Most consultations I see are for medical dermatology problems.  Often, a patient has a specific concern to address, but we often do full skin exams.  I like to identify specific things on the exam to educate my patient, and if a skin condition such as Rosacea is identified, we discuss the diagnosis, its’ manifestations and trigger factors and treatment possibilities.  This often leads to questions on how the patient’s skin can look better, and cosmetic possibilities are often discussed.