Dermatology dress codes loosen their ties

By Emily Margosian, Senior Editor, August 1, 2025

The physician’s white coat: iconic and instantly recognizable as a symbol of authority and professionalism. Like a judge’s robe or firefighter’s uniform, it signals a specific role.

However, in recent years, many medical office dress codes have shifted away from white coats and formal attire to a more practical and comfortable approach, with a focus on hygiene and functionality.

As dermatology offices continue to adjust to post-pandemic practice, how have dress code norms further changed? This month, dermatologists across the country discuss the factors that shaped their dress codes and how they set and enforce a successful dress code policy.

Evolution of medical office wear

In the past, white coats and formal attire were the standard for physicians and other medical staff. Now, many practices encourage a more business casual dress code, prioritizing comfort and functionality while maintaining a professional appearance.

“At our practice, front desk personnel, medical assistants, administrative staff, laser technicians, and aestheticians wear black scrubs and closed-toe shoes. Physicians and physician assistants typically wear business professional or our preference of scrubs with or without a white coat,” said Sheila Farhang, MD, FAAD, who practices in Tucson, Arizona, and Beverly Hills, California. “I personally enjoy dressing up with heels on certain days and opt for scrubs on procedure-heavy or surgery days.”

“I have worn scrubs as a Mohs surgeon for 15 years, and before that, professional attire with a lab coat, but times changed! Most of our younger clinicians prefer to wear scrubs.”

“Everyone is in matching scrubs that we provide for them. The scrubs have our logo, their name, and title. Physicians and non-physician clinicians have first and last names. Everyone else has first names only,” said Karyn Grossman, MD, FAAD, who practices in Santa Monica, California, and New York City. “All physicians and physician assistants wear white coats. Medical assistants have grey coats that match their scrubs. It’s a personal choice if they want to wear coats or just their scrubs. I am always in a white coat.”

Scrubs, originally designed for operating rooms, have also become increasingly favored in other medical settings due to their practicality, comfort, and ease of cleaning. Their popularity may be influenced by new infection control and hygiene standards which encourage short sleeves or short-sleeved white coats to minimize the risk of pathogens transferring from sleeves to patients.

“I have worn scrubs as a Mohs surgeon for 15 years, and before that, professional attire with a lab coat, but times changed! Most of our younger clinicians prefer to wear scrubs,” said Beth Goldstein, MD, FAAD, member of the Academy’s Practice Management Committee.

“Scrubs all the way these days! Everyone at our practice wears scrubs, from the receptionist to the medical assistants,” agreed Samantha Pop, MD, FAAD, a dermatologist in private practice in Voorhees, New Jersey. “As the sole physician, I typically also wear scrubs, but will also sometimes throw a white coat on top.”

Post-COVID changes

The pandemic changed how many industries dress for the office. While the COVID public health emergency (PHE) has officially ended, some dermatology practices have seen lasting changes to their dress code policy post-PHE.

“I opened my practice in 2020. I wore scrubs and a mask throughout the peak of the pandemic,” said Dr. Farhang. “I still wear a mask during many patient encounters, especially during flu and cold season.”

In a 2016 study, patients were found to prefer professional attire (white coat or use of a tie) for their dermatologist in the medical, surgical, and wound care setting (doi: 10.1016/j.jaad.2016.02.1105). However, nearly 10 years later, the realities of post-pandemic practice have reset these expectations, some say.

“In this day and age, especially after COVID, I’ve just found that scrubs are more comfortable and easier to clean,” said Dr. Pop. “Before the pandemic, there were studies done on whether patients preferred physicians in scrubs versus a white coat, but now I think preferences among physicians and patients have changed a lot. Clinicians at all levels are more accustomed to wearing scrubs, and patients seeing their doctors in scrubs has become much more the norm.”

“Certainly, during COVID and right after, a lot of people were much more concerned about infection. At the end of the day, you can go home and easily wash your scrubs, whereas it’s more effort to dry clean your professional clothes. A lot of people permanently made the switch,” said Dr. Grossman. “What’s interesting is that within the past year, I’ve noticed the pendulum has swung a bit back the other way. There was a big move to dress down, but now people want to dress up a bit again. We’re still in scrubs because I prefer it that way, but I do get the sense that as people are starting to feel more ‘normal’ there’s a desire to come into work dressed more formally again.”

Factors influencing practice dress code policy

While COVID had a strong influence on medical office dress codes, many other factors contribute to a practice’s chosen policy.

Patient preferences

Patients may or may not have a strong preference for their physicians to wear specific attire. In some cases, dermatologists have found that the white coat remains a powerful visual cue to denote their role in the practice. “I’ve noticed that patients — especially our more mature demographic or new patients — prefer a white coat as it decreases confusion about who is providing their care and who they are speaking with,” said Dr. Farhang. “I personally will put on a white coat for new medical dermatology patients or surgery consultation visits. I will, however, typically remove my coat during procedures as the coat can be restrictive. I have many established patients, so I don’t feel the need to always wear my white coat.”

According to Dr. Pop, the ‘white coat question’ can also be career stage- and practice setting-dependent. “Since I’m in solo practice, they know they’re coming in to see Dr. Pop. They easily recognize me as the physician. However, for dermatologists in training, and especially younger female physicians who may be confused for a nurse or another person on the team, it may be helpful to wear a white coat to better identify yourself as the dermatologist.”

Patient preferences regarding visible tattoos and piercings among medical staff also vary.

“We don’t have anything explicit in our policy about tattoos or piercings but prefer staff to keep their tattoos relatively hidden. Most of the time they’re covered by the sleeves of our scrubs,” said Dr. Grossman. “We do have some staff with neck tattoos that are visible, but tattoos seem to be so prevalent now they don’t faze any of our patients.”

Hygiene

Infection control, patient safety, and hygiene are also key considerations in medical dress codes. “Anybody who has direct contact with a patient must wear their hair tied back so it doesn’t fall onto their face or the patient’s face. Staff who don’t provide direct patient care, such as the front desk, can wear their hair down or up,” said Dr. Grossman. “We also stipulate that nails can’t go a quarter inch past the end of your fingertips, and no one can have pointed stiletto nails.”

Dr. Grossman’s dress code policy also prohibits clinical staff from wearing large jewelry that could interfere with patient care. “Staff can’t wear large earrings or necklaces that might hang down on a patient. Same thing for rings, because a ring could interfere with their gloves and potentially cause them to rip. Essentially, all jewelry needs to be minimal or left at home.”

“It really simplifies things and creates a ‘Steve Jobs effect’ where you can wake up in the morning and not have the mental load of deciding what to wear.”

Staff comfort and functionality

Medical professionals need clothing that allows them to move freely and efficiently. “Staff can wear any kind of closed-toe shoe, but no sandals. We used to limit it to certain colors, but now allow any shoes that aren’t bright,” said Dr. Grossman. “Most of our staff prefer to wear sneakers or nursing clogs.”

According to Dr. Pop, the decision to have all staff in scrubs versus professional wear has also helped alleviate daily decision-making fatigue. “It really simplifies things and creates a ‘Steve Jobs effect’ where you can wake up in the morning and not have the mental load of deciding what to wear,” she said. “It’s already predetermined and one less thing on your plate.”

Practice image and professionalism

Dress codes can also play a significant role in a practice’s overall branding strategy by reinforcing the image, values, and professionalism that the practice wants to convey to patients. “Our scrubs sort of match the color of the walls and the iPads we use. It all comes together to present a clean, unified look,” said Dr. Pop.

“Matching scrubs was partly a branding decision,” agreed Dr. Grossman. “It also came from experience with staff wearing what I wouldn’t necessarily consider professional attire. We had a surgery coordinator show up once with fishnet stockings and her stomach exposed. That’s just not medical professional attire. We also recently added guidelines about fake eyelashes and eyelash extensions. That was the result of direct patient feedback that a certain staff member looked like they were ready to go out to a nightclub. We also require staff to keep makeup muted and nail polish needs to be some neutral color.”

According to Dr. Grossman, the decision to implement matching scrubs not only ensures a professional appearance and consistent brand — but also fosters a sense of camaraderie and among her staff. “Sometimes there’s a division between the front and the back of the office, but in this case, they’re all a team and all wear the same uniform.”

Setting the standard: Dress code implementation

A formal dress code policy outlines what is expected of employees related to their dress during work and work-related events. It should provide clear direction of the overall practice dress code and specifics about common questions related to the policy (e.g., if the practice wants staff in scrubs of a certain color, that should be outlined in the policy).

“Our dress code policy for staff is outlined in our employee handbook. It includes mention of piercings, tattoos, and personal hygiene. For example, ensuring scrubs are washed or not stained,” said Dr. Farhang.

Offices should also ensure their policy is legal in the state the practice is located, and have it reviewed by a health care or employment attorney. “Our dress code policy is part of the employee handbook that staff sign when they are hired,” said Dr. Grossman. “Additionally, our entire employee handbook is reviewed annually by an employment attorney.”

Some practices may opt to forgo a formal dress code policy depending on practice size and setting. “We currently have no formal policy in writing. When we hire staff, the expectation is that they must be clean and presentable,” explained Dr. Pop. “Since we are a small solo practice, I’ve let people decide for themselves what ‘presentable’ means. As the practice expands, it may be something I have to address in the future. For now, it’s worked out to allow people to self-monitor.”

Enforcement and getting staff on board

Dress codes can be sometimes unpopular. When implementing a new dress code policy or changes to the existing policy, start by educating the practice team. Be prepared to provide the “why” behind the requirements. Staff are typically more supportive if they understand why they are being asked to dress a particular way.

“We haven’t had a lot of pushback from staff, but one person did have an issue with the eyelash requirement. She preferred to wear extremely long eyelash extensions. Ultimately, she complied and scaled back when we explained that patients had commented,” said Dr. Grossman. “Our dress code policy regarding nails is something that we’ve had issues with and do end up enforcing. We have a ruler and have come around to measure people’s nails because they’ve been way too long.”

Physician team leaders may consider choosing a ‘dress code champion’ or point person who is capable of effectively communicating and enforcing your code. This person should be able to manage related questions reasonably and fairly. For example, if the physician is male, consider having a female manager or senior staff member take the lead on dress code discussions delivered to a primarily female staff.

According to Dr. Grossman, conversations about dress code enforcement vary depending on the unique situation. “The practice manager may lead the conversation, or in some cases I will, depending on the intensity of the conversation or individual staff member involved. Sometimes people need a stronger push coming directly from the physician.”

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