A note from Dr. Dupati to our Apollo Dermatology patients
If you’ve been with our practice for a while, you may wonder why we ask you to come back in for a visit before we continue a medication you’ve been using for months, sometimes even years. It can feel like an inconvenience, especially when the medication seems to be working fine. I want to take a few minutes to explain why we do this, because it isn’t about paperwork or rules for their own sake. It comes from genuinely wanting to take good care of you, and from knowing that skin, and health in general, can quietly change even when everything seems okay on the surface.
Skin can change, even when you don’t notice
Most of the medications we prescribe are treating a specific area or a specific process on your skin at a specific point in time. A patch of eczema, a stubborn spot of psoriasis, a pattern of acne, a mole we’re keeping an eye on. None of these stay perfectly still. Skin responds, adapts, and sometimes turns into something that needs a gentler approach, or a different one altogether.
When I look at an area again in person, I’m not just confirming it’s still there. I’m checking things like:
Whether the treatment is truly still working, or whether you’ve reached a point where you need something a little stronger, a little gentler, or simply different
Whether a spot that looks familiar has quietly started to change in its border, color, texture, or size in a way worth a closer look
Whether skin that’s been treated for a while is showing any early, subtle effects of the medication itself, such as thinning from a topical steroid
Whether the original diagnosis still fits, since skin conditions can evolve, or a new one can appear right alongside the first
I can’t assess any of this over the phone, through a refill request, or from a photo from a year or two ago. It really does take me seeing you.
Side effects deserve to be talked about more than once
When we start you on a medication, we talk through the possible side effects together at that visit. But I don’t think a single conversation is enough for something you’ll be using long term, especially with two kinds of medications in particular.
Medications taken by mouth. Pills that treat skin conditions often work throughout your whole body, not just your skin. Depending on the medication, that can mean gentle but important effects on your liver, kidneys, blood counts, or blood pressure, or an interaction with something new you’ve started taking since we last spoke. Bloodwork and an honest conversation about how you’re feeling on the medication are how I make sure it’s still the safest choice for you.
Topical steroids. These are wonderfully effective, and easy to underestimate simply because they go on the skin. Used the right way, for the right amount of time, in the right place, they’re very safe. Used for a long stretch without a check in, they can lead to thinning skin, stretch marks, visible small blood vessels, or changes in skin color, sometimes faster than people expect, especially on the face or in skin folds. I want to make sure you always understand which strength you’re using, where it’s safe to use it, and I want the chance to gently check for any early signs before they become something bigger than what we were originally treating.
I would rather remind you of this in person, every single time, than assume you remember something we talked about a while back.
This is also simply part of caring for you well
Beyond my own judgment as your doctor, there are professional standards in dermatology that guide how long a medication can reasonably continue without a proper reevaluation. Continuing something indefinitely without seeing you isn’t the kind of care I want to offer, not because of rules alone, but because I know it wouldn’t truly be looking after you the way I’d want to be looked after. Seeing you regularly is how I make sure, and can honestly say, that your treatment is still right for you.
I take this seriously, and I hope you’ll feel that care in it rather than friction. I’m not comfortable renewing a medication without seeing you again, even when you feel certain everything is fine. Often, feeling fine is exactly the moment something quiet is just beginning, and catching it early is so much easier than catching it late.
What this means for you
If our office asks you to come in before renewing a prescription, please don’t take it as distrust or as us making things difficult. It’s simply us doing right by you. A follow up visit is usually brief, and it’s how I make sure that
the medication is still the right one for what your skin needs today,
it’s still working the way it should,
it isn’t quietly causing something you haven’t noticed,
and your care is getting the attention I want it to have.
Your skin and your overall wellbeing are worth those few minutes. I would always rather see you a little more often than necessary than risk missing something that mattered.
If a prescription is coming up for renewal, please reach out to our team to get your follow up on the calendar. We’re always glad to see you.
Warmly,
Arjun Dupati, MD, FAAD
Apollo Dermatology
