tanning services.

Cosmeceuticals carry the promising suggestion of providing cosmetic treatments with active ingredients that give them pharmaceutical-like efficacy to address skin aging and skin problems. Dermatologists are faced with the unique challenge of wading through these claims.

The Food and Drug Administration's rebuke of Florida dermatologist Leslie S. Baumann, M.D., for promoting a then-unapproved drug serves as a warning for clinical investigators to speak carefully in public forums, dermatologists say.

Established in 1985, the so-called "ABCD" criteria (assymetry, border, color and diameter) were designed to help laypersons and physicians evaluate suspicious cutaneous lesions and, possibly, make an early diagnosis of potentially curable melanoma. Currently, there is a grassroots move in dermatology to change the "D" criterion from "diameter" to "dark."

Dermatologists welcome the FTC's recent crackdown on what the agency labels deceptive advertising by the Indoor Tanning Association (ITA). The ITA, meanwhile, says a recent settlement with the federal regulatory agency will allow the industry to continue to have a "meaningful voice" in the debate over the health benefits and risks of tanning.

Dr. Skin is given basic privileges in dermatology, but is told that nobody in the department of medicine is comfortable providing her with surgical privileges. She subsequently applies for the same privileges under the department of surgery. Her request - reviewed by three general surgeons and two plastic surgeons in their monthly peer review meeting - is turned down.

Minimizing pain while performing botulinum toxin injections is of paramount importance to patient and physician alike. Though there are several topical anesthetic techniques from which to choose, Pain Ease (Gebauer Company), a topical anesthetic skin refrigerant, appears to be the best choice, according to an expert.

Love or loathe them, public Web sites that let patients rate their physicians aren't going away, experts say. Making these sites work for you rather than against you requires ongoing vigilance, broad-based patient participation and - for some physicians - patient contracts, they add.

Skincare products developed for a specific purpose work best. Most companies put a lot of time and effort into formulation, and there is no doubt that shaving cream is the best product for any shave in any area in both sexes.

We asked a number of doctors around the country whether they are adding procedures, therapies or equipment to their practices this year, and how those plans are being impacted by economic conditions. While some dermatologists are being cautious, others are actually using the economic challenges to plan for the future of their businesses.

A recent study that ranks dermatology among the most satisfying medical specialties to practice finds agreement among dermatologists, who count the specialty's diversity, flexibility and visual nature among its charms.