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The dermatology consultation is fully asynchronous. There is no video call, no telephone consultation and no live examination, so the photograph you upload does the work that an in-person examination would normally do. A good photograph is the difference between a case a doctor can grade and a case they cannot. This guide covers what to send and how, and the file limits the upload actually enforces.

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Where photos are required

Rosacea — photo required

The twelve-step rosacea questionnaire cannot be submitted without a photograph. The differential — seborrhoeic dermatitis, perioral dermatitis, contact dermatitis, lupus — is wide, and none of it can be separated from a description alone.

Melasma — photo required

The thirteen-step melasma questionnaire likewise cannot be submitted without one. Symmetry, border and distribution are what distinguish melasma from the pigmented lesions that need an in-person examination instead.

Acne — photo optional

The acne questionnaire lets you choose to send photos later. Choosing that flags the case internally as missing them. A doctor grading acne severity with no image has very little to grade.

Anti-ageing — photo optional

The anti-ageing questionnaire also offers the send-later choice, and flags the case the same way. Photoageing is graded visually or not at all.
“Optional” here means the form will accept the submission. It does not mean the doctor can reach a decision without the image. On the two optional pathways, an ungradeable case is a common reason no prescription is issued.

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What the doctor is actually grading

Knowing what they are looking for is what makes the difference between four snapshots and four useful photographs.
  • Lesion type. In acne, whether there are comedones — blackheads and whiteheads — and whether the inflammatory lesions are papules, pustules, or something deeper. The presence or absence of comedones is the main thing separating acne from rosacea.
  • Severity and distribution. How much of the face is affected, how densely, and where. Central-face concentration means something different from a jawline pattern.
  • Sequelae. Scarring, post-inflammatory redness and post-inflammatory pigment. Scarring is the finding most likely to change the answer, because it means in-person care.
  • Background skin. Erythema, visible vessels, thickening, texture, and how photoaged the surrounding skin is.
  • Anything that argues against the working diagnosis. Asymmetry, a single odd lesion, an irregular border, several colours within one lesion, crusting or bleeding. These are the findings that stop an online consultation rather than steer it.

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Taking the photographs

1

Clean, bare skin

Wash gently and pat dry. No makeup, no concealer, no foundation, no tinted sunscreen, no serum sheen. Makeup hides exactly what the doctor is grading, and colour-correcting products are specifically designed to disguise the redness a rosacea assessment depends on. Wait until the skin is fully dry — wet skin reflects and the highlights read as lesions.
2

Find indirect daylight

Stand facing a window during the day, with the light on your face and not behind you. Daylight is neutral; indoor bulbs push the colour warm or green and change how red the skin looks. Avoid direct sun, which throws hard shadows and blows out detail. Turn off the overhead light — downward light casts shadows that mimic texture.
3

No flash, no filters, no beauty mode

Flash flattens texture and washes out redness, which is the opposite of useful. Turn off any beauty, smoothing or portrait mode, and any automatic skin-tone adjustment. A filtered photograph is not evidence; it is a picture of what a filter thinks your skin should look like. Portrait mode also blurs the background and sometimes the edges of the face, which loses information.
4

Frame it at about 30 centimetres

Roughly an arm’s length. Close enough that individual lesions are visible, far enough that the whole affected area is in one frame. Hold the camera at eye level rather than above or below. Keep still, tap the screen on the affected area to focus, and check the result is sharp before you accept it.
5

Take the four standard angles

Straight on, left profile, right profile, and a close-up of the worst-affected area. Faces are three-dimensional and a single frontal shot hides the cheeks and the jawline. For a body area, take a wide shot showing the location and a close-up showing the lesions.
6

Check it before you upload it

Look at it full-screen. If you cannot see the individual spots, the doctor cannot either. Blurred, dark, yellow-tinted, filtered or too-distant images are the four most common reasons a case cannot be graded.
Do not use a photograph as a skin cancer check. Any mole or pigmented lesion that is new, changing, asymmetric, irregularly bordered, multicoloured, larger than about six millimetres, bleeding, crusting or itching needs an in-person examination with dermoscopy. A dermatology consultation for acne, rosacea, melasma or photoageing is not a skin lesion assessment and must not be treated as one.

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What the upload accepts

There are two separate image surfaces, and their limits are not the same.

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The questionnaire photo answer

This is the upload step inside the questionnaire itself. The file is stored as a patient document and its identifier becomes the answer to that step.
The upload step takes one photograph, not a set. The answer is a single document, so if you have four angles you cannot attach all four to that one step. Either upload the single most representative image — usually the straight-on shot, or the close-up of the worst-affected area — or send the rest through the consultation once it exists, which is the second surface below.

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Photos added to an existing consultation

Once a consultation exists, further images can be attached to it directly. This is a different endpoint with different limits. The technical detail for both is in the API reference if you are building against them.

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Common mistakes

  • Makeup left on. The most frequent cause of an ungradeable rosacea or melasma photograph.
  • A filter or beauty mode left enabled by default. Many phones apply smoothing without announcing it. Check.
  • Bathroom lighting. Overhead bulbs above a mirror produce downward shadows and a colour cast, and both distort the assessment.
  • Too far away. A photograph of a whole head from two metres shows a doctor nothing about individual lesions.
  • A screenshot of a photograph. Recompression destroys the detail that was the point of taking it.
  • A photograph from six months ago. The doctor is grading what your skin is doing now.
  • Sending only one angle when the condition is on the cheeks. A frontal shot foreshortens the cheeks badly.

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After you submit

A registered doctor reviews the questionnaire and the images together and decides whether treatment is appropriate. If they need a better image or a different angle, they message you through the private chat in your account — that is the channel for it, and the review remains asynchronous throughout. A prescription is never guaranteed, and if one is not issued, the consultation fee is refunded in full.

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Start a consultation

Dermatology consultations

Four pathways use photographs: acne, rosacea, melasma and anti-ageing. A registered doctor reviews each one and declining is a normal outcome. See what it costs and how the review works.
This page is reference information, not medical advice and not a prescription. Whether a medicine is appropriate for you is decided by a registered doctor after reviewing your consultation.