The median income for a dermatologist is around $200k, but the amount you make depends on where you work. Dermatologists work in hospitals, private practices, and clinics. There are benefits for working at a hospital or at your own practice. The nice thing about working in a hospital is that you don't have to deal with insurance companies delaying or denying payment for procedures. Dermatologists who work in hospitals do not have to spend money on marketing themselves or for the overhead of having an office. Their income is generally pretty steady.
Dermatologists who have their own practice must pay employees, pay different taxes, spend money on marketing, pay the rent on their office, and buy equipment. The upside is that they can create their own price list for services. Because insurance companies do not cover cosmetic procedures, dermatologists can set prices for any aesthetic or elective procedure without haggling with insurance companies. Botox is priced by the unit (how much is used). For example, someone erasing frown lines may need between 20 to 30 units of Botox. (Men need more units of Botox for the drug to be effective.) The average cost comes out to between $350 and $500. Maybe they just should have smiled more?
However, most people go into the dermatologist to have more than just frown lines erased. To treat excessive armpit sweat, a person may have to pay around $1,400. Botox lasts eight months. Performing a ton of cosmetic or elective procedures is a great way for dermatologists to get additional cash flow.