Worth a thousand words? Pictures can speak volumes; make sure you like what they're saying

July 1, 2008

Clinical photography in dermatology can be an invaluable tool, if used properly. Following some basic guidelines can take the guesswork out, lend credibility and present a much more accurate picture.

Key Points

Chicago - Clinical photography for dermatology goes far beyond creating a pretty picture to convince the viewer of the efficacy of a treatment or product - it is an unparalleled tool that, when used properly, is invaluable in any dermatology practice.

"When used properly" is a key term here, and unfortunately, an axiom by which too few clinical photographs are captured, managed and used.

And for dermatology - one of the most visually oriented fields of medicine - clinical photography is a necessity.

Clinical photos are an important way for dermatologists not only to show patients "before" and "after" images, but also to record patient progress for patient records and referrals, and to evaluate efficacy of treatments.

Accurate, quality clinical photography

Too often, photographs can be - and have been - modified in one way or another to embellish results; bad, misleading or "doctored" photography can be worse than no photography at all.

"There are several issues regarding the use of software to alter images to demonstrate possible post-treatment results," Dr. Bhatia tells Dermatology Times.

"It is commonly used in cosmetic surgery for consultations in nasal surgery and breast augmentation surgery, but not often used in dermatology.

"If (software) applications do develop in dermatology, it is important to avoid setting patient expectations based upon altered images. Doing so can lead to disappointment if such results are not achieved," he says.

However, "misleading" images may be the result of simple inexperience or naivety on the part of the photographer. For example, all clinical photographs of patients - especially "before" and "after" photographs - should be obtained following a set of standard guidelines to ensure consistency, and allow easy comparison between the images.

Here are some general rules:

Dr. Bhatia suggests five standard poses for facial pictures of patients: Profile (each side), frontal and oblique (each side).

These may seem like simple directives, but they're imperative for accurately reflecting "patient reality."

"You don't have to flip through too many pages of a newspaper to see the abuse of "before" and "after" pictures! Though it may be intentional or unintentional, small modifications in lighting or patient positioning can lead to photographs not representative of the actual results," Dr. Bhatia says.

"This can be abused to make a wrinkle that is not really gone disappear. Similarly, inconsistent neck position can accentuate or detract from the results of a procedure done to tighten the neck," he says.

While some misrepresentative photography may be intentional, much of it is simply due to not knowing how to take the "trick" out of photography - which becomes especially important in this day and age of easy and accessible digital photography, in which just about anyone can - and will - take a picture.

"Many of these pitfalls can be avoided," Dr. Bhatia says, "by taking the time to learn how to consistently position and set the lighting for your photographs."