Before you come
Once your referral has been reviewed we will call you to book. Please arrive 10 minutes before your appointment time so that registration can be completed and your visit can start on time. If you are going to be late or cannot attend, call 905 625 5600 as early as you can so the appointment can be offered to another patient.
Where possible, come with skin that has not been covered with make up, self tanner or thick creams on the area to be examined, and with nail polish removed if your nails are part of the problem. Wear clothing that is easy to remove, since a full skin examination is part of most first visits.
What to bring
- Your Ontario health card. It must be valid. If it has expired, contact ServiceOntario before your visit.
- A list of your medications, including over the counter products, vitamins and supplements, with doses. A pharmacy printout is ideal.
- Images of flares. Many skin conditions come and go. If the rash is quiet on the day, images of what it looks like at its worst are very helpful. Phone images are fine.
- A list of products you have used on your skin for this problem, prescription and non prescription, with roughly how long you used each and whether it helped. Bring the tubes if that is easier.
- Reading glasses if you need them, for forms and written instructions.
- A support person or interpreter if you would like one. Tell us when we call to book if you need an interpreter.
What happens at the visit
Registration
Reception confirms your health card, contact details and family doctor, and asks you to complete a short medical history form if one has not already been sent to you.
History
The dermatologist asks about the problem you were referred for: when it started, how it has changed, what makes it better or worse, what you have tried, and how it affects your daily life. You will also be asked about your general health, medications, allergies and family history.
Skin examination
A full skin examination is standard at a first visit for most conditions, and always where a mole or skin cancer is the concern. You will be given a gown and asked to undress to your underwear. The dermatologist examines the skin systematically, including the scalp, nails and areas you may not have noticed. A dermatoscope, a handheld magnifier with a light, is often used to look at moles closely.
Discussion and plan
The dermatologist explains what they have found and what they think is going on, and discusses treatment options with you. You will leave with a plan and, where treatment is started, written or verbal instructions on how to use it. Ask questions. Writing them down beforehand helps.
Follow up
You may be asked to return to DermCare, return to your family doctor, or both. Where phototherapy is recommended, the first treatment is scheduled separately.
A biopsy may be recommended
If the diagnosis is not clear from examination, or a lesion needs to be tested, the dermatologist may recommend a skin biopsy. This is a small procedure done in the clinic, often at the same visit. The area is numbed with a local anaesthetic injection, a small sample of skin is removed, and the spot is closed with a stitch or dressed. It takes a few minutes. You will be told how to care for the site and when any stitch should come out.
You can ask for the biopsy to be done at a later date if you prefer, although for a suspicious mole we recommend it is not delayed. Biopsies at DermCare are read by a dermatopathologist within the practice.
If you take a blood thinner
Do not stop any medication before your visit. Tell the dermatologist what you take. Most skin biopsies can be done safely without stopping blood thinners.
How results come back
Biopsy results usually take one to three weeks. When the result is available the dermatologist reviews it and the clinic contacts you. For a result that is benign or expected, this may be by telephone or at your planned follow up visit. For a result that changes the plan, or shows a skin cancer, you will be called and an appointment arranged to discuss it and the next steps. Please make sure we have a telephone number that reaches you.
A copy of the result and the dermatologist's report is sent to the doctor who referred you and to your family doctor if that is a different person. If you have not heard about a result within three weeks, call 905 625 5600.