“Patients often ask me, ‘What do you do?’” said Dr. Francesca Fusco the other day from behind a large antique desk in her cream-colored office in the Wexler Dermatology practice on East 32nd Street. “And then I tell them, ‘I do chemical peels; I use, for example, Retin-A, I use Vitamin C, I have had Botox …’”

“I’m due,” she whispered, casually gesturing towards her smooth forehead with a French-manicured hand.

A petite brunette with large brown eyes who will admit only to being “in her 40’s” (she’s been practicing for 18 years), Dr. Fusco is, in a word, gorgeous—just one in the city’s growing brigade of attractive female dermatologists, who, even more than their famous clients, serve as “faces” of the treatments they peddle.

“Appearance does matter,” said Dr. Grace Pak, a private practitioner on lower Fifth Avenue who wears her hair short and sleek and, at 43, lacks any trace of a wrinkle. “I go to great lengths to present a consistent image,” she said.

Long gone are the days when women went to see skin specialists just to get a zit popped or a mole checked. With injectable face fillers, glycolic acid treatments and new lasers zapping onto the market every minute, patients shopping for a dermatologist these days are really “shopping for a new face,” said Dr. Gervaise Gerstner, 34, a former colleague of Dr. Fusco’s who now practices at Park Avenue Skincare further uptown—and practices what she preaches! “People say, ‘Give me exactly what you do,’” said Dr. Gerstner, a lithe blonde pictured in windswept black and white on her practice’s Web site. “It’s really sweet.”

Vamping In Vogue

Of course, one expects one’s dermatologist of either gender to have a smooth complexion. But no one ever compared, say, Dr. Zizmor to George Clooney.

“I think there is a kind of a high bar as a female dermatologist,” said Dr. Anne Chapas, a fetching young specialist who practices at the Laser and Skin Surgery Center of New York. “Men are just as into keeping up their appearance as the women in the field, but there’s probably a little more pressure on the women. “Patients say, ‘Oh, I want to have skin like yours. Your skin is gorgeous.’ And I always wonder, ‘Do they ask my male colleagues that?’”

In the past, dermatology was hardly a glamour field. “Historically, they were geeks,” said Dr. Ellen Marmur, chief of dermatologic and cosmetic surgery at the Mt. Sinai Medical Center. But over the past decade, the specialty has changed radically, thanks to developments like the mass marketing of Botox and the blockbuster idea that the fat on one’s ass would actually look better puffing up one’s cheeks. Baby-boomer demand for safe, noninvasive anti-aging procedures has taken dermatology from the unpleasant realm of acne and rashes and elevated it to “a lifestyle specialty,” to use Dr. Pak’s lofty term.

And such a specialty requires the right kind of ambassador, at least in competitive Manhattan. Like socialites, designers, magazine editors and fashion publicists, female dermatologists now tend to be a youthful, well-coiffed bunch, blending seamlessly with their patients at high-profile society gatherings, even popping up occasionally in Vogue’s party pages.

The most recognizable face of the bunch is Dr. Lisa Airan, a photogenic Northwestern University-educated (and frequently designer-clad) dermatologist who trained at UCLA before setting up shop on Fifth Avenue, marrying a plastic surgeon, appearing on The Oprah Winfrey Show and achieving ubiquity on the benefit circuit (she refused to be interviewed for this article).

Then there is Dr. Gerstner, a Princeton-educated former chief resident at Mt. Sinai with two young children who currently works six days a week, while still finding time to pose beside socialite patients Marjorie Gubelmann and Cristina Greeven Cuomo and friend Tory Burch, herself a client of grande-dame glamour derm Pat Wexler.

“It’s true with anything,” said Katherine Pearle, an Upper East Side mother of three who sees Dr. Gerstner every one to three months and also brings her husband and kids in when they need it, explaining her choice of a dermatologist that dazzles. “You want to go to a dentist with nice teeth.”

“When I send patients to her, they’re always impressed with what her office looks like and what she looks like,” said Dr. Jennifer Salzer, an orthodontist and another patient of Dr. Gerstner’s. “I usually feel confident they’re going to feel comfortable when they see her that she’ll understand what they to want to accomplish.”

‘Harder Than Becoming An Astronaut’

Dr. Rosemarie Ingleton, a dermatologist of African descent with close-cropped hair and glowing skin, has been in private practice on East Fourth Street since 1996. She said that dermatologists have “definitely, definitely, definitely” become more glamorous than their colleagues in various other medical specialties.

“It’s one of those things that’s never discussed, but we all laugh about it behind closed doors,” Dr. Ingleton said. “You always wonder, do they look at it when they’re selecting or is it just that the pretty girls are interested in dermatology?”

They can’t just be pretty, of course. As the field becomes more lucrative, landing a residency in dermatology has become exponentially more difficult. “My father is a Shakespeare professor”—apparently with a sideline in probability—“and he [calculated] that it’s harder to become a dermatologist than an astronaut,” said Dr. Marmur of Mt. Sinai. “I think it’s a reflection of how bad the insurance situation is for most doctors across the board.” (Aesthetic treatments are not covered by insurance, so most elite New York dermatologists don’t bother taking it even for medical visits).

“Dermatology is one of the most competitive residencies in the United States,” said Dr. Nicholas Soter, head of the dermatological residency program at N.Y.U. School of Medicine (which has lately received 450 applicants for its approximately eight spots per year, he said). “You have to distinguish yourself academically as well as in other ways.”

Dr. Soter, in practice since 1973, said he had not necessarily noticed a rise in pulchritude among his fellow pimple-poppers, to borrow a term from a Seinfeld episode that still rankles with clinicians. “Maybe they’re more concerned about their appearance,” he allowed.

Dr. Stephen Webster, of the American Board of Dermatology, the specialty’s certifying board, said that there are only about 300 residency positions in dermatology nationwide per year. Across the country, he said, women currently outnumber men in these programs by just over half. However, top programs in New York tell a different story: 16 of 23 current residents at N.Y.U. are women, said Dr. Soter, and at Mt. Sinai, 10 of 11 are, according to Dr. Shira Maryles, 30, the chief resident.

“They all have the credentials, they’re intelligent and on top of it they’re beautiful,” said Dr. Sylvie Khorenian, a lovely, deep-voiced brunette who practices on Park Avenue and in Englewood Cliffs, N.J., and teaches residents at Mt. Sinai. “And that is an asset, unfortunately, because it’s become so cosmetic. [Patients] can’t help but look at whom they’re taking advice from.”

Meanwhile, brand-name male doctors such as Frederick Brandt, Howard Murad and Peter Thomas Roth, all of whom have their own skin-care lines, are increasingly yielding airtime to female doctors who are currently the preferred experts of editors and producers, perhaps because of the “relatability” favor. “When you turn on the TV and you watch your morning news shows, I’m seeing more female dermatologists than men,” Dr. Fusco said.

“I guess I feel like a woman’s more in touch with what a woman wants,” said Ms. Pearle, Dr. Gerstner’s patient. “Especially in New York, where everybody wants to have perfect skin. I just think she can relate to me better [than a male dermatologist].”

“We’re traditionally the more significant consumers of beauty services, as compared to men,” Dr. Pak said. “I think the aesthetic sense and the sociability of a woman adds to our ability to provide comprehensive skin care for our patients.”

Skincare’s Swish Sewing Circle

One can’t deny the lifestyle benefits of the field, either; dermatologic emergencies, unlike heart attacks, rarely occur at 2 a.m. A typical glamour derm’s schedule will allow her to drop kids off at school personally in the morning before heading into the office to meet with 20 to 30 patients until about 6, when she’ll be home again to see Junior off to bed. “Most of us have kids,” said Harvard-educated Dr. Susan Taylor, who founded the Skin of Color Center at St. Luke’s-Roosevelt a decade ago. “I never miss their school functions,” said Dr. Amy Wechsler, a beautiful blonde with a flourishing Park Avenue private practice, of her two children, ages 6 and 9. “Everyone thinks dermatology is so the right choice.”

Indeed, could the sedermatological demoiselles, what with their perfect skin, their flexible schedules and their lucrative laser machines, be attracting the envy of elite doctors in other disciplines? “Absolutely, absolutely,” Dr. Khorenian said. “I’m married to an opthamologist. Every dinner I go to, banquet, doctor’s event, the joke is always, ‘You’re so lucky you’re a dermatologist.’ They tease you, and at the same time, they all want to do what we’re doing. I’ve had several opthamologists come to my office to learn how to do Botox.”

“Who can blame a discouraged internist who gets a job as a Botox injector?” said Dr. Pak dismissively, of those angling for a piece of the aesthetic-procedure pie. “But it’s sad on many grounds; the way our health-care system is makes it hard for a hardworking doctor to make a living wage.”

Dr. Gerstner disagreed that derms are the envy of other docs; indeed, she feels “a little bit looked down upon, because I think they feel like we’ve sold out to just cosmetics,” she sniffed. “One of my passions is also dysplastic moles and melanoma!”

The other day, Dr. Wechsler was in her offices on Park Avenue—which she is sharing with two gastroenterologists while she renovates new, private digs up the street—wearing a gray dress with a delicate silver necklace and knee-high black boots. Her straight blond hair fell partially in her face, giving her the affect of a shy undergraduate.

An uncannily lovely and youthful-looking 38, Dr. Wechsler is a current darling of the major beauty magazines, who feature her advice and picture regularly in their pages; she has her own column in Marie Claire. She is also the only female doctor in the United States to be board-certified in both psychiatry (her initial choice) and dermatology (for which she completed a second residency after working briefly as a psychiatrist). She has been approached by several skin-care companies offering her a collaborative line, she said, all of which she has turned down because “unless I love something and really believe it works, I’d never put my name on it”; apparently that criterion applies to her yet-untitled book on the mind-body connection, which Simon & Schuster will publish in October.

Dr. Wechsler is interested in the troubled intersection of a woman’s appearance and psyche. “A lot of patients come just for dermatology and we end up talking about stuff,” she said. “For example, someone comes for upper-lip laser hair removal. I like to talk about how it feels as a woman to have all this hair on their upper lip.” Skin care can be so emotional, she said, that “people cry every day here. They don’t leave crying. But I think it’s a positive experience for patients. These days, in most doctor’s offices, it’s just a five-minute appointment. And you don’t really get to know anybody that way.”

The modern New York glamour derm, on the other hand, usually gets to know her patients quite well. This is because she sees many of them “once a month for a peel or microdermabrasion,” Dr. Gerstner said. “And then usually every three to four months for their Botox and filler. My No. 1 procedure right now, that people just are begging for, is the Fraxel laser. I call it Fraxel Friday. It takes 12 to 24 hours to recover, so women love doing it on Friday afternoons so they can recover on the weekends.”

With these kinds of regular dates, perhaps it’s only natural that glamorous derms would begin to inhabit their glamorous patients’ worlds more fully.

“Do I write prescriptions for antibiotics?” said Dr. Wechsler. “Yes. I keep up with a lot of other fields of medicine. I refer to ear, nose and throat all the time, OB/GYN, in vitro, massage therapists, a good place to get a manicure/pedicure, where’d you get those shoes, everything! And kid-related stuff. Camp, school … I have a lot of patients whose kids are applying to nursery school, and I’ve been through that, so I help them. I mean, the skin diseases are interesting and fun and neat to treat. But it’s really the people, people interaction, that’s to me satisfying.”

“I end up giving out all sorts of advice that I probably shouldn’t give,” said Dr. Pak. “Like, you should think about doing your hair this way, or I think that that lip color accentuates the pink undertone in your skin.”

“My patients are my friends. You know?” Dr. Gerstner said. “Half the time when I’m going out to dinner I’m meeting a patient for dinner. Tonight I’m going over to a patient’s house for dinner; she’s having 14 women over. That’s a typical night for me.”