Planning a visit to the dermatologist might seem straightforward. Maybe you want your doctor to look at an unusual rash, or maybe you’re going in for a routine skin exam. But there are steps you should take beforehand to ensure you make the most of your time in the exam room, and some of them (like removing your toenail polish) aren’t so obvious. We talked to Dr. Melissa Piliang, a dermatologist at the Cleveland Clinic, to learn how patients should prepare for different types of dermatology appointments.
Preparing for a consultation
In general, there are two types of dermatology appointments: a consultation and a skin check, also known as a cancer screening.
If you’re going in for a consultation on a specific problem like a rash, a medication reaction or a brush with poison ivy, prepare ahead of time by taking inventory of the issue: Make note of when the problem started and take stock of your symptoms. Do you have pain? Bleeding? Itching?
“It’s important to be able to have some information for the dermatologist,” Piliang said, “like how long has it been going on, have you had any treatments and what’s helped.”
If your primary care doctor has already performed lab work or a biopsy, bring the results to your appointment so your dermatologist doesn’t order repeat tests. If you’re worried about incurring a bill, check with your insurance provider to see which tests and procedures are covered and which you’re responsible for. In general, any procedure classified as cosmetic won’t be covered by insurance, Piliang says.
“But if you come in for a lesion you’re worried about and your doctor orders a biopsy, that should be covered by your co-pay for most traditional plans,” she said. The main exception would be a high-deductible plan; in that case, you’ll pay out of pocket until you’ve paid your deductible for the year.
Preparing for a skin check or cancer screening
If your appointment is for a routine skin check or cancer screening rather than an acute concern, get ready by performing a self-check at home. Examine your skin from head to toe and look for any unusual spots or changes. If your appointment is that same day, you may want to use a washable marker to circle spots on your body. It sounds weird, but Piliang says the physical cues can be helpful in the exam room.
“Sometimes when you get into the doctor’s office,” Piliang said, “things are moving fast, you might be a little bit nervous, and it’s easy to forget.”
If you have a family history of skin cancer, Piliang says to find out exactly what type of skin cancer runs in your family and bring that info with you.
“It makes a difference if it’s a melanoma or not,” Piliang said. “Having a family history of non-melanoma skin cancers has less impact on your risk for developing skin cancer.”
Preparing for any derm visit
Bring a list of all your current medications, including supplements; many patients don’t realize that their supplements can have side effects on the skin, Piliang says. Any medication or supplement you ingest has the potential to cause a skin reaction, including supplements labeled “natural.”
“You have to keep in mind that things like poison ivy are very natural,” said Piliang, “but they still cause a terrible skin reaction.”
Also bring a list of products you’re using on your skin and be prepared to discuss any changes you’ve noticed, such as a mole changing colors.
If you’re heading to the dermatologist because of a facial skin issue, your doctor will probably want to see your bare face without makeup. If you’re wearing makeup when you arrive, Piliang says it’s no big deal to wash it off in the office. But if you’re wearing nail polish, Piliang recommends removing it ahead of time. “We like to look at nails as part of a skin exam,” Piliang said. Certain nail symptoms, like dark streaks, can be a sign of cancer.
Tempting as it may be to bring all your skincare questions to the table, Piliang says to prioritize just one or two concerns during an appointment. If you arrive with a long list of issues — a rash, a skin spot, acne, hair loss — your dermatologist won’t be able to give each one the attention it deserves.
“You’ll get each problem addressed with more detail and more care if you have it limited to one or two things,” she said.
If you have a laundry list of skin issues, schedule a follow-up appointment to talk through the topics you didn’t have time to discuss in detail.
Be savvy with skin selfies
If you wake up with a surprise swollen lip or a new swath of bumps on your arm, your instinct may be to reach for your phone and snap a photo. Follow your instinct. Photos can be helpful to your dermatologist, especially if you’re dealing with a skin condition that comes and goes. Piliang suggests taking a few photos from different angles and distances to share with your doctor, particularly if the condition isn’t present in the exam room.
But patients should be cautious about sharing their photos electronically, Piliang says. Sending photos via text message or email isn’t secure, and it could put the patient’s privacy at risk. If you feel that it’s critical to share photos with your provider ahead of your appointment, call the office and ask if they have a secure online portal for sending images.
If you’re hoping to receive a diagnosis based on a photo, you can ask if your doctor offers teledermatology, which is essentially the same thing as an e-visit. The laws governing teledermatology, including reimbursement policies, vary from state to state. For your first appointment with a new dermatologist, Piliang suggests establishing care in -person.
Tips for tweaking your skincare regimen
When patients come in with questions about serums, moisturizers, peels and other treatments, Piliang suggests a common-sense approach.
Readily available commercial products made by reputable brands are generally safe, she says. If you have sensitive skin, look for fragrance-free products with extra-gentle formulations. If you’re not sure which brands or products are reputable, check with your dermatologist. And don’t be overzealous — if you want to try something new, ease into it, one product at a time.
“Many of these peels and retinoids can be irritating to the skin,” Piliang said. “If you apply them all at once, you’ll likely be miserable.”