6 Things You Should Know About Teledermatology

Like many healthcare specializations, dermatology saw expanded telehealth coverage during the pandemic to limit COVID exposure. Even as regulations and recommendations ease, many dermatologists — including those at institutions like Yale — continue to offer teledermatology as a supplement to in-person care.

Both patients and doctors benefit from teledermatology. Doctors can bill for more services with telehealth codes related to asynchronous and synchronous care. Meanwhile, vulnerable populations like the elderly or those in rural areas can access a board-certified dermatologist from home. 

Below, we answer questions about teledermatology for patients, traditional medical providers, and digital health companies who offer dermatological services.  

1. What is teledermatology?

Teledermatology is a type of at-home care that provides remote dermatology support for medical conditions like acne, skin cancer, and allergic reactions. Unlike some healthcare specializations, dermatology is a visually-dependent field and therefore well suited for remote supervision. 

2. How does teledermatology work? 

There are two popular types of remote dermatology: store-and-forward and video conferencing. Store-and-forward is an asynchronous variety of teledermatology wherein the patient submits a photograph or video for review and diagnosis. Medical personnel can coach patients on how to take pictures, such as placing a penny beside a skin lesion to communicate size. 

Interactive video conferencing, on the other hand, lets the patient and dermatologist interact in real time. 

3. How effective is teledermatology?

Some studies suggest that store-and-forward teledermatology is more reliable than face-to-face dermatology if the dermatologist in question is an expert (as opposed to a newer in-person dermatologist). Good quality pictures are essential for effective teledermatology, and the prevalence of smartphones have made it easier for doctors to evaluate skin abnormalities from a patient-submitted image. 

Teledermatology can also improve wait times for suspected skin cancer patients. One study published in The Educational Journal of the British Association of Dermatologists found that 91% of patients who submitted pictures of suspected skin cancer were able to “achieve definitive care at first visit [...] compared to 63% via the conventional referral pathway.” This technique also reduced the number of patients requiring in-person clinic care by 72%.  

While a skin biopsy is necessary to confirm a cancer diagnosis, teledermatology is effective at linking suspected skin cancer patients to care fast. 

4. What conditions can be treated through teledermatology?

Teledermatology can be used to treat skin, hair, and nail conditions such as atopic dermatitis, acne, and psoriasis. Dermatologists can perform screenings, prescribe medicine, and help patients maintain chronic care remotely. Teledermatology works best for conditions with symptoms visible to the naked eye. 

5. How can at-home diagnostics support teledermatology?

At-home diagnostics can support medication adherence for drugs commonly prescribed by dermatologists such as Isotretinoin. Doctors can conduct routine cholesterol, triglyceride and LDL-cholesterol tests with self-collect dried blood spot test cards. 

To submit a sample, a patient pricks capillary blood onto five 13 millimeter circles on a dried blood spot card. Once the blood dries, the patient ships the card to a CLIA/CAP certified telemedicine lab, where technicians punch out the five circles and extract target analytes with a liquid solvent. Technicians analyze the patient samples to determine results. The dermatologist can review these test results and follow up as necessary. 

Some digital health companies incorporate at-home diagnostics through teledermatology to offer tailored products. Veracity Selfcare, for example, uses an at-home saliva self-test to determine customer skincare and supplement recommendations. Apostrophe offers relevant prescriptions for topical medications like tretinoin as well as oral acne medications that require routine blood testing. 

6. How do I consult a dermatologist online?

Insurance often covers teledermatology services, and Medicaid patients can also receive care from a remote dermatologist thanks to new guidelines. Patients should reach out to their current dermatologist to determine if remote care is offered, or use services like Find a Dermatologist from the American Academy of Dermatology Association. Patients can also contact their insurance provider directly to locate a dermatologist offering telehealth services. 

Teledermatology with at-home self-testing testing is not the only type of specialty care supported by the Ash Wellness solution. Check out 5 Types of Specialty Care Supported By Home Diagnostics.