Can an Online Dermatologist Prescribe Medication? How Virtual Dermatology Works

Yes, an online dermatology provider can diagnose most common skin problems from photos and prescribe treatment when it is appropriate. For acne, rosacea, eczema, fungal rashes, and similar conditions, it often means a treatment plan in about a day instead of a months-long wait for an in-person dermatologist. Here is what online dermatology handles well, what it does not, and how to get the most out of a visit.

How online dermatology works

Most online dermatology is asynchronous, which means you do not need to schedule a live video call.

1. You answer questions about the problem: where it is, how long you have had it, what you have tried, and your medications and allergies.
2. You upload photos from your phone.
3. A licensed provider reviews your photos and history, then sends back a diagnosis and a treatment plan.
4. If a prescription is appropriate, it goes to your pharmacy.

Because skin is visual, good photos do most of the work that an exam room would.

What online dermatology handles well

• Acne, including hormonal acne in adult women
• Rosacea
• Eczema and contact dermatitis
• Psoriasis
• Fungal infections such as athlete's foot, ringworm, and jock itch
• Dandruff and seborrheic dermatitis
• Hives and many common rashes
• Pattern hair loss

What needs to be seen in person

• A mole or spot that is new, changing, bleeding, or looks different from your other moles. A provider can look at photos and tell you whether it is worrying, but only a biopsy can rule out skin cancer.
• A rash with a fever, blisters over a large area, or skin that is peeling
• Red, hot, swollen skin that is spreading fast, which can be a serious infection
• Anything that needs a procedure, like removing a growth or draining a cyst

A good online provider will tell you when something needs an in-person visit instead of guessing.

Common prescriptions from an online dermatology visit

Depending on the problem, a provider might prescribe:

• Tretinoin or another topical retinoid for acne
• Topical clindamycin or an oral antibiotic such as doxycycline for inflamed acne or rosacea
• Spironolactone for hormonal acne in women, used off-label
• Steroid creams such as triamcinolone or hydrocortisone for eczema and dermatitis
• Antifungal creams or shampoos such as clotrimazole or ketoconazole

Severe, scarring acne sometimes needs isotretinoin, which requires enrollment in a federal safety program and regular lab work. If that is where you are headed, expect the provider to talk through whether online follow-up can handle it or whether you need a local dermatologist.

How to take photos that get you a real answer

• Use daylight near a window, not a flash or a warm lamp.
• Take one close-up and one wider shot that shows where it is on your body.
• Hold the camera steady and tap to focus. A blurry photo is a wasted photo.
• No filters and no beauty mode.
• For a spot or mole, put a coin or ruler next to it so the provider can judge the size.
• If the problem comes and goes, take photos when it looks its worst.

What it costs with us

Dermatology consults are included with our Primary Care membership, along with unlimited primary care, 24/7 urgent care, and behavioral health support. There is no separate dermatology fee.

Several of the most common skin prescriptions are on our membership formulary, including tretinoin gel, topical clindamycin, doxycycline, spironolactone, triamcinolone, hydrocortisone, clotrimazole, and ketoconazole shampoo. With a Prescription Discount plan, those come at no extra cost when a provider determines they are appropriate and prescribes them. For hair loss specifically, read our guide to getting a hair loss prescription online.

One more thing about skin cancer

Online dermatology is great for the everyday stuff. It does not replace a full-body skin check if you have a lot of moles, a history of bad sunburns, or a family history of melanoma. If a spot is changing, do not wait on it.

Questions? Reach out. If you have a rash with trouble breathing, or swelling of your lips, tongue, or throat, call 911.