Health Apps Have Arrived: One Parent’s Maiden Voyage With First Derm

My First Derm experiment

Recently my four old developed a small, pimple like irritation on her cheek. After a few days my wife concluded the family needed to address, and promptly outsourced task execution to me. I initially considered running the traps through our new health insurance provider to find an in-network solution to my newly assigned deliverable. However, after about a pico-second of consideration, I elected not to invest time in that direction, one in which “success” would require getting behind the wheel. Instead, I went to the app store. Enter First Derm.

Lest you think me a bad parent, willing to sacrifice my little girl’s safety for a brief digital kick, allow me to provide some history.

Like many kids I suffered through a few years of acne. However, before I really had to hunker down to weather the storm of pimples that seemed my fate, an aunt sent a copy of James Fulton’s “Step-by-step program for clearing acne.” Published in 1983, Fulton’s book changed my personal trajectory of this scourge of teenage existence.

The author dove into skin chemistry, the biological nature of acne — bacteria, skin oil, layers of compacted, dead skin cells — and how to address. Helpfully, Fulton described why many of the then popular, over the counter acne treatments did not work. While the only permanent cure was time, after reading and applying his counsel my acne all but disappeared; I rarely had a pimple, freeing me to focus on all the other teenage stresses. It was my first biohack (and props to Dave Asprey for subsequently institutionalizing) (a more recent, and necessity driven biohack here)

The other lasting impact of Fulton’s book was a healthy respect for new ideas, particularly outside of ordinary channels. Many may recall the standard institutional medical response to acne, certainly presented to me at the time, Accutane. While we never pulled the trigger on that remedy, a quarter century later Accutane has become the subject of some controversy.

Nowadays one needn’t rely on the good intentions of a concerned Aunt. Enter mobile health.

As a parent who must allocate time to household admin, efficiency becomes the watchword. Routine health checkups can often consume an afternoon. A tool which removes a medical visit, holding out a tantalizing gift of time, has a certain, perhaps innate, appeal. In this case the opportunity for no travel, no office wait time, and priced at a 75% discount to the out of pocket deductible or co-pay costs feels almost (digitally) criminal. Yet as someone who is mesmerized by these things, it is only a more recent example of the power of silicon economics over traditional bricks and mortar-centered processes.

The First Derm app experience is very straightforward; one smartphone camera picture at 12 inches over the affected area, then a close up at 3 inches. Enter a few sentences about the condition; elect a response time (tiered pricing structure for faster responses) and payment info, then hit “submit.” We had our answer by the end of the day — in our case a common bacterial infection we could treat with over the counter meds, with caveat that if it persisted after a week to visit a specialist.

I’m just a parent, not a dermatologist and no longer a professional equity investor, but the idea of mobile health sensors and remote diagnostic tools feels like a winner. Remove many of the fixed costs associated with diagnosing common health conditions, insert schedule flexibility into the day of a highly trained professional, then distribute on a nearly fully subsidized platform (i.e. a smart phone). Rinse and repeat many times over.

Medical devices will continue to evolve, expanding options to future health consumers. Importantly, these options will also shift decision making to the consumer by providing the tools, knowledge, and alternatives to improve their medical care, as well as their life. We have much to look forward to.

First Derm is the shape of things to come. Well done team.

Thanks for reading. Welcome comments or suggestions on this and other topics.

HSA Coach. Health is Wealth.

Click here to read my review of Eric Topol’s “The Patient Will See You Now” on the coming wave of personalized health data.

Within the health genre, click here to read my review of Robert Lustig’s, “Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity and Disease.”