Summary
| Condition | Fit | Go in person for |
|---|---|---|
| Acne | Usually suits online care | Deep, painful nodules or cysts, or acne that is leaving scars |
| Rosacea | Usually suits online care | Burning, gritty, red or watery eyes |
| Eczema | Sometimes suits online care | Signs of infection, such as crusting, oozing, pus, spreading pain or fever |
| Hyperpigmentation and melasma | Usually suits online care | A single spot that is new, growing, changing color or shape, itching or bleeding |
| Wrinkles and photoaging | Usually suits online care | Neuromodulator injections, fillers, lasers, microneedling and chemical peels are in-clinic procedures. |
| Moles and changing spots | Start in person | Asymmetry, an irregular Border, uneven Color, a Diameter larger than a pencil eraser (about 6 mm), or Evolving size, shape or color |
| Rashes and hives | Sometimes suits online care | Trouble breathing or swallowing, or swelling of the lips, tongue or throat |
Acne
Acne is one of the conditions online dermatology handles best. It is diagnosed by how it looks and how it has behaved, both of which photos and questions capture, and most treatment is topical or oral medication that is judged over weeks. The limits are the most severe acne, scarring treatment and isotretinoin, which comes with monthly program requirements.[4,5,6,2]
Usually fine online
- Blackheads, whiteheads, red bumps and pus bumps on the face, chest or back.
- Acne that hasn't cleared with over-the-counter products after a fair trial.
- Adjusting a prescription that's working partly, or irritating your skin.
- Ongoing check-ins every few weeks, since acne treatment takes time to show results.
Go in person instead
- Deep, painful nodules or cysts, or acne that is leaving scars: see a dermatologist who can examine you and discuss every option.
- Scar treatments such as lasers, chemical peels or fillers are procedures done in a clinic.
- Isotretinoin: the iPLEDGE program sets monthly requirements, including pregnancy tests for anyone who can become pregnant. Ask whether a service prescribes it and handles those steps before you start.
- Acne that arrives suddenly alongside other new symptoms: tell a clinician who can order tests.
What an online visit involves
- Photos of the front of your face and each side, plus any affected chest or back, in daylight.
- Questions about how long you've had it, what you've tried and for how long, periods and hormonal contraception, and other medications.
- A plan, usually a topical prescription (such as a retinoid) alone or with other medicines, and a date to check progress.
Photo tips: Take the same three face angles each time so progress can be compared. No makeup, and no filters or beauty modes on the camera. More in how to take good photos.
Where Nolla Derm fits
Nolla Derm is built for this: you upload photos, its software does the first assessment, a licensed U.S. medical provider reviews and approves the prescription, and the formula is adjusted each month as your skin responds. It fits ongoing acne that needs a prescription and steady follow-up. It isn't where to go for scarring procedures, and if you may need isotretinoin, ask Nolla first whether it is part of your plan.[7,8]
Rosacea
Rosacea usually suits online care: redness, flushing and bumps show in photos, and much of treatment is prescription creams or pills plus avoiding your triggers. Eye symptoms, thickening skin and laser or light treatment for visible blood vessels need an in-person visit.[9]
Usually fine online
- Facial redness, flushing, and bumps or pimples on the cheeks, nose, chin or forehead.
- Working out your triggers and adjusting a treatment that isn't controlling flares.
- Telling rosacea apart from acne, which a clinician can often do from good photos and your history.
Go in person instead
- Burning, gritty, red or watery eyes: rosacea can affect the eyes, and those need an in-person exam.
- Skin thickening, especially on the nose: treatment is procedural.
- Lasers or light treatments for visible blood vessels and persistent redness are done in a clinic.
What an online visit involves
- Photos of your whole face from the front and both sides, and a close-up of the most affected area.
- Questions about flushing, triggers (heat, sun, alcohol, spicy food, stress), eye symptoms and products you use.
- A plan, often a prescription cream or gel, sometimes a pill, plus trigger and sun-protection advice.
Photo tips: Photograph during a typical day, and if you can, a second set during a flare. Avoid flash: it washes out redness. More in how to take good photos.
Eczema
Online care works well for eczema that is already diagnosed and flaring, where the question is which treatment to use and how. A first diagnosis, possible infection, suspected contact allergy that needs patch testing, and severe eczema that needs systemic treatment are better started in person.[10,2]
Usually fine online
- Flares of eczema you've already been diagnosed with.
- Reviewing your skin-care routine and how you use prescription creams.
- Follow-ups once a treatment plan is set.
Go in person instead
- Signs of infection, such as crusting, oozing, pus, spreading pain or fever: get seen promptly.
- A rash you think is a reaction to something you touch: finding the cause may need patch testing in a clinic.
- Severe or widespread eczema that hasn't responded to creams, where stronger treatments need an exam and sometimes monitoring.
- A new rash in a baby or child that hasn't been diagnosed yet.
What an online visit involves
- Photos of every affected area, close-up and from further away, and of skin folds if involved.
- Questions about itch, sleep, triggers, family history of allergies or asthma, and every product you put on your skin.
- A plan for calming the flare and a routine to prevent the next one.
Photo tips: Photograph the worst area and a typical area. Note where it started and how it has spread. More in how to take good photos.
Nolla Derm
Eczema isn't among the concerns Nolla Derm lists. Use a service where a dermatologist diagnoses and treats rashes, or your own dermatologist.[7]
Hyperpigmentation and melasma
Dark spots and melasma are a good fit for online care, because treatment is mainly prescription creams, daily sun protection and patience. The exception matters: a new, changing or unusual dark spot needs an in-person exam, because some skin cancers are dark.[11,12,13]
Usually fine online
- Dark marks left after acne or other inflammation.
- Melasma: patches of brown or gray-brown color, often on the cheeks, forehead, nose or upper lip.
- Uneven skin tone that hasn't improved with over-the-counter products.
Go in person instead
- A single spot that is new, growing, changing color or shape, itching or bleeding: have it checked in person.
- Chemical peels and laser treatments are done in a clinic, and in darker skin tones need a clinician experienced with them.
What an online visit involves
- Photos in daylight without makeup, from the front and both sides.
- Questions about sun exposure, pregnancy and hormonal medicines, which can trigger melasma, and what you've already used.
- A plan that combines a prescription with daily broad-spectrum sunscreen, and a realistic time frame.
Photo tips: Use the same spot, light and distance each time: pigment changes slowly. Turn off any beauty or HDR mode. More in how to take good photos.
Where Nolla Derm fits
Nolla Derm lists hyperpigmentation and melasma among its concerns, with a prescription formula that is adjusted each month. It is not for checking an individual dark spot that's new or changing.[7]
Full guide: teledermatology for hyperpigmentation and melasma →
Wrinkles and photoaging
Online care fits the prescription side of wrinkle care, mainly topical retinoids and a sun-protection routine. Injectables, fillers, lasers and resurfacing are procedures done in person.[14,15,16]
Usually fine online
- Fine lines and rough texture from sun exposure and age.
- Starting and adjusting a prescription retinoid without too much irritation.
Go in person instead
- Neuromodulator injections, fillers, lasers, microneedling and chemical peels are in-clinic procedures.
- Any rough, scaly patch that doesn't heal, or a spot that bleeds: have it examined, since sun damage also raises skin cancer risk.
What an online visit involves
- Photos of your face in even daylight, front and both sides.
- Questions about your current routine, sun exposure, sensitivity and whether you're pregnant or planning to be.
- A plan, typically a retinoid started slowly, with sunscreen and moisturizer.
Photo tips: Keep the same expression in every photo, relaxed, so changes are comparable. More in how to take good photos.
Where Nolla Derm fits
Nolla Derm lists wrinkles among its concerns: a prescription formula, reviewed by a licensed provider and adjusted monthly. It doesn't offer injectables, fillers or lasers.[7]
Moles and changing spots
A photo can help a dermatologist decide how urgently a mole needs to be seen, but it can't rule out skin cancer. A Cochrane review of teledermatology for skin cancer found the evidence limited and noted that some melanomas could be missed or delayed. Any spot that matches the ABCDE warning signs, or is new, changing, itching or bleeding, needs an in-person exam, and a biopsy if the dermatologist advises one.[13,17,18,3,19]
Usually fine online
- Asking how urgently a spot should be seen, as a step toward an in-person appointment.
- Sharing photos of a spot a dermatologist has already examined, to track it over time.
Go in person instead
- Asymmetry, an irregular Border, uneven Color, a Diameter larger than a pencil eraser (about 6 mm), or Evolving size, shape or color: book an in-person exam.
- A spot that bleeds, itches, crusts or doesn't heal.
- A full-body skin check, and any biopsy, which only an in-person visit can do.
What an online visit involves
- If you use online care for triage, send a close-up with a ruler or coin beside the spot, and a wider photo that shows where it is on your body.
- Say when you first noticed it and how it has changed.
Photo tips: Photograph a mole every month the same way, so you and your dermatologist can see change. More in how to take good photos.
Nolla Derm
Moles and skin cancer concerns are outside what Nolla Derm treats: see a board-certified dermatologist in person.
Full guide: teledermatology for moles and skin cancer concerns →
Rashes and hives
Many common rashes can be diagnosed from good photos and a clear history, which is why dermatologist-run photo services treat them. Some can't wait: a rash with fever, blistering or peeling skin, fast spread, or swelling of the lips, tongue or throat needs urgent or emergency care, not an online queue.[20,21,22,2]
Usually fine online
- A localized, itchy rash without fever, such as many cases of contact dermatitis.
- Hives that come and go without any trouble breathing or swallowing.
- Suspected fungal infections such as ringworm.
Go in person instead
- Trouble breathing or swallowing, or swelling of the lips, tongue or throat: call emergency services.
- A rash with fever, blisters, peeling skin, or one that involves the eyes, mouth or genitals: get urgent care.
- A rash that spreads quickly, is very painful, or follows a new medication.
What an online visit involves
- Photos of the rash close-up and from further away, and of every area it affects.
- Questions about when it started, new medicines, products, foods, plants or animals, and anyone else with it.
- A diagnosis or a short list of possibilities, a plan, and what to do if it worsens.
Photo tips: Photograph it as soon as you notice it: rashes and hives can fade before a reply comes. More in how to take good photos.
Nolla Derm
Rashes aren't among the concerns Nolla Derm lists. Use a dermatologist-run photo service, your own doctor, or urgent care if any warning sign is present.
Red flags: go now, not online
- Trouble breathing or swallowing, or swelling of the lips, tongue or throat: call emergency services.
- A rash with fever, blistering or peeling skin, or one involving the eyes, mouth or genitals.
- A rapidly spreading, hot, painful area of skin.
- A mole or spot that is changing, bleeding or matches the ABCDE warning signs.
Sources: the AAD's hives guidance and ABCDEs of melanoma.[20,13]
Questions
What skin conditions can be treated online?
Visible, common conditions such as acne, rosacea, eczema flares, many rashes, dark spots and the prescription side of wrinkle care. The AAD says telemedicine works best for visible skin, hair and nail conditions.[1]
Can teledermatology check a mole for skin cancer?
It can help decide how urgently a mole should be seen, but it can't rule cancer out. A Cochrane review found the evidence limited and that some melanomas could be missed or delayed.[3] A suspicious spot needs an in-person exam, and a biopsy if advised.
Sources
Every numbered claim on this page points here. Providers' own pages were read in November 2026; prices and terms change, so check them again before you pay.
- What is telemedicine? · American Academy of Dermatology
- AAD Teledermatology Standards · American Academy of Dermatology
- Teledermatology for diagnosing skin cancer in adults (Cochrane review, 2018) · Cochrane Database of Systematic Reviews
- Acne resource center · American Academy of Dermatology
- Acne: Diagnosis and treatment · American Academy of Dermatology
- iPLEDGE REMS program · iPLEDGE
- Nolla Derm · Nolla
- Nolla frequently asked questions · Nolla
- Rosacea resource center · American Academy of Dermatology
- Eczema resource center · American Academy of Dermatology
- Melasma: Overview · American Academy of Dermatology
- How to fade dark spots in darker skin tones · American Academy of Dermatology
- What to look for: ABCDEs of melanoma · American Academy of Dermatology
- Wrinkles · American Academy of Dermatology
- Anti-aging skin care · American Academy of Dermatology
- Skin cancer: Symptoms, diagnosis, and causes · American Academy of Dermatology
- How to perform a skin self-exam · American Academy of Dermatology
- Skin cancer types: Melanoma · American Academy of Dermatology
- Find a Dermatologist · American Academy of Dermatology
- Hives: FAQs · American Academy of Dermatology
- DermatologistOnCall · DermatologistOnCall
- Teladoc Health online dermatology · Teladoc Health