Six Tips for a Productive Telehealth Appointment With A Dermatologist

Are people with a serious skin condition—specifically, hidradenitis suppurativa (HS)—willing to use telemedicine to meet with their dermatologist? That’s the question researchers at Penn State Hershey School of Medicine asked adults with HS in the early days of COVID-19.

Using telemedicine to meet with your dermatologist (a.k.a., teledermatology) has been around for a while. But it wasn’t commonly used, mostly because health insurance policies didn’t typically cover it. The pandemic has changed that.

But it’s one thing to video-conference with your derm for something like everyday acne or a rash, and quite another to do so when the visit requires you to send photos or a video of areas—like the groin, buttocks, armpits, and breasts—most commonly affected by HS.

Among those who responded to the survey: One in three were worried about privacy and the security of their photos; half were concerned that the dermatologist wouldn’t be able to properly evaluate their HS via telemedicine. And yet the overwhelming majority were open to teledermatology, even post-pandemic.

Here’s how to make sure you get the most out of a teledermatology appointment.

1. Confirm you’re covered

Thanks to the pandemic (did we really just write those four words?), many insurance providers have updated their plans to cover telemedicine visits, at least in the short term. Find out if teledermatology visits are covered by your plan before you make your appointment.

2. Gather essential info

Besides arming yourself with the standard health info you’d bring to any doctor’s appointment—family medical history, medications you take, major illnesses or surgeries you’ve had—be prepared to discuss previous skin problems and when your current symptoms began. Write down specific questions so you don’t waste time trying to remember them.

3. Get up to speed on tech

Find out in advance if your dermatologist plans to meet by video or phone. For video visits, you’ll likely be sent a website link to connect with your derm. Make sure you’ve downloaded the correct software and if it’s your first time using it, consider a dry run to avoid any last-minute glitches. If you’re uncomfortable showing affected areas by video and prefer instead to send snapshots in advance—as most people in the Penn State survey were—then be sure to make that request beforehand.

4. Take high-res photos

Photos are critical to the success of any teledermatology appointment. But some conditions can occur in places where it can be difficult to take pictures. Indeed, about one in five of HS patients surveyed worried about how they would take clear photos. If possible, enlist a trusted loved one to take pictures. Make sure they’re well-lit (ideally, in natural light; if that’s not possible, use a book light or flashlight) and that there aren’t any shadows or glares on the area being photographed.

If using a smartphone, take pictures in portrait mode, avoid using the flash, and make sure the skin is in focus, suggests Anthony Rossi, MD, an assistant professor of dermatology at Weill Cornell Medical College and dermatologic surgeon at Memorial Sloan Kettering Cancer Center in New York City. Try for multiple pictures from different angles—close-up and from about three feet away.

5. Avoid irritating your skin

Before your telemedicine appointment, try to avoid doing things—like taking a hot shower or picking at your skin—that could change your skin’s appearance.

6. Find a quiet, well-lit space

“It’s important to have a well-lit, private place for your visit since you may need to remove some clothing to show the skin changes,” says Steven Daveluy, MD, associate professor, and program director in the Department of Dermatology at Wayne State University. Dr. Daveluy recommends practicing showing the affected areas on camera once you know whether you’ll use your computer or phone for the visit, and suggests having a loved one assist if possible.

In addition, “You want a camera that has a high resolution, in an area that has access to natural light,” says Dr. Rossi. “That will give you the ability to best show the skin.” If that’s not possible, try for a spot with good overhead light.

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