Healthy skin starts with understanding what’s happening beneath the surface.

Many skin conditions look alike. Eczema, psoriasis, fungal infection and contact allergy can all produce a red, scaly patch — and the treatment for one can worsen another. That is why every medical visit here starts with history and examination rather than a prescription pad.

Dr. Gaul is trained in both Internal Medicine and Dermatology, which means the skin is never considered in isolation. Sometimes a rash is a rash. Sometimes it is the first visible sign of something systemic, a medication effect, or a condition that needs coordination with your primary care physician.

When a diagnosis is uncertain, we say so — and we use the tools that resolve it: biopsy, culture, patch testing or laboratory work.

Complex concerns are scheduled as standalone visits. A rash evaluation, an acne consultation, a hair loss evaluation and a full-body skin cancer screening each require their own time, history and discussion, so they cannot be combined into a single appointment.

It can feel like an inconvenience. It is the difference between being examined and being processed.

Please arrive without makeup or tinted sunscreen when your visit involves examination of facial skin, and bring a list of your medications, supplements and the products you apply to your skin.

Skin conditions do not wait for adulthood. Dr. Gaul treats infants, children, teenagers and adults, adapting both the treatment and the explanation to the patient in the room.