• # source data 
    • capture date
       - -
    • previous submit date
       - -
    • # demographics 

    • Demographics

      MY PERSONAL DETAILS

      We require this information to track your progress and provide you with the best advice and insight.

       

  • Demographics

    MY PERSONAL DETAILS

     
  • My Date Of Birth*
     / /

  • Age Verification

    Thank you for entering your birth date. It appears that you are under the age of 18. As a minor, registration must be completed by an adult (parent or legal guardian).

    Please confirm in the checkbox below that you are an adult filling out this form on behalf of a minor.

  • Age Verification

    Thank you for entering your birth date. Based on the information provided, the age appears to be under 7. Unfortunately, our Dermal Diagnosis form are not designed for children age 7 and below.

    Please verify the information if the date was entered incorrectly. Alternatively, please get in touch with our support team for services tailored to younger children.

    • # calculations: age 
    • today
       / /
    • page navigation 

  • Demographics

    MY GENDER

  • I was born with a*

  • # demographic calculations

  • *demographic
  • *minor/adult
  • *hormone age
  • *pregnancy demographic
    • page navigation 

  • WHEN NOT EXPOSED TO THE SUN

    MY NATURAL SKIN COLOR IS

    • # data: skin color 
    • #skin color category

  • WITH NO CONTACT LENSES

    MY NATURAL EYE COLOR IS

    • # data: eye color 

  • WITH NO ARTIFICIAL COLORANT

    MY NATURAL HAIR COLOR IS

    • # data: hair color 

  • Medical Background

    My Gynecological History

     
  • I am pregnant*
  • I am
  • I am taking a birth control pill
  • I use an IUD such as Mirena

  • Medical Background

    My Hormone Therapy History

  • My history of gender-affirming treatment in the form of Hormone Replacement Therapy (HRT)
  • My history of Hormone Replacement Therapy (HRT)

  • Medical Background

    My Steroid Use History

  • Please answer the below question for prescription as well as non-prescription steroids:

  • My steroid use history is:*
  • The last time I received steroid treatment was*
    • page navigation 

  • Oxidative Stress

    My Skin and Lifestyle

  • I would describe my stress levels as*
  • I sleep*
  • The air where I live is*
  • On an average day, I spend most of my time*
  • When I go out in the sun*

  • Oxidative Stress

    My Skin and Lifestyle

  • The amount of sugar and processed foods in my diet is*
  • I eat foods high in antioxidants like berries, herbs, nuts or green vegetables*
  • My cigarettes exposure over my entire life is*

  • For the below question, consider the sun during outdoor activities, as well as a sunbed:

  • During the last five years, my skin tanned*

  • Family History

    My Skin and Genetics

     
  • My mother’s facial skin look/looked*
  • My father’s facial skin look/looked*
    • # calculations: aging 
    • page navigation 

  • Medical Background

    My Allergenic History

     

    * Select all that apply and click next

  • I develop allergies when I... *

  • Error! You indicated that you don't have any allergies, but also selected an allergen. Please rectify the error to proceed.

    • # calculation: allergy list 
    • page navigation 

  • Sensitivity and Inflammation

    My Skin's Sensitivity

     
  • I have been diagnosed with atopic dermatitis, eczema, or contact dermatitis (an allergic skin rash)*
  • Members of my family have been diagnosed with dermatitis, eczema, asthma or chronic allergies*
  • Certain skin care or makeup products cause my face to break out, get a rash, itch, or sting*

  • Sensitivity and Inflammation

    My Skin's Sensitivity

     
  • Fragranced bubble bath, massage oil, or body lotions make my skin break out, itch, or feel dry*
  • I can use the soap provided in hotels on my skin without a problem*
  • When I use scented or fragranced laundry detergents*

  • Sensitivity and Inflammation

    My Skin's Sensitivity

     
  • I get a rash on my hands underneath certain types of jewellery*
  • If I wear jewellery that is not 14-carat gold, I get a rash*
  • Sunscreens make my skin itch, burn, breakout, or turn red*

  • Sensitivity and Inflammation

    My Skin's Sensitivity

     
  • I have been diagnosed with acne*
  • I have skin blemishes in the form of blackheads, whiteheads or pimple breakouts*
  • I have clogged pores (blackheads / whiteheads)*

  • Sensitivity and Inflammation

    My Skin's Sensitivity

     
  • I have been diagnosed with rosacea*
  • I experience sudden symptoms of skin redness with a sensation of warmth or flushing*
  • My face looks red in photographs*

  • Sensitivity and Inflammation

    My Skin's Sensitivity

     
  • My face or neck feels warm or flushed after moderate exercise, with stress or strong emotion such as anger*
  • I feel warm or look flushed after drinking alcohol*
  • I feel warm or flushed after eating spicy or hot (temperature) foods or beverages*

  • Sensitivity and Inflammation

    My Skin's Sensitivity

     
  • I'm using skincare products that contain retinol, salicylic acid or glycolic acid*
  • I often feel a burning, stinging, or itching sensation on my skin without any visible signs*
  • I believe my skin is sensitive*

  • # sensitivity pre-screening calculations

    • # redness pre-screening 
    • # allergy pre-screening 
    • # acne pre-screening 
    • *comedones frequency

  • Inflammatory Conditions

    My Skin's Dermatitis Risks

     
  • The itching I experience on my face or scalp*
  • I notice scaly, rough patches on my skin or scalp that are sometimes itchy or flaky*
  • The above symptoms on my face or scalp are*

  • Inflammatory Conditions

    My Skin's Dermatitis Risks

     

  • The best description for the scaly patches / flakes / broken skin areas on my skin is:

    Please select the image closest to the symptoms you experience - even if it's only a tiny area.

    • Dry Skin Patches: Areas with dry skin with white or ashy flakes. Mild or no itchiness and redness.
    • Dry, Itchy Skin Scales:Extremely itchy, dry scales with thickened skin.
    • Oily, Itchy Skin Scales: Red skin with oily, itchy skin scales. The scales may be yellow or white.

  • Inflammatory Conditions

    My Skin's Dermatitis Risks

     

  • Please select all the areas that you experience these scales (even if it's only occasionally)

  • The following areas are affected*
  • Other than my facial skin, the following areas are also affected*
  • I have dandruff and / or itchy scalp*
  • These symptoms impact my daily activities or sleep due to discomfort or itching*

  • # allergy calculations

  • *symptom frequency
  • Dx: allergy
    • page navigation 

  • Inflammatory Conditions

    My Acne Medication History

     
  • I have used or currently use treatments for pimples / acne / breakouts*

  • Select all options that apply:

  • Types of treatment I used in the past*
  • Types of treatment I'm currently using*

  • Select all options that apply:

  • Over the counter products*

  • Select all options that apply:

  • Topical Antibiotics*

  • Select all options that apply:

  • Oral Antibiotics*

  • Select all options that apply:

  • Vitamin A / Retinoids*

  • Inflammatory Conditions

    My Skin's Acne Risks

     

  • I have the following type/s of breakouts:

    Important: Read the description of each breakout type to ensure your selection is accurate. Select all the images that apply to you.

     
    • Blackheads: Small, dark spots
    • Whiteheads: Small, flesh-colored or slightly red bumps, and not painful
    • Papules: Red, slightly raised bumps, and sometimes tender
    • Pastules: Larger, clearly visible bumps, filled with pus, and may be painful
    • Nodules / Cysts: Large, pus-filled, painful lumps, deep under the skin
  • I typically have the following amount of comedones (blackheads/whiteheads) at any one time*

  • Inflammatory Conditions

    My Skin's Acne Risks

     

  • I have breakouts or congested pores in the following area/s:

    Please select the images of all the applicable areas.

  • The acne / breakouts on my face are located on my:

    Please select all the images where most of your breakouts are located.

  • Inflammatory Conditions

    My Skin's Acne Risks

     
  • My breakouts often feels itchy*
  • I have dandruff and / or itchy scalp*
  • The best description for my breakouts is*

  • I typically have the following amount of breakouts at any one time:

    Important: Read the descriptions below to ensure you select the correct option.

     
    • Mild: Your skin has a few small spots and occasional pimples, but mostly whiteheads or blackheads.
    • Moderate: You notice more frequent pimples along with blackheads or whiteheads that might be red and tender.
    • Moderately-severe: Your skin shows many red and inflamed pimples, including more prominent, painful spots. You might see some deeper lumps (nodules). There’s a chance you could have mild scarring.
    • Severe: You have many large, painful pimples, cysts, and nodules that are noticeably inflamed. Your acne is widespread across your face and perhaps on your body, too. Scarring is common, and your skin might feel tender or painful.
  • I typically have the following amount of breakouts at any one time*

  • # acne calculations

  • *acne grades
  • *acne types
  • Dx: breakouts
  • #acne vs folliculitis result

  • Inflammatory Conditions

    My Skin's Redness and Rosacea Risks

    Rosacea is a hypersensitive skin condition that appears as inflamed and mostly dry patches. Unlike acne, there are no blocked pores, and no scarring is left.

     
  • I have acne-like bumps (papules and pustules) on my face*
  • The acne-like bumps on my face are often tender or sensitive to touch*
  • I only have facial redness on areas where I have breakouts*
  • My facial redness / flushing appears or worsens by factors such as hot drinks, spicy foods, alcohol, temperature changes, or stress*

  • Inflammatory Conditions

    My Skin's Redness and Rosacea Risks

    Rosacea is a hypersensitive skin condition that appears as inflamed and mostly dry patches. Unlike acne, there are no blocked pores, and no scarring is left.

     

  • I experience skin redness in the following regions:

    Please select all the images that apply.

  • Inflammatory Conditions

    My Skin's Redness and Rosacea Risks

    Rosacea is a hypersensitive skin condition that appears as inflamed and mostly dry patches. Unlike acne, there are no blocked pores, and no scarring is left.

     
  • I have visible red or blue broken blood vessels on my face*
  • I experience one or more of the following: eye irritation, dry eyes, swollen eyelids, the sensation of having something in my eye*
  • I have noticed thickening of the skin on my nose, which may appear enlarged or bumpy (rhinophyma)*
  • These symptoms affect my daily activities and emotional well-being*

  • # rosacea calculations

  • * rosacea types

  • Data: Rosacea

  • Dx: rosacea
    • # inflammation: mild - allergy / breakouts / rosacea 

    • Inflammation Dx

      INFLAMMATORY CONDITION

      Based on your answers, you may have mild symptoms of allergy-prone skin, congested pores with possible occasional breakouts, and red, inflammation-prone skin.

      Please select an option below to help us better understand which condition most significantly affects your skin.

    • Select the option below that best describes your facial skin:*
    • # inflammation: mild - allergy / breakouts 

    • Inflammation Dx

      INFLAMMATORY CONDITION

      Based on your answers, you may have mild symptoms of allergy-prone skin, and congested pores with possible occasional breakouts.

      Please select an option below to help us better understand which condition most significantly affects your skin.

    • Select the option below that best describes your facial skin:*
    • # inflammation: mild - allergy / rosacea 

    • Inflammation Dx

      INFLAMMATORY CONDITION

      Based on your answers, you may have mild symptoms of allergy-prone and red, inflammation-prone skin.

      Please select an option below to help us better understand which condition most significantly affects your skin.

    • Select the option below that best describes your facial skin:*
    • # inflammation: mild - breakouts / rosacea 

    • Inflammation Dx

      INFLAMMATORY CONDITION

      Based on your answers, you may have mild symptoms of congested pores, possible occasional breakouts, and red, inflammation-prone skin.

      Please select an option below to help us better understand which condition most significantly affects your skin.

    • Select the option below that best describes your facial skin:*
    • # inflammation: allergy / breakouts / rosacea 

    • Inflammation Dx

      INFLAMMATORY CONDITION

      Based on your answers, you may have symptoms associated with allergy-prone skin, acne breakouts, and rosacea. To help us better understand which condition most significantly affects your skin, please select the option that best represents your most frequent and severe symptoms.

    • Select the symptom group that you want to target first:*
    • # inflammation: allergy / breakouts 

    • Inflammation Dx

      INFLAMMATORY CONDITION

      Based on your answers, you may have symptoms associated with allergy-prone skin and acne breakouts.

      To help us better understand which condition most significantly affects your skin, please select the option that best represents your most frequent and severe symptoms.

       
    • Select the symptom group that you want to target first:*
    • # inflammation: allergy / rosacea 

    • Inflammation Dx

      INFLAMMATORY CONDITION

      Based on your answers, you may have allergy- and rosacea-prone skin symptoms. To help us better understand which condition most significantly affects your skin, please select the option that best represents your most frequent and severe symptoms.

       
    • Select the symptom group that you want to target first:*
    • # inflammation: breakouts / rosacea 

    • Inflammation Dx

      INFLAMMATORY CONDITION

      You may have acne breakouts and rosacea-prone skin symptoms based on your answers. To help us better understand which condition most significantly affects your skin, please select the option that best represents your most frequent and severe symptoms.

       
    • Select the symptom group that you want to target first:*
    • Select the one the options below that best describes your facial skin:*
    • # data: inflammation conflict 
    • * dx inflammation conflict
    • page navigation 

  • SKIN HYDRATION

    Oily vs. Dry Skin

    This section measures your skin's oil production and hydration. Studies show that people's preconceptions about whether their skin is oily or dry are often inaccurate. Don't allow your preconceptions or what others think and say about your skin to influence your answers.

     
  • I feel roughness when I slide my fingers over my face*
  • After washing my face and not following-up with any other products, 2-3 hours later, my forehead and cheeks feel*
  • In photos, my face appears shiny*
  • 2-3 hours after applying makeup foundation, but no powder, my makeup appears*

  • SKIN HYDRATION

    Oily vs. Dry Skin

    This section measures your skin's oil production and hydration. Studies show that people's preconceptions about whether their skin is oily or dry are often inaccurate. Don't allow your preconceptions or what others think and say about your skin to influence your answers.

     
  • If I don’t use moisturizers or sunscreen, my facial skin*
  • When I look at my skin in a mirror, I notice large pores that are*
  • I characterize my facial skin as*
  • When I use soap that foams, my facial skin*

  • SKIN HYDRATION

    Oily vs. Dry Skin

    This section measures your skin's oil production and hydration. Studies show that people's preconceptions about whether their skin is oily or dry are often inaccurate. Don't allow your preconceptions or what others think and say about your skin to influence your answers.

     
  • If I don't moisturize, my facial skin feels tight*
  • I have clogged pores (blackheads or whiteheads):*
  • *oily: comedones frequency
  • My face is oily in the T-zone (forehead and nose):*
  • 2-3 hours after applying moisturizer my cheeks are:*

  • # calculations: hydration

  • Dx: hydration
  • *final hydration
    • page navigation 

  • SKIN TEXTURE

    My Skin & Roughness

     
  • I feel roughness when I slide my fingers over my face*
  • I exfoliate my skin with*
  • I exfoliate my skin*
  • I go for a professional chemical peel treatment at least once every 6 months*
  • I swim in chlorinated pools*
  • I engage in in outdoor sports*
  • I often have flaking skin even though I don’t have sunburns, eczema or psoriasis*
    • # calculations: texture 
    • Dx: rough texture

  • SKIN PIGMENTATION

    My Skin & Pigmentation

    Skin's tendency to form melanin, the skin pigment that produces darker skin tones and dark patches, freckles, and dark areas after trauma.

     
  • I have hyperpigmentation on my skin that I would like to soften*

  • I have hyperpigmentation on the following areas:

    Please select all the areas that apply to you.

  • SKIN PIGMENTATION

    My Skin & Pigmentation

    Skin's tendency to form melanin, the skin pigment that produces darker skin tones and dark patches, freckles, and dark areas after trauma.

     
  • The dark spots or patches in these areas are*
  • The dark spots or patches on my face gets worse when I go in the sun*
  • After I have a pimple or ingrown hair, it’s followed by a dark brownish/black spot:*
  • When I have a cut, the brown mark remains for*

  • SKIN PIGMENTATION

    My Skin & Pigmentation

    Skin's tendency to form melanin, the skin pigment that produces darker skin tones and dark patches, freckles, and dark areas after trauma.

     
  • I developed dark spots on my face during my pregnancy, while I was on birth control pills, or during hormone replacement therapy*
  • I developed dark spots on my face when I'm on hormone replacement therapy*
  • When I'm exposed to sun for the first time in several months, my skin:*
  • I have been diagnosed with melasma (light / dark brown or grey patches on the face)*
  • I have a history of melanoma in my immediate family*

  • SKIN PIGMENTATION

    My Skin & Pigmentation

    Skin's tendency to form melanin, the skin pigment that produces darker skin tones and dark patches, freckles, and dark areas after trauma.

     
  • If I spent a significant time in the sun without protection*
  • I develop freckles when I spent time in the sun*
  • One or both of my parents had freckles*

  • * Answer the following question as it relates to the parent with the most freckles:

  • My parent's freckles is/was*
  • My natural natural hair color is (If grey - state color before grey)*

  • # pigmentation calculations

  • *pigmentation locations
  • Dx: pigmentation
    • page navigation 

  • # diagnosis calculations

  • *aging-word
  • *aging-code
  • *hydration-word
  • *hydration-code
  • *inflammation word
  • *inflammation code

  • Healthy Skin Aging

    My Skin and Aging

     
  • I have facial wrinkles*
  • My skin has become thinner over time*

  • Skin thinning is one inevitable consequence of aging. As people age, their bodies produce less of the components that support skin health and development.

  • My skin has become drier and tighter with time*

  • As we age, skin loses the ability to effectively regenerate collagen and elastin, essential in maintaining plump. hydrated skin. Accelerated by lifestyle and environmental factors, a lack of moisture in the skin can cause inflammation, constant tightness and itching.

  • My pores*

  • As skin ages, collagen production slows dramatically. Without the firming effects of collagen, pores lose elasticity and can become dilated.

  • I have wrinkles and fine lines that I would like to soften*

  • Medical Background

    My Skin and Exfoliants

     
  • I'm currently using skincare products that contain significant concentrations of Salicylic Acid, Retinol, or Glycolic Acid*
  • My skin tolerates actives like Retinol, Salicylic acid or Glycolic acid*
  • The current Retinol, Glycolic acid and/or Salicylic acid products I use are*

  • DermExcel uses high-quality exfoliants ingredients at higher concentrations than other brands. Used in combination with other exfoliant skincare products may result in irritation and allergic reaction on your skin. We recommend you to stop using other exfoliating skincare before switching to DermExcel ingredients.

  • The reaction I experienced was
  • The active/s that caused my adverse reaction was (select all that apply)
  • My adverse reactions was caused by a DermExcel product*
  • I'm open to slowly introduce these active ingredients in my regimen again*

  • Healthy Skin Aging

    My Eye Concerns

     

  • Error! "None" can't be selected with one of the eye concerns. Please correct the error before proceeding.

  • The dark circles under my eye is*

  • Bluish: The skin is thinnest below the eye area making the underlying color more visible.
    Late nights, allergies or nasal congestion can indicate that there is sluggish circulation in the area, resulting in bluish-toned dark circles

    Pigmented: The delicate area under the eye can be affected by hyperpigmentation due to sun damage.
    Genetics also play a role; medium to darker skin tones are the most susceptible skin types.

    Hollowed: Loss of volume in the face can cause hollowing under the eye area.
    Whilst this is not discoloration, it can create a dark Shadowy area and is due to the natural. process of aging.

  • I have hollowed dark circles since childhood*

  • Premature vs. Healthy skin aging

    HEALTHY AGING SCORE

    This section measures your risk for premature skin aging. Changing your habits now could change your score in the future.

     
  • 1. Do you have facial wrinkles?*
  • 2. How old do you think your skin look?*
  • 3. How old does/did your mother’s facial skin look?*
  • 4. How old does/did your father’s facial skin look?*
  • 5. At any time in your life, have you ever engaged in seasonal tanning? (Yes, summer vacation counts!) If so, how often?*
  • 6. During the last five years, how often have you allowed your skin to tan intentionally or unintentionally through outdoor sports or other activities?*
  • 7. Over your entire life, how many cigarettes have you smoked (or been exposed to)?*
  • 8. Please describe the air pollution where you reside:*
  • 9. How often do you currently eat fruits and vegetables?*
  • 11. What is your natural skin color (without tanning or self-tanners)?*
  • 12. Please describe the length of time that you have used retinoid facial creams such as Retinol, Retin-A, Differin.*

  • Inflammation vs. Resistant

    INFLAMMATORY CONDITIONS

    This section measures your skin's tendency to develop pimples, redness, flushing, and itching. All signs of inflammatory skin conditions.

     
  • 1. You get red bumps on your face:
  • 2. Skin care products (including cleanser, moisturizers, toners, and makeup) cause your face to break out, get a rash, itch, or sting:
  • 3. Have you ever been diagnosed with acne or rosacea?
  • 4. How often do you get a rash on your hands underneath your jewellery?
  • 5. If you wear jewellery that is not 14-carat gold, how often do you get a rash?
  • 6. Sunscreens make your skin itch, burn, breakout, or turn red:
  • 7. Have you ever been diagnosed with atopic dermatitis, eczema, or contact dermatitis (an allergic skin rash)?
  • 8. Has someone in your family been diagnosed with atopic dermatitis, eczema, asthma, and/or allergies?
  • 9. Fragranced bubble bath, massage oil, or body lotions make your skin break out, itch, or feel dry:
  • 10. Can you use the soap provided in hotels on your body or face without a problem?
  • 11. What happens if you use scented or fragranced laundry detergents?
  • 12. How often does your face and/or neck feel warm or look flushed after moderate exercise, and/or with stress or a strong emotion, such as anger?
  • 13. How often do you tend to feel warm or look flushed after drinking alcohol?
  • 14. How often do you feel warm or look flushed after eating spicy or hot (temperature) foods or beverages?
  • 15. How many visible red or blue broken blood vessels do you have (or did you have prior to treatment) on your face and nose?
  • 16. Your face looks red in photographs:

  • Track and monitor your progress

    YOUR PERSONALIZED SKINCARE JOURNEY

    The Dermal Diagnosis™ Assessment is integrated with your Dermalhealthstore™ account to enhance your experience.

    The result calculations will be shared with you via email and linked to your Dermalhealthstore™ account if applicable.

     
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    • We will send your Dermal Diagnosis result to the email address below:

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    • Terms and Conditions*
    • # view terms and conditions 

    • Dermal Diagnosis™

      TERMS AND CONDITIONS

      1. Nature of Assessment: The term "diagnosis" used here does not constitute a medical diagnosis. It is not intended to replace, alter, or equate to a medical diagnosis provided by a licensed medical practitioner. The term "dermal diagnosis" specifically refers to an online skin assessment based on the information you, as an online customer, provide.
      2. Accuracy and Reliability: The effectiveness of your online skin assessment is entirely dependent on the accuracy and completeness of the answers you provide. Dermal Health Science™; bears no responsibility for outcomes that do not align with your expectations or perceptions.
      3. Reassessment Option: You are welcome to resubmit your online assessment at any time if you wish to update, revise, or correct your responses.
      4. No Replacement for Professional Advice: Please be aware that our online skin assessment does not substitute for a proper consultation with a healthcare professional or dermatologist. We highly recommend seeking professional advice for your skin concerns.
      5. Interpretation of 'Prescription': Within this context, the term "prescription" is not an official medical directive from Dermal Health Science™, authorizing issuance of medication or treatment. It is merely a recommendation based on your online assessment. Without an in-person consultation, no formal patient-practitioner relationship is established.
      6. Consultation Requirement for Prescription: An actual written prescription requires a physical, one-on-one consultation with a medical practitioner. Online customers who have not had such a consultation cannot claim to have received a formal prescription.
      7. Product Use and Liability: All products should be used strictly according to their application instructions. Dermal Health Science™; is not liable for any misuse or deviation from these instructions. Furthermore, no liability falls upon a medical practitioner in the absence of a direct, physical consultation.

      By participating in this online skin assessment, you acknowledge and agree to these terms and conditions.

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