Short answer: online dermatology is usually enough for common, non‑urgent, image‑based problems (mild acne, uncomplicated rashes, medication refills, hair loss follow‑ups). See an in‑person dermatologist when a diagnosis requires a physical exam or procedure (suspicious moles, biopsies, excisions, cryotherapy, rapidly changing or painful/bleeding lesions, severe or widespread disease, or when initial telecare fails). When online dermatology is appropriate Mild-to-moderate acne (initial treatment and follow-ups) Eczema, rosacea, mild psoriasis flares (routine care and med adjustments) New or chronic non‑urgent rashes (clear photos + history often suffice) Hair loss evaluation (pattern hair loss vs telogen effluvium) Medication refills and routine follow‑up of a known skin condition Quick triage for whether a lesion needs urgent in‑person care When you should see someone in person Any mole or spot that is changing, irregular, bleeding, painful, or meets ABCDE criteria for melanoma Lesions that need biopsy, excision, cryotherapy, laser, or other procedures Severe, widespread, infected, or rapidly worsening skin disease Unclear diagnosis after a televisit or failure to improve with recommended treatment Need for dermoscopy, palpation, or systemic workup (labs, imaging) Strengths and limitations of telederm Strengths: convenience, faster access, lower cost, good for photo‑based diagnoses and prescriptions. Limits: no palpation or dermoscopy, limited ability to perform procedures or skin biopsy, accuracy depends on photo quality and patient history, some controlled meds have prescribing limits. How to get the most out of a telederm visit Take several clear photos (close‑up, from a distance, good lighting, include a ruler or coin for scale) Describe onset, symptoms (itch, pain), changes, and prior treatments List medicines, allergies, and relevant medical history Ask if an in‑person exam or biopsy is needed if anything is suspicious Recommended telederm services (examples; availability varies by country) First Derm — quick asynchronous photo consults by dermatologists; good for fast triage and second opinions. Curology — subscription service focused on acne with personalized topical prescriptions and follow‑up. DermatologistOnCall — video visits with board‑certified dermatologists for a wide range of skin issues. Teladoc and Amwell — large telemedicine platforms that include dermatology and often integrate with insurance and primary care. (If you’re in the UK or elsewhere, similar options include Babylon, Push Doctor, or regionally offered telederm by major hospital systems.) If you want, tell me where you are (country) and what specific skin problem you have and I’ll recommend the best telederm services in your area and whether a virtual consult is reasonable now.
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