Hair, Skin & Rash
Chronic Skin Conditions — Ongoing Management Online
Psoriasis, rosacea, or eczema that keeps coming back? A licensed provider can evaluate your symptoms, assess your current management, and adjust your treatment plan — including prescription options — without a months-long wait to see a specialist.
Start a VisitAbout these conditions
♾️ Chronic skin conditions — what they have in common
Psoriasis, rosacea, and eczema are chronic inflammatory skin conditions that tend to flare and improve over time. Their causes differ — psoriasis and eczema involve immune system overactivity, while rosacea is a multifactorial inflammatory and neurovascular condition — but all usually require ongoing management rather than a single course of treatment. They are not infections, they are not contagious, and they are not caused by poor hygiene.
Many people with these conditions manage well for years with the right treatment plan, then get stuck when a flare happens, a prescription runs out, or they need an adjustment they cannot get quickly. This is where telehealth fits particularly well. If you have a known diagnosis and need ongoing management, a prescription refill, or an adjustment to a regimen that is not working, a licensed provider can evaluate and treat you same day.
What we treat on this page
Mild-to-moderate plaque psoriasis, papulopustular and erythematotelangiectatic rosacea, and ongoing eczema (atopic dermatitis) management beyond acute flares. Each condition has its own treatment approach — use the section links above to jump directly to what applies to you. For an acute eczema flare or new contact rash, see our Rashes & Irritated Skin page. For infected or acutely worsening skin, see our Skin & Minor Infections page.
When chronic skin conditions need in-person or specialist care
Seek in-person evaluation for: suspected psoriatic arthritis (joint pain, swelling, or stiffness alongside psoriasis); guttate, pustular, or erythrodermic psoriasis subtypes; eye pain, light sensitivity, or vision changes alongside rosacea; rosacea with prominent telangiectasias (visible blood vessels) requiring laser or light treatment; severe or widespread eczema unresponsive to topical therapy; or any skin condition where the diagnosis is uncertain. MyPhysician360 does not initiate or manage biologics, systemic immunosuppressants, or phototherapy through this service. Patients who may need these treatments will be referred to dermatology or another appropriate specialist.
Condition deep-dive
🔴 Psoriasis — what it is and how it's treated
Psoriasis is a chronic autoimmune inflammatory skin condition in which the immune system accelerates skin cell turnover, causing cells to build up rapidly on the surface and form the thick, scaly patches known as plaques. It is not contagious. It is not caused by anything you did or did not do. It tends to run in families and is associated with other systemic conditions including cardiovascular disease, diabetes, and inflammatory bowel disease — which is one reason ongoing management matters beyond just the skin.
The main subtypes — telehealth is appropriate for mild-to-moderate plaque psoriasis:
| Subtype | What it looks like | Telehealth appropriate? |
|---|---|---|
| Plaque psoriasis (most common) | Well-defined red, raised patches covered with silvery-white scale; typically on elbows, knees, scalp, and lower back; may involve nails (pitting, thickening) | Yes — mild to moderate disease with typical distribution |
| Guttate psoriasis | Sudden onset of small, drop-shaped red patches across the trunk and limbs; often triggered by streptococcal infection | New or suspected guttate psoriasis should be evaluated in person to confirm diagnosis and assess possible triggers. Dermatology referral may be recommended. |
| Pustular psoriasis | Generalized pustular psoriasis causes widespread redness and sterile pustules, often with fever or systemic illness. Localized pustular forms also exist. | Generalized pustular psoriasis requires urgent emergency evaluation. Localized pustular symptoms require in-person dermatology assessment. |
| Erythrodermic psoriasis | Generalized red, scaling rash covering most of the body surface; high-risk for serious complications | Requires emergency evaluation |
| Inverse (intertriginous) psoriasis | Smooth, shiny red patches in skin folds — armpits, groin, under breasts, buttock creases — without the typical scale | May be evaluated via telehealth when diagnosis is established |
Important: screen for psoriatic arthritis
Up to 30% of people with psoriasis develop psoriatic arthritis — joint pain, stiffness, and swelling that can cause permanent joint damage if untreated. If you have psoriasis and are experiencing joint symptoms, let your provider know at your intake. Psoriatic arthritis requires a dedicated musculoskeletal evaluation and may need rheumatology referral.
How psoriasis is treated — topical first-line
Telehealth management of psoriasis focuses on topical therapies for mild-to-moderate plaque disease. Treatment is tailored to the location and severity of plaques — potency and agent selection differ significantly between thick body plaques, sensitive areas, and the scalp.
- →Topical corticosteroids — first-line for most patients. Prescription topical steroids reduce inflammation, itch, and scale. Potency is matched to the location and severity — higher-potency agents may be used for limited, thick plaques on appropriate body areas for a defined period; lower-potency agents are used for the face, genitals, and skin folds where prolonged high-potency use carries risk of skin thinning. Higher-potency steroids are generally avoided on the face, groin, genitals, skin folds, and large body areas unless specifically directed. Frequency and duration depend on the specific product, plaque location, severity, and individual treatment plan. Prolonged or inappropriate use can cause skin thinning and other adverse effects — follow the prescribed duration and do not extend treatment without guidance. Your provider selects the appropriate potency and regimen for your specific situation.
- →Calcipotriene (topical vitamin D analog) — reduces scaling and plaque formation. Often used alone or in a fixed combination with a topical corticosteroid. Fixed combination products are specifically formulated for concurrent use. Follow the product-specific instructions, because some topical products should not be layered together at the same time. Calcipotriene is suitable for longer-term maintenance therapy and some patients notice improvement within the first two weeks.
- →Topical calcineurin inhibitors (tacrolimus, pimecrolimus) — off-label option for sensitive areas. Tacrolimus and pimecrolimus are not FDA-approved for psoriasis but may be used off-label for sensitive areas — including the face, intertriginous areas, and genitals — where repeated topical steroid use is not preferred. Some patients notice improvement within the first two weeks with continued improvement over subsequent weeks.
- →Tazarotene (topical retinoid) — often combined with a corticosteroid. A topical retinoid that reduces plaque thickness. Some patients notice improvement within the first week. Not typically used on the face, intertriginous areas, or genitals. Most effective when combined with a topical corticosteroid. A fixed-dose combination (halobetasol-tazarotene lotion) is available and applied once daily. Tazarotene must not be used during pregnancy. Patients who could become pregnant should discuss pregnancy screening and contraception with their provider before starting this medication.
- →Tapinarof 1% cream — once-daily non-steroidal option. An FDA-approved once-daily non-steroidal topical for plaque psoriasis in eligible adults. Some patients notice clinical improvement within 4 to 8 weeks. May be an option when steroid-sparing therapy is preferred.
- →Roflumilast — once-daily non-steroidal option. Available in cream and foam formulations for eligible patients with plaque psoriasis. Approved ages and application areas differ by formulation — your provider will select the appropriate product. Some patients notice clinical improvement within the first 4 weeks. A useful option when long-term non-steroidal maintenance therapy is the goal.
- →Salicylic acid — adjunct to reduce scale. Helps remove thick scale and improve penetration of other topical therapies. Available in 2% to 6% concentrations. Should not be applied at the same time as calcipotriene.
- →Coal tar shampoo — adjunct for scalp psoriasis. Coal tar shampoos may help reduce scalp scale and itching. Follow the product-specific directions. Stop use if significant scalp irritation occurs. Coal tar can stain light hair or fabrics and may increase sun sensitivity.
When psoriasis requires specialist referral
Your provider will recommend specialist referral when: disease is moderate to severe or covers significant body surface area; topical therapy is not providing adequate control; the diagnosis is uncertain; psoriatic arthritis is suspected; or when guttate, pustular, or erythrodermic presentations are present. MyPhysician360 does not initiate or manage biologic therapies or phototherapy through this service. Biologics (injectable medications that target specific immune pathways) have transformed psoriasis care for moderate-to-severe disease — patients who may need these treatments will be referred to dermatology.
Condition deep-dive
🌹 Rosacea — what it is and how it's treated
Rosacea is a chronic inflammatory and neurovascular skin condition that most often affects the central face. It can cause persistent redness, flushing, visible blood vessels, papules and pustules, eye symptoms, or skin thickening. Many people have more than one feature at the same time, so treatment is based on the symptoms that are most prominent rather than a single fixed category. Understanding your triggers is as important as the medication you use.
Rosacea is more common in fair-skinned adults and affects women more often than men, though men more commonly develop skin thickening (most often on the nose). It is not contagious. It cannot currently be cured, but symptoms can often be well controlled with trigger management, gentle skincare, and prescription treatment — and in some cases, laser or other in-person procedures.
Pregnancy and breastfeeding — important note for all rosacea medications
Several rosacea medications discussed on this page require special consideration during pregnancy or breastfeeding. Pregnancy information for brimonidine, oxymetazoline, ivermectin, topical minocycline, and doxycycline is limited or includes important cautions. Tell your provider if you are pregnant, planning pregnancy, or breastfeeding — treatment will be individualized based on current labeling and your specific situation. Azelaic acid is commonly considered one of the more acceptable options when treatment is needed during pregnancy, though the decision should still be made with your provider.
Rosacea features and presentations — telehealth is appropriate when redness, flushing, or papulopustular features are most prominent:
| Rosacea feature or presentation | What it looks like | Telehealth appropriate? |
|---|---|---|
| Persistent redness and flushing | Persistent central facial redness and flushing; may have visible small blood vessels (telangiectasias); skin often sensitive and reactive | Yes for redness and flushing management; telangiectasias require laser/light treatment in person |
| Papules and pustules | Acne-like papules and pustules on a background of facial redness; often confused with adult acne (rosacea does not produce blackheads or whiteheads) | Yes — mild to moderate papulopustular features are well-suited for telehealth |
| Skin thickening (phymatous changes) | Skin thickening, most commonly on the nose (rhinophyma); irregular surface texture | Requires in-person evaluation; treatment typically involves procedural or surgical approaches |
| Eye involvement (ocular features) | Eye symptoms — redness, irritation, sensitivity to light, feeling of grittiness; lid margin involvement | Eye pain, light sensitivity, vision changes, or significant eye redness require prompt in-person eye evaluation. Mild eyelid or dry-eye symptoms may also require ophthalmology referral if persistent. |
Rosacea vs. adult acne — key differences
Both can produce papules and pustules on the face, but rosacea has important distinguishing features: rosacea occurs on a background of persistent central facial redness and flushing; rosacea does not produce blackheads or whiteheads (comedones); rosacea lesions tend to cluster on the central face; and rosacea triggers (heat, spicy food, alcohol, sun, stress) differ from acne triggers. If you are not sure whether you have rosacea or acne, your provider can help distinguish these during your visit. For acne evaluation, see our Acne Treatment page.
How rosacea is treated — by symptom type
Treatment is driven by your dominant features. Many patients have more than one feature and may need a combination approach. Trigger avoidance and gentle skincare are the foundation for all rosacea presentations.
For persistent facial redness and flushing:
- →Brimonidine 0.33% gel — topical alpha-adrenergic agonist. Applied once daily to the entire face. Works by constricting blood vessels, reducing visible redness. Some patients notice improvement within approximately 30 minutes; duration of effect varies. Tell your provider if you are pregnant, planning pregnancy, or breastfeeding — available pregnancy data are limited and treatment should be individualized. Caution is also advised in patients with cardiovascular conditions, orthostatic hypotension, Raynaud's phenomenon, narrow-angle glaucoma, depression, or scleroderma — discuss your full medical history with your provider before use. Some patients experience increased redness, flushing, or rebound redness; stop use and contact your provider if symptoms significantly worsen.
- →Oxymetazoline 1% cream — topical alpha-adrenergic agonist. A thin layer applied once daily to the face, avoiding the eyes and lips. Duration of effect varies. Pregnancy and breastfeeding considerations should be reviewed before use because available human data are limited. Similar cardiovascular cautions apply as with brimonidine — discuss your full medical history with your provider.
For papules and pustules (papulopustular rosacea):
- →Topical metronidazole — first-line for papulopustular rosacea. Available as 0.75% gel or cream applied twice daily, or 1% gel applied once daily. A three-month course is typically recommended to assess response. If there is a good response, continue on the same regimen. If partial response, your provider may switch to or add a second-line agent. Topical metronidazole has anti-inflammatory effects and generally creates less systemic antibiotic exposure than oral antibiotic therapy.
- →Azelaic acid 15% gel or foam — second-line. Applied twice daily to affected areas. Reassess at 12 weeks if no improvement. Azelaic acid reduces inflammation, papules, and redness. It is commonly considered when treatment is needed during pregnancy or breastfeeding because systemic absorption is low, but the decision should still be individualized with your provider.
- →Topical ivermectin 1% cream — second-line. Applied as a pea-size amount to each affected area once daily (forehead, chin, nose, each cheek). Addresses both inflammatory papules and the Demodex mite component that contributes to rosacea in many patients. Topical ivermectin is generally avoided or used cautiously during pregnancy because pregnancy safety data are limited. Your provider will recommend an alternative when appropriate.
- →Topical minocycline foam 1.5% (Zilxi) — second-line. Applied as a thin layer to all areas of the face once daily. Topical minocycline is generally avoided during pregnancy because it belongs to the tetracycline class. Tell your provider if you are pregnant, planning pregnancy, or breastfeeding.
- →Prescription benzoyl peroxide formulations — second-line. Certain prescription benzoyl peroxide formulations may be considered for papules and pustules in selected patients. Standard OTC benzoyl peroxide can be irritating for rosacea-prone skin and should not be started without provider guidance.
For severe or poorly responsive papulopustular rosacea:
- →Oral doxycycline — for significant papulopustular rosacea not controlled by topicals. Anti-inflammatory-dose doxycycline is often preferred when oral treatment is needed, targeting the anti-inflammatory properties of doxycycline rather than its antibiotic effect. Higher antimicrobial doses may be used selectively for severe disease, but dose and duration are determined by the prescriber based on individual clinical factors. Treatment is used in combination with appropriate topical therapy, with transition to topical maintenance after satisfactory response. Doxycycline is generally avoided during pregnancy — tell your provider if you are pregnant, planning pregnancy, or breastfeeding. Patient counseling: doxycycline can cause nausea, sun sensitivity, and esophageal irritation. Take it according to the product instructions with adequate water, and do not lie down immediately afterward.
When rosacea requires specialist referral
Your provider will recommend specialist referral when: the diagnosis is uncertain; eye pain, light sensitivity, vision changes, or significant eye redness are present; prominent telangiectasias require laser or light-based treatment; phymatous changes are developing; or rosacea is not responding to standard topical and oral therapy. Laser, intense pulsed light (IPL), and vascular treatments for redness and telangiectasias require in-person specialist care. MyPhysician360 does not provide these services through this platform.
Condition deep-dive
🔁 Eczema — long-term management and flare prevention
This section covers ongoing eczema (atopic dermatitis) management for patients with a known diagnosis — prescription maintenance therapy, flare prevention, steroid-sparing strategies, and when to pursue specialist evaluation. For a first-time eczema flare or a rash you are not sure is eczema, see our Rashes & Irritated Skin page, which covers eczema flare treatment in more detail.
Eczema is a chronic condition, and management is ongoing even during periods when skin appears clear. The goal is not just to treat flares — it is to reduce how often they occur and how severe they are when they do. This requires a combination of consistent skin barrier support, trigger avoidance, and appropriate use of prescription therapy during and between flares.
Long-term eczema management strategies
- →Proactive (maintenance) topical therapy. Rather than only treating active flares, proactive therapy involves applying a low-potency topical corticosteroid or a non-steroidal topical (tacrolimus, pimecrolimus) 1 to 2 times per week to previously affected areas — even when the skin currently looks clear. This approach reduces flare frequency and is supported by strong clinical evidence. Your provider will discuss whether proactive therapy is appropriate for your situation.
- →Steroid-sparing agents for sensitive or frequently affected areas. For areas that flare repeatedly — particularly the face, eyelids, neck, and skin folds — long-term topical steroid use carries risk of skin thinning. Tacrolimus ointment (0.03% for patients ages 2 to 15; either 0.03% or 0.1% for patients age 16 and older) and pimecrolimus cream 1% (age 2 and older) are non-steroidal alternatives that can be used for maintenance without skin-thinning risk. Crisaborole 2% ointment is approved for patients age 3 months and older. Roflumilast and tapinarof are additional FDA-approved nonsteroidal options for eligible patients.
- →Trigger identification and avoidance. Common eczema triggers include fragranced soaps and laundry detergents, wool and synthetic fabrics, sweat, heat, stress, dust mites, pet dander, and mold. Identifying which triggers drive your individual flares — rather than eliminating all potential triggers broadly — is most effective. Do not restrict major food groups based on eczema alone without evaluation and guidance from a provider.
- →Consistent skin barrier support. Consistent moisturization is a foundation of long-term eczema management. Thick, fragrance-free emollients applied frequently — petrolatum-based ointments and ceramide-containing creams are among the most effective options — help maintain the skin barrier and reduce flare frequency. This applies even when skin looks clear.
- →Recognizing possible secondary infection promptly. Scratched or disrupted eczema skin is vulnerable to bacterial infection, most commonly with Staphylococcus aureus. New pain, spreading redness, purulent drainage, fever, or rapid worsening requires prompt evaluation. Antibiotics are used when bacterial infection is clinically supported — not every worsening eczema flare represents a bacterial infection. See our Skin & Minor Infections page if you suspect infection.
When ongoing eczema requires specialist referral
Referral is appropriate when: eczema is not adequately controlled with first- and second-line topical therapy; recurrent secondary infections are occurring; significant quality-of-life impairment persists; a specific food allergy, contact allergy, or environmental trigger is clinically suspected and testing would change management; or when systemic therapy is being considered. MyPhysician360 does not initiate or manage biologic therapies or phototherapy through this service. Biologic therapies (dupilumab and newer agents) have dramatically improved outcomes for patients with moderate-to-severe eczema — these require specialist initiation and monitoring. Patients who may need these treatments will be referred appropriately.
How online care can help
💻 Chronic skin care online — what works and what it cannot replace
Ongoing management of mild-to-moderate psoriasis, papulopustular rosacea, and chronic eczema is well-suited for telehealth — particularly for patients with an established diagnosis who need a prescription adjusted, a new medication tried, or a flare addressed without waiting weeks for a dermatology appointment. A detailed symptom history and photographs give a licensed provider substantial information to work with.
| What online chronic skin care can do | What it cannot replace |
|---|---|
| Evaluate and manage mild-to-moderate plaque psoriasis with topical therapy | In-person evaluation for guttate, pustular, or erythrodermic psoriasis |
| Prescribe topical corticosteroids, calcipotriene, tapinarof, roflumilast for psoriasis | Phototherapy or biologic therapy (requires in-person specialist) |
| Evaluate and manage papulopustular and erythematotelangiectatic rosacea | Laser or light-based treatment for telangiectasias or redness |
| Prescribe topical metronidazole, azelaic acid, ivermectin, brimonidine for rosacea | Ocular rosacea evaluation (requires ophthalmology) |
| Prescribe oral doxycycline for moderate-to-severe papulopustular rosacea | Phymatous rosacea treatment (procedural/surgical) |
| Manage eczema with topical steroids, calcineurin inhibitors, and maintenance planning | Biologic therapy or phototherapy for eczema (requires specialist) |
| Adjust treatment regimens that are not providing adequate control | Skin biopsy for diagnostic uncertainty |
| Screen for psoriatic arthritis symptoms and refer when indicated | Psoriatic arthritis management (requires rheumatology) |
- →⏰ Convenient access for selected chronic skin concerns. A licensed healthcare provider can review whether continuing, adjusting, or changing your current treatment is medically appropriate — without waiting weeks for a scheduled appointment.
- →🏪 Your prescription goes to your local pharmacy. Topical prescriptions and oral doxycycline sent to the pharmacy you already use. No mail-order required.
- →💰 No monthly subscription. A flat fee per visit. No required membership to access our telehealth services.
- →🩺 A real clinical evaluation. A licensed provider reviews your full history, current regimen, and symptom picture — not an automated questionnaire. Your provider will refer you to a specialist when that is the right next step.
★★★★★ Patient review
"My psoriasis had been well-controlled for years and then I moved and lost my dermatologist. MyPhysician360 helped me get back on the right treatment without having to wait months for a new specialist. The provider understood what I needed and helped me get my plaques back under control."
Individual treatment recommendations, pharmacy timing, and results vary.
Patient, MyPhysician360
What to expect
🗓️ Your visit, start to finish
Here is what happens from the moment you start your visit to when you have a treatment plan.
|
1
Describe your condition
Complete a short intake covering your diagnosis, how long you have had it, current and prior treatments, what has and has not worked, any recent changes or flares, associated symptoms (joint pain for psoriasis, eye symptoms for rosacea), and current skincare products. Photos of affected areas are very helpful. About 5 to 7 minutes. |
2
Meet with your provider
You speak with a licensed provider who reviews your intake and photos, asks follow-up questions about your history and current control, assesses whether your current regimen is appropriate or needs adjustment, and screens for signs that would indicate a specialist referral. This is a real clinical evaluation. |
3
Receive your treatment plan
Your provider explains the recommended approach — whether continuing, adjusting, or changing your current therapy. If prescription treatment is appropriate, it may be sent electronically to your preferred pharmacy the same day. Your provider also explains what to watch for and when to follow up or escalate. |
4
Ongoing follow-up
Chronic skin conditions require ongoing follow-up. Follow-up timing depends on the condition, treatment selected, and your response — many topical regimens are reassessed within several weeks, with longer-term check-ins once symptoms are stable. Your provider will help you establish a maintenance plan, not just treat the current flare. |
When will I see improvement?
Psoriasis with topical corticosteroids: some patients notice improvement within the first 1 to 2 weeks; full benefit may require several weeks of consistent treatment. Calcipotriene: some improvement may be noticeable within a few weeks. Tapinarof and roflumilast: full benefit may take 4 to 8 weeks or longer. Rosacea with topical metronidazole: response is typically assessed after 3 months of consistent use. Brimonidine or oxymetazoline for redness: some patients notice an effect within approximately 30 minutes, though response varies. Oral doxycycline for rosacea: some improvement in papulopustular features may be seen within several weeks. Eczema with proactive topical therapy: flare frequency and severity may reduce over several months of consistent use. Individual response varies by medication, condition, and patient — some treatments can initially cause irritation or appear to worsen symptoms before improving.
Supporting your treatment
🏠 What to do alongside treatment
Medication controls the inflammatory process. These habits reduce trigger exposure, support the skin barrier, and reduce how hard medication has to work.
For psoriasis:
- →Moisturize consistently with fragrance-free, thick emollients. Keeping plaques moisturized reduces scale, improves comfort, and helps topical medications penetrate more effectively. Apply after bathing while skin is still slightly damp.
- →Avoid known triggers: stress, skin injury (the Koebner phenomenon — psoriasis can appear at sites of skin trauma), and certain medications. Some medications — including lithium and certain beta-blockers — are associated with psoriasis worsening in some patients. Do not stop any prescribed or over-the-counter medication without discussing the suspected connection with a healthcare provider. Streptococcal throat infections can trigger guttate psoriasis flares.
- →Use topical medications only on the areas and for the duration prescribed. Do not extend, restart, or change the schedule without speaking with your provider.
- →Apply salicylic acid products at a different time than calcipotriene — they should not be used simultaneously as salicylic acid inactivates the vitamin D analog.
- →Limit alcohol and avoid smoking — both are associated with worsening psoriasis and reduced treatment response.
- →Protect skin from injury. Even small cuts, insect bites, or sunburns can trigger new plaques at those sites in psoriasis-prone individuals.
For rosacea:
- →Identify and avoid your personal triggers. The most common triggers include sun exposure, heat, spicy foods, hot beverages, alcohol, vigorous exercise, stress, and certain skincare products. Triggers vary between individuals — keeping a simple diary for a few weeks can help identify your specific pattern.
- →Wear broad-spectrum SPF 30 or higher sunscreen every day. Sun exposure is one of the most consistent rosacea triggers and a key driver of skin damage and worsening. Choose a mineral (zinc oxide or titanium dioxide) sunscreen formulated for sensitive skin.
- →Use a gentle, non-soap cleanser twice daily and a fragrance-free moisturizer twice daily. Rosacea skin is reactive — avoid harsh toners, astringents, physical scrubs, and exfoliants. Avoid anything that stings or burns on application.
- →Apply topical medications gently to dry skin. For brimonidine or oxymetazoline, apply in the morning; for metronidazole, azelaic acid, or ivermectin, follow your provider's specific instructions about timing and application area.
- →Use cooling strategies during flushing episodes — a cool mist, cool water, or a cold compress. Avoid heat-based skin treatments during active rosacea.
- →Introduce new skincare products one at a time to identify anything that causes irritation or flushing. Rosacea skin reacts to many ingredients that normal skin tolerates.
For eczema (ongoing management):
- →Moisturize twice daily — every day, not just during flares. Thick, fragrance-free emollients (petrolatum-based ointments or ceramide-containing creams) are most effective. This is the single most important thing you can do to reduce flare frequency.
- →Use fragrance-free, dye-free soaps, shampoos, and laundry detergents. Look for "fragrance-free," not just "unscented."
- →Apply any prescribed maintenance topical as directed — including to skin that currently looks clear, if proactive therapy has been recommended.
- →Avoid scratching. Keep nails short. Use cool compresses during intense itch episodes rather than scratching. Scratching breaks the skin barrier and increases secondary infection risk.
- →Monitor for signs of secondary infection (sudden worsening, new oozing, yellow crusting, fever) and seek prompt treatment when these occur.
⚠️ Contact your provider or seek in-person care if:
- Psoriasis is spreading rapidly, changing in character, or you develop joint pain, swelling, or stiffness
- Rosacea develops eye symptoms — redness, irritation, light sensitivity, or blurred vision
- Eczema develops signs of secondary infection: spreading redness, yellow discharge, worsening pain, or fever
- Your condition is not adequately controlled after 6 to 8 weeks of appropriate treatment
- You need a medication that requires in-person specialist oversight — biologics, systemic immunosuppressants, phototherapy
- The diagnosis is uncertain or the rash is changing in a way that no longer matches your known condition
Care connected to your pharmacy
🏪 Your prescription. Your pharmacy. Same day.
Pharmacies are the front door of healthcare in most communities. We built MyPhysician360 to respect that. When treatment is appropriate, your prescription goes to the pharmacy you already trust, filled by the pharmacist who already knows you.
Many of our partner pharmacies have a MyPhysician360 QR code right at the counter. If prescription treatment is appropriate, it may be sent electronically to your selected pharmacy the same day. Medication availability, cost, insurance requirements, and dispensing time vary.
- ✓Prescription sent electronically to your pharmacy same day your visit ends
- ✓Pick up at your neighborhood pharmacy or any major chain
- ✓Home delivery available by request at many local pharmacies
- ✓No required memberships to access our telehealth services
- ✓If we cannot treat you online, you will not be charged
Frequently asked questions
❓ Questions about chronic skin condition management online
Straight answers to what patients ask most before their first visit.
Can I get treatment for psoriasis through telehealth?
Yes, for mild-to-moderate plaque psoriasis. A licensed provider can evaluate your plaques based on your description and photographs, prescribe topical corticosteroids, calcipotriene combinations, tapinarof, roflumilast, tazarotene, or calcineurin inhibitors depending on the location and severity of your disease, and discuss scalp-specific treatments including coal tar shampoo. If your psoriasis is widespread, involves atypical subtypes (guttate, pustular, erythrodermic), or has not responded to topical therapy, your provider will recommend dermatologist referral for systemic therapy or biologic evaluation.
Is psoriasis contagious?
No. Psoriasis is not contagious and cannot be spread to other people through skin contact, touching plaques, or any form of transmission. It is an autoimmune condition driven by the patient's own immune system causing accelerated skin cell turnover. Family members, partners, and coworkers are not at risk from contact with someone who has psoriasis.
What is the difference between psoriasis and eczema?
Both cause red, inflamed, and sometimes scaly skin, but they have distinct characteristics. Psoriasis typically produces thick, well-defined plaques with silvery-white scale on a red base, most commonly on the elbows, knees, scalp, and lower back. Eczema produces dry, intensely itchy, less-defined patches typically in flexural locations (inner elbows, behind the knees, wrists, neck) and is strongly associated with asthma and seasonal allergies. Psoriasis tends to be less itchy than eczema in most patients, though both can cause significant discomfort. The treatments also differ — psoriasis benefits from vitamin D analogs and coal tar that are not typically used for eczema. Your provider will assess which condition you are dealing with based on your symptom pattern, history, and description.
Can I get rosacea treatment through telehealth?
Yes, for rosacea with persistent redness, flushing, or papulopustular features. A licensed provider can prescribe topical metronidazole, azelaic acid, ivermectin, brimonidine, oxymetazoline, and oral doxycycline depending on your dominant symptoms. Rosacea presentations requiring in-person care include eye involvement, skin thickening (phymatous changes), and prominent telangiectasias requiring laser or light-based treatment. If any of these apply to you, your provider will refer you appropriately.
My rosacea looks like acne. How can I tell the difference?
The key distinguishing features: rosacea occurs on a background of persistent facial redness and flushing that acne does not produce; rosacea does not cause blackheads or whiteheads (comedones) — if you have these, acne is more likely; rosacea is triggered by heat, sun, alcohol, spicy food, and stress in characteristic ways; and rosacea tends to appear in people over 30 on the central face. Adult acne most commonly affects the jawline, chin, and cheeks without the persistent background redness. Many adults have both conditions simultaneously. For acne evaluation, see our Acne Treatment page.
Can I use topical steroids on my psoriasis long-term?
With appropriate precautions, yes for periodic use — but continuous uninterrupted long-term use of high-potency topical corticosteroids on any single area is not recommended. Prolonged use can lead to skin thinning (atrophy), striae, and potentially a rebound flare when stopped. The standard approach is to use topical steroids during flares, taper once improvement is achieved, and transition to steroid-sparing maintenance therapy (such as calcipotriene, tapinarof, or roflumilast) for ongoing control. Your provider will help you develop a regimen that balances effective treatment with appropriate steroid management.
I have psoriasis and my joints have been bothering me. Is that related?
It may be. Psoriatic arthritis develops in up to 30% of people with psoriasis and can cause joint pain, stiffness, swelling, and — if untreated — permanent joint damage. It most commonly affects the fingers, toes, wrists, knees, and lower back. The joint symptoms can occur before, alongside, or after the skin symptoms, and the severity of psoriatic arthritis does not always parallel the severity of skin disease. If you have psoriasis and are experiencing new or worsening joint symptoms, mention this specifically in your intake. Your provider will screen for psoriatic arthritis and refer you to rheumatology if indicated — joint involvement is not something to monitor and wait on.
Can rosacea be cured?
Rosacea cannot be cured, but it can be very well controlled. With the right combination of trigger avoidance, consistent skincare, and appropriate prescription treatment, most patients achieve significant reduction in redness, papules, and flushing. The goal of treatment is long-term control — not just suppression of the current flare. Patients who identify their triggers and are consistent with their skincare regimen and medications typically experience less frequent and less severe flares over time. Some features of rosacea — particularly telangiectasias (visible blood vessels) and phymatous changes — may require in-person laser or procedural treatment that cannot be managed with medications alone.
My eczema keeps coming back in the same spots. What should I do differently?
Recurring eczema in the same locations is very common and is the typical pattern of atopic dermatitis. The key to breaking this cycle is proactive therapy — applying a low-potency topical corticosteroid or a non-steroidal topical (tacrolimus, pimecrolimus) to those specific areas two to three times per week even when the skin currently looks clear. This maintenance approach significantly reduces how often flares occur. Combined with consistent twice-daily moisturization and trigger avoidance, many patients see a significant reduction in flare frequency and severity over several months. If proactive topical therapy is not providing adequate control, specialist evaluation for advanced options (biologics, phototherapy) is warranted.
Is this visit HSA or FSA eligible?
Yes. MyPhysician360 consultations are HSA and FSA eligible. Your visit cost is reimbursable through your Health Savings Account or Flexible Spending Account, making this accessible through your existing health benefits even without insurance.
Helpful resources
📚 Learn more
Your provider may reference these educational materials during your visit. Links go straight to the source.
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🔴 Psoriasis Psoriasis — Overview, Causes, Symptoms, and Treatment National Psoriasis Foundation Visit NPF → |
🌹 Rosacea Rosacea — Overview, Features, Triggers, and Treatment National Rosacea Society Visit NRS → |
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🔁 Eczema Eczema (Atopic Dermatitis) — Long-Term Management National Eczema Association Visit NEA → |
🦴 Psoriatic arthritis Psoriatic Arthritis — Symptoms, Diagnosis, and Treatment Arthritis Foundation Visit Arthritis Foundation → |
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Medical disclaimer & sources: The information on this page is for general educational purposes only and does not constitute medical advice. Diagnosis and treatment of chronic skin conditions requires clinical evaluation by a licensed provider. Not all skin conditions or presentations are appropriate for telehealth management. Guttate, pustular, and erythrodermic psoriasis require urgent in-person evaluation. Ocular rosacea requires ophthalmology evaluation. Suspected psoriatic arthritis requires rheumatology evaluation. MyPhysician360 does not initiate or manage biologics, systemic immunosuppressants, or phototherapy through this service; patients who may need these treatments will be referred to appropriate specialist care. Psoriasis content is informed by the MyPhysician360 Psoriasis Clinical Protocol and National Psoriasis Foundation guidelines. Rosacea content is informed by the MyPhysician360 Rosacea Clinical Protocol and National Rosacea Society guidelines. Eczema content is informed by the MyPhysician360 Eczema Clinical Protocol. Prescribing decisions are made by a licensed provider on an individual basis. MyPhysician360 services are available in most states. Services are not currently available in Mississippi or Alaska.