After months of dealing with red, itchy and scaly skin around her eyelids, Susan Scott of Groveland, Illinois decided it was time to stop trying to diagnose and treat the problem herself.

She turned to a new virtual dermatology service from OSF OnCall and within hours, she had a diagnosis and a prescription.

Since the beginning of the summer, Scott had itching and redness around her eyelids and tried to treat it with over-the-counter ointments and it did not clear up. A busy mom who was tied up with medical appointments for her children, Scott didn’t want to take time away from work for what she viewed as a minor issue.

“I didn’t want another appointment in my life and so I just figured I would treat myself … It wasn’t worth the time and effort to go see a doctor and so the virtual solution was a great solution for me,” Scott shares.

Rather than scheduling an in-person appointment with a dermatologist, she went to her OSF MyChart account, found the virtual dermatology link and submitted information and photos about her condition.

The process took about five minutes, Scott says. She completed basic medical information, photographed the affected area and submitted the request for review.

Her experience came on Labor Day, when she happened to be home and had time to address the problem.

Received a diagnosis on Labor Day

“Much to my surprise, that same day, on Labor Day, I got an email back from a doctor telling me that the condition was eczema and that they had called in prescription to Walmart in Morton (her pharmacy) to pick up my ointment.”

By the following weekend, the condition had cleared.

OSF OnCall Virtual Dermatology allows people to submit information about a skin concern and upload photos for review by a board-certified dermatologist. The patient receives a personalized treatment plan within three business days or less, and prescriptions may be provided when appropriate.

The digital option is available for common conditions including acne, eczema, rosacea, rashes, psoriasis, warts, hives, ringworm and pediatric skin concerns.

Susan Wolf, DNP, MBA, APRN, clinical director of digital care for OSF OnCall says skin issues can be uncomfortable, frustrating and sometimes embarrassing and yet the wait time for an in-person dermatology appointment was an average of five weeks.

“When we looked into dermatology access across the state, we were noticing at least a month to two months for a wait time for non-urgent concerns. We thought that wait time was too long, especially with frontline providers wanting answers, along with patients, sooner than later to determine is this more benign or is this more serious and concerning that we need to address sooner than later?”

Popular with all ages

Wolf says the virtual dermatology option has been helpful to people with transportation issues or limited access to providers in rural areas. And so far, it has a wide range of users.

“We’re seeing anybody from one year or less up to 90 plus that are using the service. We’re also noticing that family members are using the service for their loved ones as well, rather than just the patient themselves using the service.”

That has included older adults who have complex medical conditions that otherwise would require emergency medical transport to get them to an appointment.

For Susan Scott, it was a revelation that OSF OnCall Virtual Dermatology lived up to its promise of being quick and easy.

“Filling out the form, providing my medical history, describing my condition and issues I was dealing with was quick and really didn’t take much time at all. So, it really was as quick and easy as they say it is.”

The care costs a flat $60 self-pay fee and is not billed to insurance. Scott says she used an easy option.

“I was able to use my HSA (health savings account) card so that way it was somewhat discounted because I was using tax-free dollars to pay for the appointment so that was good.”

The experience changed Susan Scott’s view of how quickly a persistent skin problem could be addressed. She regrets letting her condition persist through the summer when she had an easy solution.

If a person’s condition requires an in-person evaluation, the care team can help coordinate follow-up with an OSF primary care provider or specialist.

The virtual option is not appropriate for a changing mole, irregular borders or colors, full body skin exams or bleeding or non-healing lesions which often require a dermoscopy or biopsy.

Here is more information about OSF OnCall virtual dermatology services.

Video clips with Susan Scott

Video clips with Susan Wolf

B-roll-Virtual dermatology

This is part one of a two part story on hygiene myths. Click here for part two.

From health care providers to websites to advice passed down through generations, there are a lot of ways to get health care information, especially tips for minor ailments you can treat at home.

Awad Alyami, MD, a pediatrician at OSF HealthCare, breaks down some common myths.

• Myth: There’s a one-size-fits-all pill for common illnesses.

Fact: It depends on whether it’s a viral infection (like influenza, the common cold or coronavirus) or a bacterial infection (like pneumonia, strep throat or food-borne illnesses like salmonella).

“For the most part, with bacterial infections you need to see a health care provider. You’re probably going to need an antibiotic,” Dr. Alyami says. “Most viral infections just run their course, and you focus on the symptoms. If you have a fever, you take fever medication. If you have pain, you take pain medication. If kids are six years or older and have a cough, they can use over-the-counter cough medication.”

Dr. Alyami points out that you can take those medications to help with bacterial infection symptoms, too. But you need an antibiotic, too, to get better.

• Myth: Feed a cold and starve a fever.

Fact: You should modify your diet when sick to avoid trigger foods, like spicy or greasy foods. But reducing the amount you eat and drink won’t make you better sooner. In fact, Dr. Alyami says hydration is critical.

“When kids have infections and a fever, one of the most common reasons they end up in the hospital is dehydration,” Dr. Alyami says. “When kids are sick, they lose fluids from their body and need hydration.”

So, drink plenty of water and eat nutritious foods as your body can tolerate.

• Myth: I can go back to work or school as soon as I start to feel better.

Fact: Dr. Alyami says you should be fever-free (body temperature less than 100.4 degrees) for 24 hours with improving symptoms.

When you go back out, practice good habits like thorough handwashing and avoiding coughing or sneezing into the open air.

• Myth: If I don’t look or feel dirty, I don’t need to shower or bathe.

Fact: Dr. Alyami says there’s no “catch all” advice for how often to wash off. Some people will shower or bathe daily. Others will do so every other day or less frequently. Dr. Alyami advises you to shower or bathe when you feel you need to or after you’ve been in a dirty or sweaty environment, like after playing sports or a hike in the woods. People with skin conditions should also clean themselves with care.

“For people with eczema or atopic dermatitis, I recommend daily showers,” Dr. Alyami says. “But they need to be quick because the more exposure to water we have, the more we dehydrate the skin. So, showers should not exceed 15 minutes, and you should apply moisturizer right away afterward.”

Interview clips

Consequences

Some people may see skin care as purely cosmetic. If I’m not a model or television news anchor, I’ll just do the bare minimum.

That’s not the right approach, Oberheim says. Poor skin care, especially in older adults, can lead to persistent bruises and skin tears leading to wounds.

“Sometimes it doesn’t take much. I’ll see patients who have small dogs that jump on them. Even just the clawing from the dog will put a tear in the skin because the skin is so thin and fragile,” Oberheim recalls. “When that happens, we have to make sure to keep the skin clean and dry. If we end up with an infection, that can lead to cellulitis. Cellulitis can lead to other things, including sepsis [a possibly deadly condition where your body responds improperly to an infection]. So we’d need to take precautions and fix the infection with maybe some antibiotics.”

The bottom line, Oberheim says, is if your skin problem isn’t responding to at-home treatment after a few days, see your primary care provider or a dermatologist.

Other conditions

Other skin conditions to be aware of:

• Eczema (also called atopic dermatitis): This causes dry, itchy scaly skin patches. Experts don’t know exactly what causes it. But Oberheim says allergies, asthma and even stress can play a role, and it’s often worse in the winter. She says eczema can affect all ages and appear anywhere on your body.
   
• Rosacea: This causes redness, pimples, broken blood vessels and, in severe cases, a misshapen nose. It most often affects the face and eyes.
   
• Age spots (also called liver spots): Oberheim says these look like “big freckles.” They’re often flat and dark-colored. They’re associated with sun exposure, and so they’re often seen on the head and face.
  
  “They’re usually not super problematic, but they’re not cosmetically appealing,” Oberheim says.
   
• Psoriasis: This causes inflamed, red raised areas of skin that can itch and be painful. This is often seen on the scalp, elbows, knees and lower back.
   
• Poison ivy and oak: Oberheim says she sees these issues often in her clinic. When someone rubs up against the plant or an object that’s touched the plant, they can get a red, bumpy itchy rash with fluid-filled blisters.

Prevention

So, what should your daily skin care routine be? Should you be getting facials at the spa regularly? That’s probably not necessary, Oberheim says. But daily washing and moisturizing is. Look from certain things on skin care product labels: retinol (helps with skin firmness and reducing wrinkles), vitamin C (helps brighten age spots), hyaluronic acid (helps with moisturizing), niacinamide (helps reduce redness), collagen and peptides.

Other things to consider:

• Wear sunscreen of 30 SPF [sun protection factor] or higher when outside, and reapply it every few hours.
   
• Wear protective clothing like a wide brimmed hat, long sleeves and long pants when outside. Wash clothes right away when you get home. Also, know which plants are in your area to avoid the pesky ones.
   
• Don’t smoke.
   
• Drink plenty of water all the time, not just during outdoor activities.
   
• Don’t bathe or shower in very hot water. This can dry the skin.
   
• Try not to itch any skin lesion. You don’t want a wound to open and risk an infection.
   
• Know your body. Watch for suspicious moles or lesions that might be a sign of skin cancer. Experts say you can remember the ABCDEs: if the mole is asymmetric, has an irregular border, has an odd color, has a big diameter or is evolving, see a provider.

Learn more

Read more about how to keep your skin healthy on the OSF HealthCare website.

Interview clips

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