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    1/15

    Express Consultation Service

    Important Information: - This questionnaire should take about 5-10 minutes to complete. Once you have finished, one of our clinicians will get back to you via Email or WhatsApp within 24-48 hours with a diagnosis and treatment advice. Please check your junk email folder just in case.

    Please note: We do not advise on suspected skin cancers, moles, growths, lumps, or wounds. We do not currently prescribe Roaccutane (Isotretinoin) for Acne. This consultation does not include the cost of any prescription medications or treatments. If the clinician recommends any treatments then you can purchase these afterwards via your account (no obligation). We send all medications via Royal Mail next day tracked delivery. You can read the FAQ section for more information.

    Let's get started...

    Please tell us about the problem in a couple of sentences.

    Where on your body is the problem? Please select all that apply.

    Head and Neck

    FaceScalpEyebrowsEyelidsEye lashesEarsMouthBeard areaNeck

    Upper Body

    ChestBreastsNipplesBackShouldersForearmsUpper ArmsArmpitsHandsFingersWristsStomach/AbdomenElbows

    Lower Body

    GroinButtocksThighsLower legsFeetToesAnklesKnees

    Hair and Nails

    Hair loss on the headFinger NailsToe Nails

    Other

    All overI'm not sureGenitals

    Face

    ForeheadBoth CheeksLeft CheekRight CheekNoseJaw lineChinCentre of face (down the middle)

    Chest

    Entire chestLeft sideRight sideIn Between Breasts

    Stomach/Abdomen

    StomachLower AbdomenBelly ButtonAll over

    Breasts

    Underneath both breasts (in the skin folds)Underneath one breast (in the skin fold)Side(s)TopBottomIn between breasts

    Nipples

    BothLeftRight

    Back

    UpperMiddleLowerAll over

    Shoulders

    BothLeftRight

    Feet

    TopSideSole (underneath)HeelLeft footRight footBoth feet

    Toes

    TopBottomSideToe webs (skin folds)Big toe2nd toeMiddle toe4th toeLittle toeLeft footRight footBoth feet

    Fingers

    TopBottomSideFinger webs (skin folds)ThumbIndex fingerMiddle fingerRing fingerLittle fingerLeft handRight handBoth hands

    Hands

    TopPalmLeft handRight handBoth hands

    Wrists

    TopInsideAll aroundLeft wristRight wristBoth wrists

    Ankles

    Front/TopBackSideAll around ankleLeft ankleRight ankleBoth ankles

    Finger Nails

    ThumbIndex fingerMiddle fingerRing fingerLittle fingerLeft handRight handBoth hands

    Toe Nails

    Big toe2nd toeMiddle toe4th toeLittle toeLeft footRight footBoth feet

    Scalp

    All over scalpFrontBackSidesNape (back of neck where hair starts)Several PatchesOne Patches

    Eyebrows

    BothLeftRightSingle patchMultiple patchesAll over

    Eyelids

    All overPatchSingle spotSingle spotLeft eyelidRight eyelidBoth eyelids

    Eye lashes

    Multiple lashesSingle lashLeft eyeRight eyeBoth eyes

    Ears

    Outside earInside earEar canalBehind earEar lobeLeft earRight earBoth ears

    Mouth

    Around the mouthCorner(s) of mouthRoof of mouthInside cheeksGumsTongueUnder tongueBottom lipTop lipBoth lips

    Beard area

    All overSeveral PatchesOne patch

    Neck

    CollarFrontBackLeft sideRight sideAll around

    Hair loss on the head

    Over the crown (topmost part of your scalp towards the back of your head)Top of the headFrontal hairline (including receeding hairline)Sides of your headGeneral thinning all over the scalpNape of the neck (where the hair starts at the back)Single patchMultiple patchesFront/ fringeBald spots with itching or burning

    Forearms

    InsideOutsideAll aroundLeft armRight armBoth arms

    Upper Arms

    InsideOutsideLeft armRight armBoth arms

    Armpits

    Left armpitRight armpitBoth armpits

    Lower legs

    CalfShinLeft legRight legBoth legs

    Thighs

    Left thighRight thighBoth thighs

    Groin

    Left groinRight groinBoth groins

    Buttocks

    Butt CheeksBum fold (skin fold)Anus

    Elbows

    Inside elbow foldOutside elbow surfaceLeftRight

    Knees

    Behind KneesOutside knee surfaceLeftRight

    Genitals

    Due to the sensitive nature of this area- DigiDerm does not treat skin problems related to the genitals. Please visit your NHS GP or local sexual health clinic.

    All over

    I'm not sure

    0%

    Is it getting worse?

    NoYesI don’t knowOther

    When did the problem first start?

    How quickly did the problem start?

    Suddenly (minutes)Quickly (hours)Gradually (days)Slowly (weeks)Very slowly (months)Over several yearsOtherI don't know

    7%

    How does the problem behave?

    It's always thereIt comes and goesOtherI don’t know

    How long does it last?

    MinutesHoursDaysWeeksMonthsYears

    Please explain:

    Have you experienced this problem before?

    NoYesI don’t know

    Please explain, e.g., When did you last experience it? Is it the same as before or different now?

    14%

    Do you have any of the following symptoms?

    Skin Appearance or Changes

    RednessRoughSmoothDryOilyCrackingBleedingWhiteheadsBlackheadsSmall firm spots (papules)Small pus filled spots (pustules)Cysts, bumps and lumpinessScarringBlisteringCrustingScaling (Flakey skin)Darkening of skin (increase in colour or pigment)Lightening of skin (loss of colour or pigment)SwellingExcessive SweatThickened skinConsistency has changedRegular infections

    Sensory Symptoms

    ItchTinglingDischarge or OozingPain or sensitivityStinging or BurningWarm to touch or hot skinCold skinFeeling of TightnessAltered sensation or feelingNumbness/Loss of sensation or feeling

    Please rate your pain or sensitivity on a scale of 1 to 10, where 0 means no pain and 10 means the worst pain imaginable:

    Hair Changes

    Excessive hair growthHair lossChange in hair colourChange in hair texture or straightness

    Nail Changes

    Change in nail colourBrittle nail(s)Pits (small holes) in nailsWhite lines on nailsCurving of nails the wrong way (spoon shaped)Nail breakdown/ lossBad smell (malodour)

    Mouth, Lips & Tongue Changes

    Cold SoresDry mouthCrackingBad smell (malodour)RoughnessBleedingDiscolourationWhite spots/film

    Eye Symptoms

    GrittinessDrynessPainIrritationSensitivity to lightBloodshotDischargeBlurred vision

    Please rate your eye pain on a scale of 1 to 10, where 0 means no pain and 10 means the worst pain imaginable:

    Other Symptoms

    OtherI don’t know

    Please explain:

    21%

    Have you been unwell in any other way recently? Do you have any of the following concerning symptoms?

    No- I have been feeling well apart from my skin problemI have been unwell recently due to another condition, illness or circumstanceTemperatureFeverNauseaVomitingNight sweatsWeight lossExcessive tirednessJoint pain/ swelling

    Please tell us more about the other condition, illness, or circumstance:

    Please tell us more about your temperature:

    Please tell us more about your fever:

    Please tell us more about your nausea:

    Please tell us more about your vomiting:

    Please tell us more about your night sweats:

    Please tell us more about your weight loss:

    Please tell us more about your excessive tiredness:

    Please tell us more about your joint pain or swelling:

    28%

    Does anything make the problem worse?

    Environmental Factors

    HeatColdSunlightDustPetsPollen/Grass/Flowers/TreesWater

    Lifestyle and Diet

    StressAlcoholExerciseSweatingSpicy foodsCaffeineFood

    Products and Chemicals

    Chemicals e.g. toothpastes, mouthwashes, washing powders, hair dyes, makeup

    Hair treatments e.g. keratin treatments, chemical relaxers, hot-combing

    Hair styles e.g. weaves, ponytails, braids, buns, shaving

    Clothing

    Certain clothes/ fabrics

    Other Factors

    Other

    I don’t knowNone of the above

    35%

    Does anything make the problem better?

    Environmental Factors

    HeatColdExerciseSunlightSea water

    Supplements

    Certain supplements

    Products

    Certain products e.g. shampoos, cosmetics, toothpastes, mouthwashes

    Other Factors

    Other

    I don’t knowNone of the above

    42%

    Have you started any new medications around the same time that this skin problem started?
    e.g. any prescription, over the counter or herbal medications/ supplements

    No
    Yes

    I don't know

    Have other people in your family suffered with this skin problem too, or do you have a personal or family history of autoimmune diseases?
    e.g. Lupus, Scleroderma, Pemphigus, Vitiligo, Lichen Planus, Sjogren’s, Rheumatoid Arthritis, Crohn’s Disease

    NoYes, other people in my family have suffered with this skin problem tooYes, I have a personal or family history of autoimmune diseaseI don’t know

    Have you tried to get help for this problem before?

    NoYes- I have seen a healthcare professional e.g. GP, Dermatologist, Pharmacist, NurseYes- I have seen a Cosmetic specialist / Aesthetic practitioner/ BeauticianOther

    50%

    Have you already tried any of the following treatments?

    Antibiotic tablets/capsules
    e.g. Lymecycline, Erythromycin, Flucloxacillin

    Antibiotic creams/ gels/ lotions
    e.g. Zineryt, Metronidazole, Clindamycin, Fucidin, Fucibet

    Steroid creams/ointments
    e.g. Hydrocortisone, Eumovate, Elocon, Betnovate, Fucibet

    Antifungal Creams/ Tablets
    e.g. Canesten, Daktarin, Daktacort, Terbinafine tablets, Itraconazole capsules

    Antiviral Creams/ Tablets
    e.g. Zovirax, Aciclovir tablets

    Retinoid creams/ gels
    e.g. Differin, Epiduo, Isotrex, Treclin, Aklief

    Azelaic acid creams/gels
    e.g. Skinoren, Finacea

    Benzoyl Peroxide gels/ creams/lotions/washes
    e.g. Acnecide gel, Clean and Clear

    Washes/ Cleansers/ Soap Substitutes
    e.g. Dermol, Cetaphil, Cerave

    Moisturisers
    e.g. Cetraben cream/ointment, Diprobase, E45, Doublebase

    Scalp Applications
    e.g. Betnovate, Enstillar, Dovobet

    Shampoos
    e.g. Capasal, Dermax, Polytar, Alphosyl, Etrivex, Nizoral

    Steroid tablets or injections

    Antihistamines
    e.g. Loratadine, Cetirizine, Fexofenadine

    Specialist Acne treatments
    e.g. Epiduo, Treclin, Aklief, Spironolactone, Isotretinoin, Dianette contraceptive pill

    Specialist Eczema treatments
    e.g. Protopic or Elidel Creams/Ointments

    Specialist Rosacea treatments
    e.g. Soolantra, Mirvaso

    Specialist Psoriasis treatments
    e.g. Dovonex, Dovobet, Enstillar

    Specialist Hair treatments
    e.g. Regaine, Finasteride/Dutasteride, PRP, Hair transplant, Wigs/hair pieces

    Mouth products
    e.g Cold sore treatments, Mouthwashes, Lip balms, Throat sprays, Artificial saliva

    Immune Suppressing tablets/injections
    e.g. Methotrexate, Azathioprine, Hydroxychloroquine, Mycophenolate, Ciclosporin

    Biologics
    e.g Humira injection, Remicade injection

    Cosmetic procedures
    e.g. Chemical peels, Micro-needling, Dermal fillers, Botox

    Laser/ Light/UV therapy

    Herbal/ Alternative treatments

    Surgical Procedures

    Other

    None - I haven't tried any treatments.

    57%

    Have you ever had any of these tests to help diagnose your skin problem?

    NoneSwabBlood testsNail clippings/scrapingsAllergy tests e.g. skin prick, patch test, blood testSkin biopsyOtherI’m not sure

    Do you suffer from any mental health conditions?
    e.g. depression, anxiety, OCD

    NoYesI don’t knowI would rather not say

    Does your skin problem affect your mental health?

    NoYes

    Do you think your mental health has a negative impact on your skin condition?

    NoYes

    64%

    Are you pregnant, breastfeeding or trying to have a baby?

    No/ Not applicablePregnantBreastfeedingTrying to have a baby

    How many weeks pregnant are you?

    Are you allergic to any of the following?

    Medications/ Supplements/ HerbsPeanutsSoyaOther substance/ materialOtherNone

    Please name the product(s) and explain what happens when you have an allergic reaction? What symptoms do you get?

    What happens when you have an allergy? What symptoms do you get?

    What happens when you have an allergy? What symptoms do you get?

    Please name the substance/material and explain what happens when you have an allergic reaction? What symptoms do you get?

    Please name the allergen and describe what happens when you have the reaction.

    71%

    Have you been diagnosed with any of the following medical conditions?

    Anaemia
    Anxiety Disorder
    Asthma
    Atrial Fibrillation (AF)
    Bipolar Disorder
    Cancer (Past or Present)
    COPD
    Depression
    Eczema
    Epilepsy
    Thyroid Disorders
    Type 1 Diabetes

    Folic acid deficiency
    Gastric Reflux Disease
    Hay fever
    Heart Disease/ Heart Attack
    Heart Failure
    High Cholesterol
    High Blood Pressure
    Inflammatory Bowel Disease
    Iron deficiency
    Irritable Bowel Syndrome (IBS)
    Type 2 Diabetes
    Vitamin D deficiency

    Kidney Disease
    Liver Disease
    Migraine
    Obsessive-Compulsive Disorder
    Osteoarthritis
    Osteoporosis
    Psoriasis
    Rheumatoid Arthritis
    Schizophrenia
    Stroke/ TIA
    Surgical History (e.g. previous surgeries)
    Other
    None

    Please provide details about your cancer diagnosis:

    Please provide details of your surgical history:

    Please provide details of any other conditions:

    78%

    Are you currently taking any medications? (this includes prescription only medications, over the counter medications and/or any herbal/homeopathic remedies)

    NoYes

    Please list the medications you are currently taking:

    85%

    Photo Upload

    • You can upload up to 6 photos of the affected area(s).

    • Use a phone or digital camera. For phones, use the main camera, not the "selfie" camera.

    • Ask someone to help you take the photos for better quality.

    • Ensure the lens is clean and take the photo in a well-lit area with natural light, but avoid direct sunlight.

    • Avoid shadows on the skin. Use a plain background (such as a plain towel, sheet or wall).

    • Take a "far away photo" (from 1 meter away) to show the location and size of the problem.

    • Take a close-up photo (10-12 cm away) to show the details. Focus is key.

    • If the lesion is raised, take a sideways photo to highlight the elevation.

    • Include a size reference (e.g., a coin or ruler) in your photo for scale.

    • Take multiple photos and send only the best ones where the skin problem is clear and in focus.

    Upload Photo 1





    Add another photo

    Upload Photo 2





    Add another photo

    Upload Photo 3





    Add another photo

    Upload Photo 4





    Add another photo

    Upload Photo 5





    Add another photo

    Upload Photo 6





    92%

    How did you hear about us?

    GoogleInstagramTikTokYouTubeFacebookRedditWord of mouthLeaflet/ PosterNewspaper/ MagazineTVRadioOther

    Please tell us more:

    Would you like to sign up to our monthly newsletter?

    YesNo

    Terms and Conditions



    By accepting these terms and conditions, you agree to read the Patient Information Leaflet of any medications or products recommended and/or prescribed and will not take the medication or product if you're allergic to any of its ingredients or if it is contraindicated for you to use. If in doubt, please contact the prescriber. You agree that a DigiDerm clinician can contact you via Email, WhatsApp or telephone in response to this consultation form to offer advice and suggest treatments where necessary or if they feel they need more information to make an accurate diagnosis or assessment of your condition. If after reviewing your consultation, your skin problem is something we cannot treat or is not suitable for our service, then we will give you a full refund and suggest a more appropriate place for you to get help. There is no obligation to purchase any products or medications. You accept that there is no obligation for a DigiDerm clinician to prescribe a medication if it is deemed to be clinically inappropriate. You acknowledge that any information received from this form, including photos, is stored securely and confidentially by DigiDerm as per our Terms and Conditions. You take responsibility to inform your own regular doctor/ NHS GP of this online consultation and any treatments supplied, or any changes in your circumstances. You confirm that you are at least 16 years old and resident in the UK at the time of the consultation. You confirm that you have read, understood and accepted our Patient Consent Form as found in our Terms and Conditions.

    [stripe* stripe-85 "Make Payment"]

    100%

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      1/15

      Express Consultation Service

      Important Information: – This questionnaire should take about 5-10 minutes to complete. Once you have finished, one of our clinicians will get back to you via Email or WhatsApp within 24-48 hours with a diagnosis and treatment advice. Please check your junk email folder just in case.

      Please note: We do not advise on suspected skin cancers, moles, growths, lumps, or wounds. We do not currently prescribe Roaccutane (Isotretinoin) for Acne. This consultation does not include the cost of any prescription medications or treatments. If the clinician recommends any treatments then you can purchase these afterwards via your account (no obligation). We send all medications via Royal Mail next day tracked delivery. You can read the FAQ section for more information.

      Let’s get started…

      Please tell us about the problem in a couple of sentences.

      Where on your body is the problem? Please select all that apply.

      Head and Neck

      FaceScalpEyebrowsEyelidsEye lashesEarsMouthBeard areaNeck

      Upper Body

      ChestBreastsNipplesBackShouldersForearmsUpper ArmsArmpitsHandsFingersWristsStomach/AbdomenElbows

      Lower Body

      GroinButtocksThighsLower legsFeetToesAnklesKnees

      Hair and Nails

      Hair loss on the headFinger NailsToe Nails

      Other

      All overI'm not sureGenitals

      Face

      ForeheadBoth CheeksLeft CheekRight CheekNoseJaw lineChinCentre of face (down the middle)

      Chest

      Entire chestLeft sideRight sideIn Between Breasts

      Stomach/Abdomen

      StomachLower AbdomenBelly ButtonAll over

      Breasts

      Underneath both breasts (in the skin folds)Underneath one breast (in the skin fold)Side(s)TopBottomIn between breasts

      Nipples

      BothLeftRight

      Back

      UpperMiddleLowerAll over

      Shoulders

      BothLeftRight

      Feet

      TopSideSole (underneath)HeelLeft footRight footBoth feet

      Toes

      TopBottomSideToe webs (skin folds)Big toe2nd toeMiddle toe4th toeLittle toeLeft footRight footBoth feet

      Fingers

      TopBottomSideFinger webs (skin folds)ThumbIndex fingerMiddle fingerRing fingerLittle fingerLeft handRight handBoth hands

      Hands

      TopPalmLeft handRight handBoth hands

      Wrists

      TopInsideAll aroundLeft wristRight wristBoth wrists

      Ankles

      Front/TopBackSideAll around ankleLeft ankleRight ankleBoth ankles

      Finger Nails

      ThumbIndex fingerMiddle fingerRing fingerLittle fingerLeft handRight handBoth hands

      Toe Nails

      Big toe2nd toeMiddle toe4th toeLittle toeLeft footRight footBoth feet

      Scalp

      All over scalpFrontBackSidesNape (back of neck where hair starts)Several PatchesOne Patches

      Eyebrows

      BothLeftRightSingle patchMultiple patchesAll over

      Eyelids

      All overPatchSingle spotSingle spotLeft eyelidRight eyelidBoth eyelids

      Eye lashes

      Multiple lashesSingle lashLeft eyeRight eyeBoth eyes

      Ears

      Outside earInside earEar canalBehind earEar lobeLeft earRight earBoth ears

      Mouth

      Around the mouthCorner(s) of mouthRoof of mouthInside cheeksGumsTongueUnder tongueBottom lipTop lipBoth lips

      Beard area

      All overSeveral PatchesOne patch

      Neck

      CollarFrontBackLeft sideRight sideAll around

      Hair loss on the head

      Over the crown (topmost part of your scalp towards the back of your head)Top of the headFrontal hairline (including receeding hairline)Sides of your headGeneral thinning all over the scalpNape of the neck (where the hair starts at the back)Single patchMultiple patchesFront/ fringeBald spots with itching or burning

      Forearms

      InsideOutsideAll aroundLeft armRight armBoth arms

      Upper Arms

      InsideOutsideLeft armRight armBoth arms

      Armpits

      Left armpitRight armpitBoth armpits

      Lower legs

      CalfShinLeft legRight legBoth legs

      Thighs

      Left thighRight thighBoth thighs

      Groin

      Left groinRight groinBoth groins

      Buttocks

      Butt CheeksBum fold (skin fold)Anus

      Elbows

      Inside elbow foldOutside elbow surfaceLeftRight

      Knees

      Behind KneesOutside knee surfaceLeftRight

      Genitals

      Due to the sensitive nature of this area- DigiDerm does not treat skin problems related to the genitals. Please visit your NHS GP or local sexual health clinic.

      All over

      I’m not sure

      0%

      Is it getting worse?

      NoYesI don’t knowOther

      When did the problem first start?

      How quickly did the problem start?

      Suddenly (minutes)Quickly (hours)Gradually (days)Slowly (weeks)Very slowly (months)Over several yearsOtherI don't know

      7%

      How does the problem behave?

      It's always thereIt comes and goesOtherI don’t know

      How long does it last?

      MinutesHoursDaysWeeksMonthsYears

      Please explain:

      Have you experienced this problem before?

      NoYesI don’t know

      Please explain, e.g., When did you last experience it? Is it the same as before or different now?

      14%

      Do you have any of the following symptoms?

      Skin Appearance or Changes

      RednessRoughSmoothDryOilyCrackingBleedingWhiteheadsBlackheadsSmall firm spots (papules)Small pus filled spots (pustules)Cysts, bumps and lumpinessScarringBlisteringCrustingScaling (Flakey skin)Darkening of skin (increase in colour or pigment)Lightening of skin (loss of colour or pigment)SwellingExcessive SweatThickened skinConsistency has changedRegular infections

      Sensory Symptoms

      ItchTinglingDischarge or OozingPain or sensitivityStinging or BurningWarm to touch or hot skinCold skinFeeling of TightnessAltered sensation or feelingNumbness/Loss of sensation or feeling

      Please rate your pain or sensitivity on a scale of 1 to 10, where 0 means no pain and 10 means the worst pain imaginable:

      Hair Changes

      Excessive hair growthHair lossChange in hair colourChange in hair texture or straightness

      Nail Changes

      Change in nail colourBrittle nail(s)Pits (small holes) in nailsWhite lines on nailsCurving of nails the wrong way (spoon shaped)Nail breakdown/ lossBad smell (malodour)

      Mouth, Lips & Tongue Changes

      Cold SoresDry mouthCrackingBad smell (malodour)RoughnessBleedingDiscolourationWhite spots/film

      Eye Symptoms

      GrittinessDrynessPainIrritationSensitivity to lightBloodshotDischargeBlurred vision

      Please rate your eye pain on a scale of 1 to 10, where 0 means no pain and 10 means the worst pain imaginable:

      Other Symptoms

      OtherI don’t know

      Please explain:

      21%

      Have you been unwell in any other way recently? Do you have any of the following concerning symptoms?

      No- I have been feeling well apart from my skin problemI have been unwell recently due to another condition, illness or circumstanceTemperatureFeverNauseaVomitingNight sweatsWeight lossExcessive tirednessJoint pain/ swelling

      Please tell us more about the other condition, illness, or circumstance:

      Please tell us more about your temperature:

      Please tell us more about your fever:

      Please tell us more about your nausea:

      Please tell us more about your vomiting:

      Please tell us more about your night sweats:

      Please tell us more about your weight loss:

      Please tell us more about your excessive tiredness:

      Please tell us more about your joint pain or swelling:

      28%

      Does anything make the problem worse?

      Environmental Factors

      HeatColdSunlightDustPetsPollen/Grass/Flowers/TreesWater

      Lifestyle and Diet

      StressAlcoholExerciseSweatingSpicy foodsCaffeineFood

      Products and Chemicals

      Chemicals e.g. toothpastes, mouthwashes, washing powders, hair dyes, makeup

      Hair treatments e.g. keratin treatments, chemical relaxers, hot-combing

      Hair styles e.g. weaves, ponytails, braids, buns, shaving

      Clothing

      Certain clothes/ fabrics

      Other Factors

      Other

      I don’t knowNone of the above

      35%

      Does anything make the problem better?

      Environmental Factors

      HeatColdExerciseSunlightSea water

      Supplements

      Certain supplements

      Products

      Certain products e.g. shampoos, cosmetics, toothpastes, mouthwashes

      Other Factors

      Other

      I don’t knowNone of the above

      42%

      Have you started any new medications around the same time that this skin problem started?
      e.g. any prescription, over the counter or herbal medications/ supplements

      No
      Yes

      I don't know

      Have other people in your family suffered with this skin problem too, or do you have a personal or family history of autoimmune diseases?
      e.g. Lupus, Scleroderma, Pemphigus, Vitiligo, Lichen Planus, Sjogren’s, Rheumatoid Arthritis, Crohn’s Disease

      NoYes, other people in my family have suffered with this skin problem tooYes, I have a personal or family history of autoimmune diseaseI don’t know

      Have you tried to get help for this problem before?

      NoYes- I have seen a healthcare professional e.g. GP, Dermatologist, Pharmacist, NurseYes- I have seen a Cosmetic specialist / Aesthetic practitioner/ BeauticianOther

      50%

      Have you already tried any of the following treatments?

      Antibiotic tablets/capsules
      e.g. Lymecycline, Erythromycin, Flucloxacillin

      Antibiotic creams/ gels/ lotions
      e.g. Zineryt, Metronidazole, Clindamycin, Fucidin, Fucibet

      Steroid creams/ointments
      e.g. Hydrocortisone, Eumovate, Elocon, Betnovate, Fucibet

      Antifungal Creams/ Tablets
      e.g. Canesten, Daktarin, Daktacort, Terbinafine tablets, Itraconazole capsules

      Antiviral Creams/ Tablets
      e.g. Zovirax, Aciclovir tablets

      Retinoid creams/ gels
      e.g. Differin, Epiduo, Isotrex, Treclin, Aklief

      Azelaic acid creams/gels
      e.g. Skinoren, Finacea

      Benzoyl Peroxide gels/ creams/lotions/washes
      e.g. Acnecide gel, Clean and Clear

      Washes/ Cleansers/ Soap Substitutes
      e.g. Dermol, Cetaphil, Cerave

      Moisturisers
      e.g. Cetraben cream/ointment, Diprobase, E45, Doublebase

      Scalp Applications
      e.g. Betnovate, Enstillar, Dovobet

      Shampoos
      e.g. Capasal, Dermax, Polytar, Alphosyl, Etrivex, Nizoral

      Steroid tablets or injections

      Antihistamines
      e.g. Loratadine, Cetirizine, Fexofenadine

      Specialist Acne treatments
      e.g. Epiduo, Treclin, Aklief, Spironolactone, Isotretinoin, Dianette contraceptive pill

      Specialist Eczema treatments
      e.g. Protopic or Elidel Creams/Ointments

      Specialist Rosacea treatments
      e.g. Soolantra, Mirvaso

      Specialist Psoriasis treatments
      e.g. Dovonex, Dovobet, Enstillar

      Specialist Hair treatments
      e.g. Regaine, Finasteride/Dutasteride, PRP, Hair transplant, Wigs/hair pieces

      Mouth products
      e.g Cold sore treatments, Mouthwashes, Lip balms, Throat sprays, Artificial saliva

      Immune Suppressing tablets/injections
      e.g. Methotrexate, Azathioprine, Hydroxychloroquine, Mycophenolate, Ciclosporin

      Biologics
      e.g Humira injection, Remicade injection

      Cosmetic procedures
      e.g. Chemical peels, Micro-needling, Dermal fillers, Botox

      Laser/ Light/UV therapy

      Herbal/ Alternative treatments

      Surgical Procedures

      Other

      None – I haven't tried any treatments.

      57%

      Have you ever had any of these tests to help diagnose your skin problem?

      NoneSwabBlood testsNail clippings/scrapingsAllergy tests e.g. skin prick, patch test, blood testSkin biopsyOtherI’m not sure

      Do you suffer from any mental health conditions?
      e.g. depression, anxiety, OCD

      NoYesI don’t knowI would rather not say

      Does your skin problem affect your mental health?

      NoYes

      Do you think your mental health has a negative impact on your skin condition?

      NoYes

      64%

      Are you pregnant, breastfeeding or trying to have a baby?

      No/ Not applicablePregnantBreastfeedingTrying to have a baby

      How many weeks pregnant are you?

      Are you allergic to any of the following?

      Medications/ Supplements/ HerbsPeanutsSoyaOther substance/ materialOtherNone

      Please name the product(s) and explain what happens when you have an allergic reaction? What symptoms do you get?

      What happens when you have an allergy? What symptoms do you get?

      What happens when you have an allergy? What symptoms do you get?

      Please name the substance/material and explain what happens when you have an allergic reaction? What symptoms do you get?

      Please name the allergen and describe what happens when you have the reaction.

      71%

      Have you been diagnosed with any of the following medical conditions?

      Anaemia
      Anxiety Disorder
      Asthma
      Atrial Fibrillation (AF)
      Bipolar Disorder
      Cancer (Past or Present)
      COPD
      Depression
      Eczema
      Epilepsy
      Thyroid Disorders
      Type 1 Diabetes

      Folic acid deficiency
      Gastric Reflux Disease
      Hay fever
      Heart Disease/ Heart Attack
      Heart Failure
      High Cholesterol
      High Blood Pressure
      Inflammatory Bowel Disease
      Iron deficiency
      Irritable Bowel Syndrome (IBS)
      Type 2 Diabetes
      Vitamin D deficiency

      Kidney Disease
      Liver Disease
      Migraine
      Obsessive-Compulsive Disorder
      Osteoarthritis
      Osteoporosis
      Psoriasis
      Rheumatoid Arthritis
      Schizophrenia
      Stroke/ TIA
      Surgical History (e.g. previous surgeries)
      Other
      None

      Please provide details about your cancer diagnosis:

      Please provide details of your surgical history:

      Please provide details of any other conditions:

      78%

      Are you currently taking any medications? (this includes prescription only medications, over the counter medications and/or any herbal/homeopathic remedies)

      NoYes

      Please list the medications you are currently taking:

      85%

      Photo Upload

      • You can upload up to 6 photos of the affected area(s).

      • Use a phone or digital camera. For phones, use the main camera, not the “selfie” camera.

      • Ask someone to help you take the photos for better quality.

      • Ensure the lens is clean and take the photo in a well-lit area with natural light, but avoid direct sunlight.

      • Avoid shadows on the skin. Use a plain background (such as a plain towel, sheet or wall).

      • Take a “far away photo” (from 1 meter away) to show the location and size of the problem.

      • Take a close-up photo (10-12 cm away) to show the details. Focus is key.

      • If the lesion is raised, take a sideways photo to highlight the elevation.

      • Include a size reference (e.g., a coin or ruler) in your photo for scale.

      • Take multiple photos and send only the best ones where the skin problem is clear and in focus.

      Upload Photo 1





      Add another photo

      Upload Photo 2





      Add another photo

      Upload Photo 3





      Add another photo

      Upload Photo 4





      Add another photo

      Upload Photo 5





      Add another photo

      Upload Photo 6





      92%

      How did you hear about us?

      GoogleInstagramTikTokYouTubeFacebookRedditWord of mouthLeaflet/ PosterNewspaper/ MagazineTVRadioOther

      Please tell us more:

      Would you like to sign up to our monthly newsletter?

      YesNo

      Terms and Conditions



      By accepting these terms and conditions, you agree to read the Patient Information Leaflet of any medications or products recommended and/or prescribed and will not take the medication or product if you’re allergic to any of its ingredients or if it is contraindicated for you to use. If in doubt, please contact the prescriber. You agree that a DigiDerm clinician can contact you via Email, WhatsApp or telephone in response to this consultation form to offer advice and suggest treatments where necessary or if they feel they need more information to make an accurate diagnosis or assessment of your condition. If after reviewing your consultation, your skin problem is something we cannot treat or is not suitable for our service, then we will give you a full refund and suggest a more appropriate place for you to get help. There is no obligation to purchase any products or medications. You accept that there is no obligation for a DigiDerm clinician to prescribe a medication if it is deemed to be clinically inappropriate. You acknowledge that any information received from this form, including photos, is stored securely and confidentially by DigiDerm as per our Terms and Conditions. You take responsibility to inform your own regular doctor/ NHS GP of this online consultation and any treatments supplied, or any changes in your circumstances. You confirm that you are at least 16 years old and resident in the UK at the time of the consultation. You confirm that you have read, understood and accepted our Patient Consent Form as found in our Terms and Conditions.

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      100%