Teledermatology: The Future of Skin Care or Just a Filtered Facade?

Happy New Year, DERM Community! 🥳🥂 

Before anything else, we want to say thank you.

Thank you for showing up every week, for reading the newsletter, engaging with the content, and sharing it with colleagues.

Thank you for downloading and actually using the free guides we create.

And most importantly, thank you for caring so deeply about learning more for your patients and striving to do your best as professionals.

We see the effort you put in. We see the curiosity. We see the commitment. And we truly appreciate this community 😊 

As we step into a new year, it’s a natural moment to pause, reflect, and think about how our work continues to evolve.

In dermatology, that evolution has been especially visible in how we connect with patients and support them over time.

Before we dive into today’s topic, a quick look back at last week’s edition. 

In the spirit of Christmas, we shared a little extra with you. Alongside our regular guide, we included two bonus PDFs: a FREE book and an in-depth guide exploring why acne keeps appearing in the same spots and what those patterns can reveal about underlying skin behavior.

If you missed it over the holidays, it’s well worth revisiting: https://news.dermforprimarycare.com/p/patterns-pores-and-the-science-behind-repeat-breakouts 

One of the most significant shifts in recent years has been the rise of teledermatology.

What once felt like a convenience has quickly become part of everyday clinical practice.

Today, patients can upload photos, describe symptoms, and receive guidance or prescriptions without ever stepping into a clinic.

The promise is compelling: greater access, improved efficiency, and care that meets patients where they are.

But as teledermatology becomes more familiar, it also invites a more thoughtful question.

Beyond speed and convenience, how well does it serve real skin health? And just as importantly, where do its limits begin?

Let’s start with what it gets right…

Teledermatology has dramatically improved access to care, especially for patients in rural, underserved, or mobility-limited settings where dermatologists are scarce.

For many, it represents the first real opportunity to be seen, triaged, and guided and that matters.

It is particularly effective when the diagnosis is already established or the clinical question is narrow and well defined.

Chronic, stable conditions such as acne, eczema, psoriasis, and rosacea often benefit from virtual care, especially when the goal is follow-up rather than discovery.

Monitoring response to therapy, assessing flares, adjusting doses, or confirming improvement can be done efficiently and safely when patterns are predictable and the patient’s history is known.

Teledermatology also excels when continuity is the priority. Medication refills for stable conditions, ongoing management plans, and visual check-ins allow patients to stay engaged in care without unnecessary delays.

In these contexts, high-resolution imagery and standardized photo protocols have made remote assessment increasingly accurate.

When the question is focused “Is this improving?”, “Is this consistent with prior flares?”, or “Can I continue my current treatment?” virtual care can deliver patient-centered medicine at its best.

It is also a valuable triage tool.

Teledermatology helps determine urgency, identify which cases require escalation, and guide appropriate referrals.

Used this way, it functions as a clinical filter that improves access without overwhelming in-person services.

But here’s where teledermatology often gets it wrong: skin health isn’t just visual, it’s contextual.

Lighting, filters, and camera quality can obscure critical details.

Color nuances, lesion texture, and tactile feedback are difficult and sometimes impossible to assess virtually.

Subtle but meaningful signs of systemic disease, such as nail changes, lymph node enlargement, or mucosal involvement, can easily be missed through a screen.

When a condition is new, evolving, atypical, or uncertain, pixels are rarely enough.

Beyond the technical limitations, teledermatology also risks diluting something deeper: the human connection.

A skin exam isn’t just about identifying lesions. It’s an opportunity to build trust, uncover anxiety, explore behaviors, and educate patients about how their skin reflects their overall health.

Virtual care can efficiently treat the condition, but it doesn’t always nurture the relationship that sustains long-term skin health.

That’s why the future of dermatology isn’t about choosing between in-person and virtual care. It’s about integration.

Teledermatology works best when it supports continuity, not when it replaces clinical judgment.

For the right cases, it’s a powerful bridge.

For complex or uncertain ones, it should guide patients back to the physical exam room.

As clinicians, our responsibility is to preserve the art of seeing the whole person, even when we only see pixels.

We’ve Put Together a Free Guide Just for You!

The Teledermatology Triage Playbook is a practical, safety-first framework designed to help clinics and health systems make clear, defensible decisions about when teledermatology is appropriate and when escalation to in-person care is the right call.

Explore the guide by clicking below:

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Book Recommendation of the Week

 “The Patient Will See You Now” by Eric Topol.

A visionary look at how digital medicine is reshaping patient autonomy and how clinicians can adapt without losing the essence of care.

Inspiration of the Week

👋🏻 See you next Thursday, DERM community!

Thanks for joining us on Beneath the Surface.

Digital care is here to stay but the healthiest skin still thrives on connection, consistency, and compassion.

Until next week, stay curious and keep looking beneath the surface.

— The Derm for Primary Care Team