Persistent skin conditions—eczema, acne, and psoriasis come to mind—are frustrating enough on their own, so if your attempts to get help aren’t getting you anywhere, the situation becomes all the more upsetting. If your dermatologist isn’t taking your skin issues seriously, isn’t offering you a treatment plan that’s as efficacious as you want it to be, or is being dismissive, it can cause stress and other negative feelings on top of whatever skin concerns you’re dealing with. 

So what are you supposed to do in this type of scenario? For answers, SELF asked three dermatologists to share their most practical, empathetic advice. “The big take-home message here is that no one knows your skin better than you do, and it’s important to be your own advocate,” Joshua Zeichner, MD, the director of cosmetic and clinical research at Mount Sinai Hospital’s Department of Dermatology in New York City, tells SELF. Here are some helpful ways to do exactly that.

Be as organized and succinct as you can.

Whether it’s your first or 15th time seeing a dermatologist for a particular issue, the more clearly you can explain what’s going on, the better, Hadley King, MD, a clinical instructor of dermatology at the Weill Medical College of Cornell University in New York City, tells SELF. Detail exactly what types of treatments (both prescription and over-the-counter) you’ve tried; how long you tried them for; and what their effects were, positive or negative, Dr. King explains. “Try to communicate calmly and be as specific as possible: ‘I tried X treatment for X amount of time, and this is how my skin reacted,’” she says. 

If you found a certain treatment hard to work into your daily routine—applying a greasy ointment for scalp psoriasis when you have curly hair that you only wash a couple times per week, for example—make sure to convey that as well, Geeta Yadav, MD, a board-certified dermatologist and the founder of Facet Dermatology in Toronto, tells SELF. Presenting your history in an organized manner—say, in a concise health file—gives your doctor something concrete to work with, Dr. Yadav says, which will help them figure out the best alternative treatment options for you. 

Using photos as a reference is a great idea too. Many chronic skin conditions ebb and flow.^{1, 2} If you experience, say, an eczema flare or a bad acne breakout before your appointment, take a photo. That way, even if it’s not quite as bad once you see your dermatologist, you’ll have a visual that will show them the severity of the issue, Dr. King explains. This will make it easier for them to see exactly what’s going on so they can hopefully make an accurate diagnosis and suggest the best treatment for you. To that point…

Know that you may have to be patient.

“Dermatologists approach things differently than many other doctors,” Dr. Yadav says. “This is one of the only specialties where we look first and ask questions later.” This is because, unlike any other organ, you can actually see the skin, so dermatologists are taught to diagnose conditions and diseases through a visual assessment, she adds. In other words: Don’t be put off if your derm wants to examine your skin before having a fuller conversation. That said, if you feel like your doctor only wants to look at your skin without hearing you out—or brushes off what you have to say—that’s a definite red flag.