Journal / Skin health
When a skin concern needs a dermatologist.
Skincare can keep skin comfortable and support it day to day. It cannot diagnose or treat a skin condition. These are the signs that a concern belongs with a doctor, and how to make that appointment useful.
The short answer
See a dermatologist or doctor about a mole or spot that looks different from your others or is changing, itching or bleeding; a rash, redness or reaction that is severe, persistent or keeps coming back; acne that is deep, painful or scarring; skin that is hot, swollen and red; and any concern that is not improving with gentle care. Sudden swelling of the lips, mouth, throat or tongue, or difficulty breathing, needs emergency help straight away. A skincare practitioner can support your routine, but cannot diagnose.
01 / Two kinds of help
Where skincare ends and medical care begins.
Home skincare and professional skincare work on comfort, routine and how healthy skin looks and feels. Diagnosing and treating skin conditions is medical work. Dermatologists are doctors who specialise in skin, hair and nails, and your family doctor is often the first step.
- A skincare practitioner can
- Review your routine and products, suggest what to simplify, offer professional skincare where it suits you, and tell you when something should be seen by a doctor.
- A skincare practitioner cannot
- Diagnose a condition, judge whether a mole is harmful, prescribe medication, or treat an infection, an allergy or a skin disease.
- A doctor or dermatologist can
- Examine and diagnose, arrange tests where they are needed, prescribe treatment and refer you on.
Self-diagnosis is not reliable, because different problems can look alike: irritation, rosacea and acne can all show up as redness and bumps. That is why this guide lists signs rather than diagnoses. If you are still working out what your skin is telling you, start with how to understand what your skin may actually need.
02 / Moles and spots
A spot that is new, different or changing.
The American Academy of Dermatology (AAD) uses the ABCDEs to describe the warning signs of melanoma, a type of skin cancer.[1]
- A — Asymmetry
- One half of the spot is unlike the other half.
- B — Border
- The border is irregular, scalloped or poorly defined.
- C — Colour
- The colour varies from one area to the next: shades of tan, brown or black, or areas of white, red or blue.
- D — Diameter
- Melanomas are usually larger than 6 millimetres, although they can be smaller.
- E — Evolving
- The spot looks different from the rest, or is changing in size, shape or colour.
The AAD also advises watching for spots that are different from your others, or that are changing, itching or bleeding, and making an appointment with a dermatologist if you notice one.[1] These signs do not mean a spot is cancer. They mean it should be examined by a doctor.
Not every dark mark is a mole. Patches of uneven colour are a different question, covered in melasma or dark spots, but if you are unsure what you are looking at, have it checked.
Not a question for a facial
A skincare appointment is not the place to have a mole assessed. A spot that worries you should be seen by a doctor before anyone treats, exfoliates or extracts around it.
03 / Skin that reacts
Rashes, redness and reactions that persist.
Many reactions follow a change in routine and settle once the product responsible is stopped; sensitive skin, or a routine that has become too much? covers that ground. Some reactions need a medical opinion.
- A suspected allergic or irritant reaction
- The NHS describes contact dermatitis as skin that becomes itchy, blistered, dry and cracked. Lighter skin can turn red, and darker skin dark brown, purple or grey. It can be triggered by substances in products such as cosmetics, usually within a few hours or days of contact. The NHS advises seeing a doctor if symptoms are persistent, recurrent or severe.[4] More in contact dermatitis and skincare.
- Redness that does not go away
- The NHS lists redness across the nose, cheeks, forehead and chin that comes and goes, and burning or stinging with water or skincare products, among the early symptoms of rosacea. Redness may be harder to see on brown or black skin. Rosacea cannot be cured, but treatment from a doctor can help control it.[3] See persistent facial redness.
- Hair and nails
- Dermatologists look after hair and nails too. If you are worried about hair loss, or a nail changes colour, lifts or develops a new dark streak, mention it to a doctor.
When you are unsure, stop the product you suspect, keep the rest of your routine minimal and note what happens. If the reaction does not settle, or comes back, book an appointment. How to describe skin symptoms can help you explain it clearly.
04 / Breakouts and infection
Breakouts that are deep, painful or scarring.
Visible pores and small dark dots on the nose are often a routine question rather than a medical one; see blackheads or sebaceous filaments? Acne is different when it starts to hurt or leave marks. The NHS advises seeing a doctor if:[2]
- you have tried treating it yourself and it is not getting better;
- you have lots of spots, or the spots are deep, painful or causing scars;
- it is affecting your mental health;
- you have signs of a skin infection, such as hot, swollen and red skin.
In the meantime, the NHS advises against picking or squeezing spots, because this can cause scars.[2] It is also a reason to postpone extractions until a doctor has seen your skin.
05 / Do not wait
Signs that need urgent help.
Most skin concerns can wait for a routine appointment. A few cannot.
Call your local emergency number (112 in Türkiye) if:
- your lips, mouth, throat or tongue suddenly become swollen;
- you are breathing very fast or struggling to breathe;
- your throat feels tight or you are struggling to swallow;
- your skin, tongue or lips turn blue, grey or pale;
- you suddenly become very confused, drowsy or dizzy.
These can be signs of anaphylaxis, a severe allergic reaction. If you have been prescribed an adrenaline auto-injector, use it as instructed.[5]
Seek medical advice promptly, the same day where you can, for skin that is hot, swollen and red, which can be a sign of infection,[2] and for a rash that blisters or spreads quickly. If you have rosacea, the NHS advises an urgent appointment if your eye is painful, red or gritty, your vision is blurred or you are sensitive to light.[3]
06 / Making the visit useful
How to prepare for the appointment.
The AAD’s advice for preparing for a video appointment with a dermatologist is useful for any visit.[6]
-
Note when it began.
Write down when your current symptoms started, and anything that changed around that time.[6]
-
List what you take and use.
Medications, allergies, previous skin problems and major illnesses or surgeries.[6] Add every skincare product you use, new ones in particular; photographs of the labels work well.
-
Take clear photographs.
Several well-lit pictures that clearly show the area, taken after removing make-up from that skin.[6] They help when a problem comes and goes.
-
Leave the skin as it is.
Before a video appointment, the AAD suggests avoiding a hot shower, rubbing or picking, and skincare products, since these can change how your skin looks.[6]
-
Write down your questions.
So that nothing is forgotten once you are in the room.[6]
Questions worth asking
- What do you think this is?
- Should I stop or change anything in my routine?
- What can I use on my skin in the meantime?
- What would mean I should come back sooner?
- When, and how, can I reintroduce products I have paused?
Once a doctor has looked at your skin, skincare can follow their advice instead of guessing around it. What a useful skin consultation should leave you with and when professional skincare belongs in the plan explain where that support fits.
A few common questions
Frequently asked questions.
When should I see a dermatologist instead of changing my skincare?
When a concern is persistent, painful, getting worse or not improving with gentle care, or when you notice a spot that is new, changing, itching or bleeding. A new product cannot answer a medical question.
Should I see a dermatologist or a skincare practitioner?
A dermatologist or doctor for anything that needs diagnosing: moles, rashes, persistent redness, painful or scarring acne, infection or a suspected allergy. A skincare practitioner for your routine, comfort and professional skincare, and to tell you when something should be seen by a doctor.
When should a mole be checked by a doctor?
The AAD advises seeing a dermatologist about a spot that looks different from your others, or that is changing, itching or bleeding. Its ABCDE warning signs are asymmetry, an irregular border, varied colour, a diameter usually over 6 millimetres and change over time.[1]
When does acne need a doctor?
The NHS advises seeing a doctor if acne is not improving with self-treatment, if spots are deep, painful or causing scars, if it is affecting your mental health, or if there are signs of infection such as hot, swollen and red skin.[2]
What should I do if I react to a skincare product?
What should I bring to a dermatology appointment?
A note of when the problem began, a list of your medications, allergies and previous skin problems, the skincare products you use, clear photographs if the problem comes and goes, and your questions written down.[6]
Sources & scope
This Journal article offers general skincare education about when a concern should be seen by a doctor. It does not provide a diagnosis, prescribe treatment or replace individual medical advice. If you are worried about your skin, speak to a doctor. The points above draw on the following published resources.
- What to look for: ABCDEs of melanoma (American Academy of Dermatology) — the warning signs of melanoma and when to see a dermatologist.
- Acne (NHS) — when acne needs a doctor, signs of skin infection and why not to squeeze spots.
- Rosacea (NHS) — early symptoms, treatment and urgent eye symptoms.
- Contact dermatitis (NHS) — symptoms, triggers including cosmetics and when to see a doctor.
- Anaphylaxis (NHS) — emergency symptoms of a severe allergic reaction and what to do.
- Telemedicine: How to prepare for your appointment (American Academy of Dermatology) — what to note, list and photograph before seeing a dermatologist.
Editorial: Merve Akkaya Journal. Learn more about Merve Akkaya.
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