Dermatology has one of the longest specialist wait times in medicine — a routine appointment can mean weeks on a calendar, longer in areas with fewer dermatologists. Teledermatology exists specifically to shorten that gap, and for a meaningful share of skin conditions, it does the job about as well as sitting in an exam room. For others, it's a useful first step that still ends with an in-person visit.
Here's the honest version of which is which.
The two models, briefly
- Store-and-forward: You submit photos and a history; a dermatologist reviews and responds, typically within 24–48 hours. No live appointment required.
- Live video visits: A real-time appointment, same-day in many cases, where the dermatologist examines the area over video and can ask follow-up questions in the moment.
Some platforms now use a hybrid of both — photos submitted in advance, reviewed before a live call — which tends to produce the most thorough visits, since the dermatologist walks in already having seen the images rather than examining cold over a webcam.
What translates well to video
- Acne — one of the most common teledermatology visits, particularly well-suited to store-and-forward review for routine management
- Eczema and psoriasis — both chronic, both highly visual, both well-suited to ongoing remote monitoring between in-person checks
- Rosacea — diagnosis and management both translate reasonably well to photos plus history
- Rashes — often assessable over video, especially when photos are clear and well-lit
- Medication refills and treatment follow-ups — logistically the easiest category, since there's often no new diagnosis needed
- Initial mole or lesion triage — a dermatologist can often tell from photos whether something looks concerning enough to warrant an urgent in-person biopsy, even though the biopsy itself can't happen over video
That gap between 82% satisfaction and 27% full replacement is the honest summary of teledermatology's place in care: people like it, and most still want some in-person dermatology relationship too. It's a complement, not a full substitute.
What still needs an in-person visit
Anything requiring a biopsy. A dermatologist can flag a concerning mole over video, but removing tissue for pathology requires being in the room.
Procedures — cryotherapy, excisions, Mohs surgery. These are hands-on by definition, and telehealth follow-ups for them often fall outside what's separately billable anyway.
Full-body skin cancer screenings. A dermatologist examining a small number of submitted photos isn't the same as a systematic head-to-toe exam looking for something you didn't know to photograph.
One clinical nuance worth knowing
Research on teledermatology for acne has flagged a specific caution: isotretinoin, a common and effective but higher-risk acne medication, has less safety and efficacy data specifically for telehealth-based prescribing in female patients, given monitoring requirements around pregnancy prevention. If isotretinoin is part of your treatment plan, an in-person component is often appropriate even if the rest of your care happens virtually.
Good teledermatology doesn't try to replace your dermatologist. It tries to get you seen faster for the 70–80% of visits that don't actually need a physical exam.
How to get a useful teledermatology visit
- Use natural light, not a bathroom mirror selfie under a warm bulb. Color accuracy matters more than people expect for a remote diagnosis.
- Take photos from multiple angles and distances — one close-up and one wider shot showing surrounding skin.
- Mention how long the condition has been present and what's already been tried, even if the intake form doesn't explicitly ask.
Providers offering dermatology access
The provider below offers a broader telehealth footprint that includes skin conditions alongside its other specialties.
Where to start for a virtual skin visit
Sesame's provider marketplace includes board-certified dermatologists alongside its other specialties, with transparent per-visit pricing rather than a subscription commitment.
See Sesame Care's providers → Paid linkThe bottom line
Teledermatology is genuinely useful for the majority of what actually walks into a dermatology office — acne, eczema, psoriasis, rosacea, refills, and initial triage. It's not a replacement for a hands-on exam when one is actually needed, and a good platform will tell you that directly rather than trying to handle everything over video regardless of fit.