I hired an online dermatologist. Here’s what happened

Recently I’ve had some less-than-stellar experiences with doctors. When I went to a podiatrist for help with a foot issue, he seemed stumped and offered a smattering of wild-guess suggestions. (None of them worked.)

When I went to a vision clinic for an eye exam and updated prescription, I waited 45 minutes to actually get into the exam room and another 25 minutes before I threw my hands up and left. (Note to doctors everywhere: Work on your customer service. If there’s a delay, acknowledge it and apologize for it. In 47 years I’ve never experienced that simple courtesy.)

So when I realized I needed to see a dermatologist, I really didn’t want to see a dermatologist. I wanted to explain my symptoms and see if maybe there was an ointment that could fix me up. Like, if I passed a dermatologist in the street, it would probably take 60 seconds.

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Dermatology apps rely on your phone to snap photos of the problem area(s).


Screenshot by Rick Broida/abchow.com

But that’s not how it works. The typical process for such a thing:

  • Look up dermatologists in my healthcare provider’s directory and hope to find one reasonably close to where I live.
  • Call to schedule an appointment.
  • Wait probably 2-3 weeks to get that appointment.
  • Drive to the dermatologist’s office.
  • Fill out countless forms while waiting god-knows-how-long to get seen.
  • Spend five minutes with a doctor who says something like, “Yeah, that’s Eczema, here’s a prescription.”
  • Drive to drugstore, get prescription filled.
  • Get ridiculous bill from healthcare provider, which maybe covers part of it, but definitely not the co-pay.

Sounds great, right? So much time and energy down the drain. And yet my problem — red, itchy, flaky skin in a few areas of my face — was getting worse.

Apps to the rescue!

I’d heard of online consultations with doctors, but I always thought those were general practitioners focused on things like coughs and allergies.

As it turns out, there are numerous apps that can pair you with a dermatologist for a virtual consultation — usually powered by the camera in your phone. I looked at four such apps and tried one. Here’s the rundown, with my initial impressions of each and the reason I chose the one I chose.

DermatologistOnCall (iOS) – Promising to diagnose “more than 3,000 skin, hair and nail conditions,” DermatologistOnCall charges $59 per online visit — but I was quickly scared off by the push to purchase a multi-visit package (starting at $165 for three).

First Derm (Android|iOS) – To use First Derm, you snap two pictures of your skin, then get an evaluation and recommendation from one of about a dozen dermatologists. However, the only issues covered are rashes and moles. You can get a response within 48 hours for $24.99; within 24 hours for $39.99; or within eight hours for $99.99.

SkyMD (Android|iOS) – Before letting you do anything else (or revealing its pricing), SkyMD requires you to create an account. Nope, sorry, not until I know what I’m getting (and paying). Even the SkyMD FAQ page says only that it’s “usually comparable to a typical office visit copay.”

Spruce (Android|iOS) With some of the best ratings on both the App Store and Google Play and a reasonable-seeming visit fee of $40, Spruce seemed like a good pick. However, it’s currently available in only about 15 states. Luckily, mine was among them, but the app starts by asking you to identify your issue: acne, Rosacea, etc. I didn’t know exactly what my issue was; that’s what I needed help with. Unfortunately, there was no “I don’t know” or “I’m not sure” option.

First, Derm no harm

I was really tempted to go with Spruce, but the reality is I’m cheap. I felt like if I was going to have another unsatisfying (and unhelpful) medical experience, I was going to pay as little as possible. (Yeah, my bad attitude wasn’t helping anything. Maybe next I’ll look for online therapists.)

So I chose First Derm. I figured the redness and itchiness qualified as “rash,” so I tapped through and began the evaluation process. It was simple: snap two photos of the area (in this case my face), then describe the symptoms.

As for the pricing tiers, I had no problem waiting 48 hours for my diagnosis. So I used PayPal (there’s no in-app purchase option for payment), checked out, and that was it. I think the entire “visit” took about five minutes.

“Cleanup on aisle 12!”

Then I waited. I’d expected some kind of confirmation and/or status e-mail, but I never received one. And as I got toward the end of the 48-hour window, I started to get a little aggravated.

Then I realized I hadn’t actually checked the app since submitting my case. When I opened it again, there was still no indication anything had been done. But when I tapped the Menu button and selected View Case, I discovered that an answer had been received — less than 90 minutes after the submission.

So, my bad for not checking back sooner, and First Derm’s bad for not notifying me of a response. (In its defense, notifications for the app were “off” in the settings, so it’s possible I’d refused the request to enable them. That’s my default choice.)

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One annoying thing about First Derm: There’s no way to save, share or export your evaluation. (Best you can do is snap a screenshot.)


Screenshot by Rick Broida/abchow.com

The “diagnosis” (which was provided “as general information only” and “not a diagnosis or treatment plan”) suggested Seborrheic Eczema and proceeded to list the various symptoms — all of which matched mine to a tee. The recommendation: “a mild steroid cream such as hydrocortisone 1% with antifungal effect (e.g. miconazole).”

Although the response didn’t expressly indicate this was available OTC, the key clue was in the conclusion: “See a dermatologist in person for prescription medication if the condition doesn’t improve.”

So I zipped up to my local drugstore and headed to the ointment aisle. Turns out there are zillions of skin creams, many of them with hydrocortisone. But I looked and looked and couldn’t find a single one with “antifungal effect” or “miconazole.”

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Luckily, an OTC remedy was all I needed.

I did, however, find a product specifically designed to treat Eczema — which, according to my virtual doc, is what I have! So although I was aggravated I couldn’t find exactly what had been recommended, I did find something.

Long story shortened: Bought the tube, used it for a couple days… problem solved. Like, literally, it was better the next morning, and hasn’t recurred except for a short period when I forgot to apply the cream.

Could I have received the same advice from, say, my friendly neighborhood pharmacist? Almost certainly. Am I glad I didn’t go through all the hassles of seeing a real-world doc? No — I’m overjoyed. To my thinking this was $25 extremely well spent, because I saved both time and aggravation (even if there was still a bit of the latter).

Your mileage will almost certainly vary, depending on your skin issue and the app you choose. In hindsight, I think I’d have gone with Spruce, because it promises a proper diagnosis and treatment plan (with a prescription, if necessary), not just “general information.”

That said, my outcome with First Derm was ultimately very positive, so you can bet that the next time I have a skin issue, one of these apps will be my first stop.

Your move, eye doctors.

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