Skin issue treatment

Question 1

When should I go to the doctor for a rash or skin infection?

Answer

If you're experiencing any of the following symptoms, you should be seen by an in-person healthcare provider as soon as possible. These symptoms cannot be treated virtually.

• Skin infection accompanied by fever (temperature above 100.4°F) or chills. Fever and chills can be a sign of a serious infection that needs in-person care. You'll need to see a primary care provider or an urgent care provider as soon as possible.

• Extensive pus or fluid oozing from the affected area. This can be a sign of a serious infection that requires in-person care.

• Allergic skin reaction (hives) accompanied by trouble breathing, swollen lips, or a swollen tongue. Multi-organ symptoms can indicate anaphylaxis, a potentially life-threatening allergic reaction. Please call 911.

• Travel-related skin infections. These may pose a risk of serious complications requiring in-person care.

• Open wounds from animal bites, puncture injuries, pressure injuries, or surgeries. These require in-person care as soon as possible.

• Suspicious moles or spots. These may require an in-person evaluation and a skin biopsy.

• Epidermoid cysts (small, shifting bumps under the skin), which may require an injection and/or excision from an in-person healthcare provider.

• Abscesses (collections of pus under the skin), which may require incision and drainage (I&D) from an in-person healthcare provider.

• Common warts. If you've already tried over-the-counter treatments for common warts and they haven't worked for you, the next step in treatment may be cryotherapy (freezing), which needs in-person treatment from a primary care provider or dermatologist.

• Extensive tissue destruction. If a foul smell is coming from your skin, you'll need to see an in-person healthcare provider as soon as possible.

• Extensive bleeding. If you're losing a significant amount of blood, please call 911 or go to the emergency room (ER).

• Pain or tenderness that seem out of proportion to your skin issue (with the exception of shingles). You may need to see a primary care provider for an in-person evaluation.

Question 2

What areas of the body might be limited for online treatment?

Answer

Eyes

If you have eye symptoms like vision changes, sensitivity to light, pain or soreness, or severe redness, an On-Demand Care provider won't be able to treat your eye area today. You may need immediate medical attention from an in-person provider. Eye injuries, pain, and vision changes should be monitored closely to prevent long-term problems.

Face

If you're having an allergic reaction (including poison ivy symptoms), shingles (painful rash), or psoriasis (red, scaly, itchy patches) on your face, you'll need to see a primary care or urgent care provider for an in-person evaluation. Treatment for skin issues around the eyes can be more complex.

Sensitive areas of the body

For privacy and safety reasons, we can't evaluate symptoms involving sensitive areas (genitals, anus, or breasts) through On-Demand Care. Instead, we recommend seeing a primary care or urgent care provider.

Nails

If you have symptoms of a nail fungus like a discolored nail, we recommend that you see a primary care provider for your treatment. Although fingernail and toenail fungus can sometimes be treated with topical antifungal medications like efinaconazole (Jublia), nails usually respond better to oral antifungal medications, which require follow-up tests to monitor liver function.

Scalp

Female hair loss and hair loss that extends over half of the scalp aren't treated through On-Demand Care at this time. They require lab testing to determine the cause of the hair loss.

Question 3

How do you recognize the signs of anaphylactic shock?

Answer

Someone with anaphylaxis might have a mild allergic reaction that rapidly gets worse, typically affecting their breathing. Most deaths from anaphylactic shock occur within the first hour. Multi-organ symptoms can include one or a combination of the following:

• Difficulty breathing

• Hives (skin rash with itchy bumps)

• Skin itching or flushing

• Swelling of the tongue, lips, or uvula

• Swelling or tightness in the throat

• Feeling like you have a "lump" in your throat

• Sudden persistent cough or throat clearing

• Wheezing

• Abdominal cramps or vomiting

• Incontinence

• Low blood pressure (systolic BP lower than 90 or at least 30% lower than usual)*

If you’re experiencing symptoms of anaphylactic shock, please call 911 or go to an emergency room (ER) as soon as possible.

*Low blood pressure (hypotension) can sometimes be the sole symptom of anaphylactic shock.

Question 4

Can I get online treatment for a tick bite through On-Demand Care?

Answer

We understand that tick bites can be concerning due to the risk of tickborne illnesses like Lyme disease. We don't recommend seeking treatment for a tick bite unless the tick has been attached for at least 36 hours. (The longer a tick is attached, the higher the risk of disease transmission.) At this point the tick will typically be engorged with blood. Make sure you completely remove the tick from your skin with tweezers as soon as possible, then thoroughly clean the area with soap and water.

For 30 days following the bite, we also recommend monitoring for symptoms like a skin rash, fever/chills, swollen lymph nodes, and joint pain, especially if you live in a part of the country where tickborne illnesses are more common.

Question 5

Can I get an online prescription for oral ivermectin?

Answer

No. Prescriptions for oral ivermectin (Stromectol) aren't available through On-Demand Care. You'll need to see a primary care provider for guidance on parasite infections that can be treated with ivermectin.

Question 6

What causes skin rashes in children?

Answer

Skin rashes in children are very common and usually harmless. The most frequent causes are viral infections (like roseola, hand-foot-and-mouth disease, and common cold viruses), allergic reactions (such as eczema, contact with irritants like poison ivy, or reactions to foods), and skin conditions like heat rash or diaper rash. Bacterial and fungal infections, including impetigo and ringworm, can also cause rashes.

While most childhood rashes are not serious and go away on their own, some may need treatment, so it's important to contact your child's provider if the rash is accompanied by fever, spreads quickly, causes severe pain, or if your child seems very ill.

Question 7

When should I take my child to the doctor for a rash or skin infection?

Answer

If your child is experiencing any of the following, please go to the nearest emergency room (ER) or urgent care clinic. These symptoms indicate that your child should be seen by an in-person healthcare provider as soon as possible.

• Breathing quickly (fast heart rate) or trouble breathing

• Difficulty swallowing

• Swollen lips or tongue

• Temperature of 102°F or higher or chills

• Nausea and/or vomiting

• Abdominal (belly) pain

• Joint pain or swelling

• Rash with red streaks that's warm to the touch

• Rash that doesn't fade (blanch) under pressure

In addition, your child will need in-person care if they have any of the following:

• Thermal burn, chemical burn, or second-degree sunburn

• Open wound from an animal or human bite, puncture wound, or recent surgery

• Skin reaction after starting a new food or medication (excluding recent vaccines)

• Symptoms inside their mouth

• Symptoms in sensitive areas like the genitals or buttocks in children older than 4 years old

• An infection under their skin (abscess)

• Ear pain or pressure

• Bites from venomous spiders

• Blistering, peeling, or shedding skin

• Severe diaper rash

• Purple or blood-like rash

Question 8

Do I have to be the parent or guardian of the child seeking care?

Answer

Yes. A parent or legal guardian must initiate the child's care and be present during their treatment.

Question 9

What type of healthcare provider will treat my child?

Answer

Children are treated by family practice physicians or licensed family nurse practitioners (FNPs). You'll be able to see the credentials of your child's provider after they're assigned to your child's treatment.

Question 10

Can I get a doctor's note for my child?

Answer

Yes. After your child completes their treatment, their One Medical provider can write excused absence notes, back-to-school notes, and no-play notes for sports or other activities if medically appropriate.

Question 11

What kind of online treatments can I request for my child?

Answer

At this time, parents and legal guardians can request treatments for their children aged 2 through 11 years old for the following health conditions through Amazon One Medical On-Demand Care (formerly Pay-per-visit):

• Head lice

• Pink eye

• Skin issue

• Eczema

• EpiPen prescription renewals

• Asthma prescription renewals