Some things should not wait for the next free routine appointment. Some things should not wait for the next free routine appointment. Telephone the practice and say what is happening, or go to an emergency room, if you have a mole or a mark that has changed shape, colour or size, that has become raised or uneven, or that bleeds, itches or will not heal; a sore anywhere that has not healed in three weeks; a rash that is spreading quickly, especially with fever, blistering, or peeling skin; a painful rash in a band on one side of the body, particularly near an eye; redness that is hot, swollen, tender and spreading, which can be a deep skin infection; a new rash after starting a medicine, especially with mouth or eye involvement; or a child under three months with any widespread rash. If you have been treated here and something is worse rather than better after a procedure, telephone us rather than waiting for the review appointment. We would far rather field a call that turns out to be nothing.
Can I send you a photograph of a mole instead of coming in?
No, and this is the firmest rule in the practice. A photograph has no history attached, cannot be felt, cannot be pressed to see whether the colour blanches, cannot be examined under a dermatoscope, and misreports colour badly — which matters most on skin that is not pale. The examination that separates a harmless growth from an early cancer uses magnification and cross-polarised light, and where there is any doubt it ends in a biopsy. An app that grades a mole from a telephone picture is selling reassurance, and wrong reassurance is the most dangerous product in this field. /no-diagnosis-online.html explains the whole reasoning.
Do you do video appointments at all?
Yes, but only for established patients with a condition we have already examined in person, and only for following it up. A video call is genuinely useful for reviewing whether a treatment plan is working, adjusting a dose, or looking at a flare of something already diagnosed. It is not useful for a new lesion, a new rash, anything on a nail, anything pigmented, or anything that needs to be felt — and we will convert the appointment to an in-person one rather than guess.
Will you tell me what brand of medication you are prescribing?
In the room, in detail, including the generic name, the strength, what it costs and what the alternatives are. What you will not find is a drug name on this website. Prescription medicines in this speciality are advertised to patients harder than in almost any other, and naming one on a public page amounts to advertising a prescription drug to somebody nobody has examined. The same goes for lasers, devices and skincare lines. What matters is the diagnosis and the person choosing the treatment, not the badge.
Why are there no before-and-after photographs on this website?
Because in this field they are close to meaningless. Nearly every condition treated here fluctuates on its own — photograph any relapsing skin disease at its worst and again at its best and you have a persuasive pair of images that demonstrates nothing about what happened in between. Add different light, a different angle and a different camera and the pair proves less still. We publish what a treatment typically achieves, in how long, in what share of people, and how often it fails.
Can you cure my eczema or my psoriasis?
No, and nobody can. These are long-term conditions that relapse, and treatment controls them rather than removing them. What good treatment achieves is long stretches of comfortable skin, flares that are shorter and milder, and knowing what to do on the first day of one instead of the twentieth. That is a genuinely different life and it is worth having — it is simply not the same thing as a cure, and telling patients it is sets them up to feel they have failed when the condition behaves normally.
Does a skin check find every skin cancer?
No. A careful examination finds most of what is present on the day it is done, and it can still miss something very early, something in a genuinely difficult place to see, or something that had not appeared yet. That is why we teach you to examine your own skin, tell you which specific marks on you are worth watching, and give you the list of changes that should bring you back before the next routine visit. A practice that implies a yearly check makes you safe is overselling the most useful appointment in dermatology.
Is a biopsy going to hurt, and will it scar?
It stings for about ten seconds while the local anaesthetic goes in, and after that you should feel pressure but not pain — if you feel pain, we stop and put more anaesthetic in. It will leave a mark. A small punch biopsy usually heals to a pale spot the size of a match head; a shave leaves a flat lighter patch; anything sutured leaves a line. On the chest, the shoulders and the jawline scars are more likely to thicken, and if that applies to you we will say so before rather than afterwards.
Are steroid creams dangerous?
They are dangerous when used at the wrong strength, on the wrong site, for too long, without review — and they are also the treatment that gets most eczema under control, so being frightened of them causes at least as much harm as overusing them. The usual problem we see is the opposite of the one people fear: something far too weak, used for three days, stopped when it did not work, repeated for years. Every prescription here leaves with a strength, a site, a frequency and a date to stop or come back.
My child has a rash. Can it wait?
Usually yes and occasionally no. Bring a child in urgently — or to an emergency room — for a rash that is spreading quickly, a rash with a fever, any blistering or peeling, a rash that does not fade when you press a glass against it, a rash with swelling of the face or mouth, or any widespread rash in a baby under three months. Ordinary eczema, warts, molluscum and most birthmarks are not emergencies, though ordinary eczema keeping a child awake every night is worth an appointment sooner than people tend to think.
Do you treat wrinkles, or do fillers?
No. This is a medical and surgical dermatology practice and injectable cosmetic treatment is not something we offer — if that is what you want, we will say so plainly and point you elsewhere rather than talk you into something we do. We do treat several things that sit near that boundary because they are medical: pigmentation after inflammation, acne scarring, rosacea, excessive sweating and sun-damaged skin. /scope-of-care.html lists exactly where the line falls.
Will my insurance cover this?
Usually for medical dermatology and usually not for cosmetic, and we will tell you which one your visit is before it starts. What we cannot do is tell you what your plan will actually pay, because we do not have your plan in front of us and anybody who promises you a figure is guessing with your money. Telephone the number on your card and ask about your deductible. One thing worth knowing in advance: if a biopsy is taken, the laboratory that reads it bills you separately from us, which surprises somebody every week.
I was told it was nothing somewhere else and I am still worried.
Then book a second opinion; it is an ordinary appointment and it offends nobody. Bring the notes, the prescriptions and the biopsy report if there was one. If we agree it is nothing, you will get the reasoning rather than the verdict — which is usually the part that was missing — and you will be told what change would make it worth returning.
Do you see patients with darker skin, and does that change anything?
Yes, and yes. Woodside is one of the most diverse neighbourhoods in the country and this practice is built around that rather than treating it as an exception. It changes real things: redness reads as violet, grey or simply darker rather than pink, which is why inflammation gets missed; pigment change after inflammation is more likely, more visible and lasts longer, and it is frequently the complaint that matters most to the patient even when it is not the disease; scars are more likely to thicken; and every laser and light treatment carries a higher burn and pigment risk, so the settings and sometimes the answer change.
Can I book without a referral?
Yes. You can book directly with any of the four clinicians from the calendar on /appointments.html. Some insurance plans require a referral from a primary care physician before they will pay, which is a rule about your coverage rather than about our door — check the number on your card if you are relying on a plan.
The four boundaries behind most of these answers
Reading the list back, most of the answers that are “no” come from one of four positions, and each has a page of its own.
- Nothing is diagnosed without an examination. Not from a photograph, not by email, not by an application. /no-diagnosis-online.html
- Chronic skin disease is controlled, not cured. Eczema, psoriasis, rosacea, vitiligo, hidradenitis and most alopecias relapse, and saying otherwise sets patients up to feel they have failed. /results-and-expectations.html
- A screening examination finds most of what is present, not all of it. What you do between appointments matters as much as the appointment. /skin-cancer-screening.html
- No drug, device or board is named on this website. In the room, in detail; on a public page, never. /scope-of-care.html
Controlled, not cured — and that distinction is not a technicality. Most of the conditions treated here are controlled rather than cured, and any practice that tells you otherwise is either being careless with the word or selling you something. Eczema, psoriasis, rosacea, vitiligo, hidradenitis and most forms of hair loss are long-term conditions with a tendency to relapse. What good treatment achieves is long stretches of skin that does not itch, hurt, bleed or stop you sleeping, with flares that are shorter and less severe and that you know how to handle. That is a genuinely different life, and it is worth having. It is not the same thing as being cured, and describing it that way sets patients up to feel they have failed when the condition does what the condition does.
A skin examination does not find every skin cancer. A skin examination does not find every skin cancer, and any practice implying otherwise is overselling the single most useful appointment in dermatology. A careful examination finds most of what is there on the day it is performed. It can miss something very early, something in a place that is genuinely hard to see, and something that had not yet appeared when you were examined — which is why what you do between appointments matters as much as the appointment. We will show you how to look at your own skin, we will tell you which marks on you specifically are worth watching, and we will give you the list of changes that should bring you back before your next routine visit rather than at it.
A named diagnosis and a written plan you leave holding
Book an appointment
Pick a physician and a time from the calendar — it shows only the hours each of them genuinely has free. A new patient appointment is thirty minutes, a full skin examination forty-five, and you leave with a named diagnosis written down. If something on your skin has changed, telephone instead and say that word: it is triaged differently.