How to photograph a skin condition for a teleconsultation

A clinically useful skin photo needs three things: good light, two distances, and sharp focus. Take one wider shot showing the body location, one close-up of the lesion in natural light near a window, and check focus before sending. That combination answers most of the questions a dermatologist would otherwise have to ask back.

Why photo quality decides the teleconsultation

In a teledermatology review, the photograph is the examination. A specialist can work with brief notes, but a blurry or colour-distorted photo can make the difference between a confident assessment and a request to resubmit — which costs you and your patient a day.

The two-photo rule

Every submission should include at least:

1. A context shot — far enough away to show which part of the body is affected and how widespread the condition is. Distribution is a diagnostic feature: the same-looking rash means different things on flexural skin versus extensor surfaces.
2. A close-up — near enough to fill the frame with the lesion and the immediately surrounding skin, showing surface detail: scale, crust, vesicles, borders, colour variation.

Add a third photo if the condition appears on more than one body site, and dermoscopy images if you have a dermatoscope — they are gold for pigmented lesions.

Light: natural, indirect, no flash

• Position the patient near a window with daylight falling on the skin.
• Avoid direct flash — it flattens texture and creates glare on stretched or moist skin.
• Avoid overhead fluorescent light alone; it shifts colour, and colour matters (erythema, pigment, violaceous hues are all diagnostic clues).

Distance and focus

• For close-ups, get as close as your camera will focus — typically 8–12 cm on a modern phone. Tap the screen on the lesion to force focus, and wait for it to lock.
• If your phone struggles to focus up close, move back slightly and use 2× zoom rather than digital-zooming a blurry frame.
• Brace your elbows against your body or a surface; motion blur ruins more clinical photos than bad lighting does.

Small details that help the reviewer

• Include a size reference next to the lesion when scale matters — a ruler is ideal.
• For lesions on curved surfaces (nose, ear, shin), take the close-up from two angles.
• Wipe away ointments or creams first if clinically appropriate; they reflect light and obscure surface detail.
• For nail or scalp conditions, good light matters double — use daylight and take more frames than you think you need, then pick the sharpest.

Before you submit, check

• Can you see surface detail (scale, border, texture) when you zoom into the photo yourself?
• Does the wider shot make the body location obvious?
• Is the colour roughly what you see with your own eyes?

If yes to all three, the photo will serve the specialist — and your patient — well.