Even though your daily life may not look the same as it did in February, now isn’t the time to let up on caring for your health — including that of your skin. While your dermatologist has likely paused in-person visits amid the COVID-19 pandemic, you can use telemedicine to meet with him or her virtually from the safety of your home.

COVID-19 and the Rise of ‘Teledermatology’

Telemedicine is a blanket term used to describe virtual doctor’s visits, whether they’re held via an app that offers its own providers or a video conferencing service through which you connect with an individual provider you’d typically meet in person.

Amid COVID-19, telemedicine has arguably gone mainstream. Medici, a telemedicine platform launched in 2016, has had a 1,409 percent increase in patient registration and a 1,822 percent increase in provider registration from March 15 to April 15, 2020, says Clint Phillips, CEO of Medici.

But with such a hands-on field of medicine, how is using telemedicine for dermatology appointments — or using “teledermatology,” as some people refer to it — possible?

“Our specialty is a visual field, and there are many skin conditions which are diagnosable from looks alone,” says Mona Gohara, MD, a Yale University–affiliated dermatologist based in New Haven, Connecticut. Yet there are limitations when it comes to what can get done through a quick video chat, phone call, or text messages — many conditions require a closer, hands-on approach. “We don’t have all of our tools, such as the dermatoscope, and some visits could necessitate further and immediate emergency testing,” she adds.

But it’s skin’s visual nature — and likewise, the manifestation of medical issues surrounding it — that lends itself to the growing practice of telemedicine. And while the COVID-19 epidemic has certainly propelled virtual care, dermatologists and medical staff are still adjusting to the brand-new (and often evolving, as a research letter to be published in the May 2020 issue of Journal of the American Academy of Dermatology noted) guidelines for telemedicine in dermatology.

How to Start Using Telemedicine With Your Dermatologist

Booking a dermatologist appointment online can be as simple as using an app like Medici — or checking in with your existing doc to see if he or she offers virtual visits. The American Academy of Dermatology officially approves of the practice, and in light of the coronavirus pandemic, has relaxed its guidelines on which providers can treat which patients, as well as on requiring prior visits and on requiring primary care referrals.

You can also check with your insurance carrier, as an increasing number of from-home health services, such as Teladoc, are rolled into the benefits received from your monthly premium. “Most insurances are covering remote visits just as they do in-person visits,” says Joshua Zeicher, MD, a board-certified dermatologist and the director of clinical and cosmetic research at of Mount Sinai Hospital in New York City. “In the event that the visit is not covered, I would say the average out-of-pocket cost would be $100 [for the appointment],” he adds, although it can vary depending on the provider.

If you have a dermatologist whom you’re specifically interested in seeing — or you’ve already been working with — start there. Some medical doctors (MDs) use video conferencing systems like Skype and Zoom. Meanwhile, others, like Peter Friedman, MD, a board-certified dermatologist based in New City, New York, have shifted technologies as they’ve advanced. “We started with Skype, but now our EHR (electronic health record) vendor added direct telehealth capability to our system where a link is texted to the patient from which they can connect to a session. They don’t need to download an app or anything, it is HIPAA compliant, secure, and works on any platform.”

Otherwise, you can ask your primary care provider for options, call the number of the back of your insurance card, or check out telehealth services such as Medici, Teladoc Health, or the one Dr. Gohara’s office currently uses, Doxy.me.

When Telemedicine Works for Dermatology — and When It Doesn’t

Already in someone’s care? Follow-up visits with your dermatologist are easily conducted via phone or video, according to Gohara and Zeichner. “Video visits have allowed me to continue to care for my patients,” explains Dr. Zeichner. “Just because a condition is not life-threatening, it does not mean it doesn’t need immediate care.”

Appropriate for: Maintenance of Skin Conditions

Gohara has also been offering virtual appointments due to the onset of social distancing guidelines amid the coronavirus epidemic, and has been seeing many patients for maintenance-related visits. “It’s been great for those who just come in for their Accutane prescription, for example,” says Gohara. (Isotretinoin is sold under the brand name Accutane, and is an oral medication used to treat severe nodular acne, according to the U.S. Food and Drug Administration.)

And thanks to dermatology’s visual nature, Gohara is able to identify more easily diagnosable conditions with a call or video chat — think eczema, psoriasis, shingles, or poison ivy. “There are just some rashes that are so distinct,” she explains, which allows for them to be cared for — and well — on the virtual level.

Inappropriate for: Annual Skin Checks and Potential Skin Cancer Diagnoses

But not everything dermatological is fit for an appointment over the phone. Annual skin checks, for example, should always be done in person. “Most skin checks are conducted with a dermatoscope, and you just can't do that. It's like a cardiologist not having their stethoscope” to listen to your heart.

Likewise, if you have a suspicious bump you suspect could be a malignant lesion (aka skin cancer), don’t stress about making your first visit about it a virtual one. “I still recommend scheduling an appointment with your dermatologist if you notice a new or changing spot,” says Zeichner. That way, if your dermatologist thinks something requires further, in-person investigation, you can schedule your in-person visit from there — or alternatively, if it’s nothing serious, skip going to the physical office altogether.

Cosmetic Procedures Also Aren’t Possible via Telemedicine

What you can’t get from a virtual visit with your dermatologist, though, is anything procedural, cosmetic or otherwise. “So while you can work on fine lines and wrinkles or melasma or discoloration with Retin-A and other fading creams and stuff like that. No procedural stuff, no Botox, no fillers,” says Gohara.

To the same effect, there are plenty of additional procedures that aren’t strictly cosmetic that can’t happen virtually. “Unfortunately, I have not figured out how to inject a pimple with cortisone or freeze a wart through my telephone,” jokes Zeichner, alluding to the fact that some things can only happen IRL. Take potentially serious conditions, such as suspected skin-cancer lesions, which require a surgical biopsy and lab analysis for a proper diagnosis.

Dermatology Telemedicine: The Bottom Line

“I don't think it's perfect, but I think that it serves a purpose, and it allows for a connection, and you can be really productive, particularly with routine follow-ups and medication refills and rashes that need to be seen,” says Gohara.

And because office visits aren’t really possible thanks to the global health pandemic — and because said pandemic has nonessential workers staying home — the proliferation of telemedicine serves as a reminder to stay healthy. “While taking care of patients with COVID-19 is the most pressing issue facing the United States right now, it is important not to forget about routine healthcare,” Zeichner says.