Teledermatology: how remote skin assessment works in the UK

In store-and-forward teledermatology, a clinician takes photographs of a lesion, often including dermoscopic images, and sends them with history to a dermatologist who reviews them and advises. In live video consultations, the patient and clinician talk in real time. Patients can also send their own images in some services. The aim is to speed triage, reduce unnecessary visits and bring specialist opinion to more people.

Many areas have a teledermatology or teledermoscopy service for urgent suspected skin cancer referrals. A GP or community clinician captures images with a dermatoscope, and a consultant dermatologist reviews them within a short time. Lesions that look benign can be discharged with advice, while suspicious ones are booked for urgent assessment or biopsy. This helps focus clinic capacity on those who need it.

Some private services allow you to upload photographs of a mole or rash for review by a clinician. Quality varies. Good services verify clinician registration, give clear instructions on image capture, explain what they can and cannot assess and advise face-to-face review where needed. Beware of any service that provides an instant risk score from an app without clinician input unless the software is a registered medical device with clear evidence.

• Use natural, even light and avoid flash glare.

• Take a wide shot to show location and a close-up showing detail.

• Place a ruler or coin beside the lesion for scale.

• Keep the camera steady and in focus; clean the lens.

• Photograph the lesion on more than one day to show change.

• Include any previous images for comparison.

Images may not capture colour accurately or depth. Some lesions, such as small amelanotic melanomas, can look benign on photographs. Remote assessment cannot examine your whole skin. A good service gives a safety-net: if a lesion changes, bleeds or worries you, seek urgent face-to-face review. Never delay seeking help because a remote review was reassuring.

Skin images are personal data. Ask how they are stored, who has access and whether they are used for training algorithms. Check the provider's privacy policy and your right to have copies and request deletion. Avoid sending images that identify you, such as faces or tattoos, unless necessary.

Ask who reviews your images and what their registration is, what happens if the images are not good enough, how quickly you will receive a response and whether the service can arrange an in-person appointment or biopsy if needed. Ask how your images are stored and whether they are used for anything other than your care. Check what is included in the fee. A reputable service will explain its limits and say clearly when you should see someone face to face.