Frequently Asked Questions

Most insurance plans do not require a referral to see a dermatologist for general skin concerns. However, some HMO plans may require one. We recommend checking with your insurance carrier before your visit. If you need help navigating your coverage, our bilingual front desk team is happy to assist.

We accept most major insurance plans for medical dermatology. Cosmetic treatments are typically not covered by insurance. Please call our office at (305) 615-5504 to verify your specific plan before your visit.

You can request an appointment by filling out our online contact form or by calling us during office hours (Mon–Fri 8:00 AM–5:00 PM, Sat by appointment). Our team responds within one business day. For urgent skin concerns, please call us directly at (305) 615-5504.

Please bring a valid photo ID, your insurance card, a list of your current medications (including supplements), and any relevant medical records or previous dermatology reports. Arriving 10–15 minutes early allows us to complete your intake forms without rush.

Mohs micrographic surgery is a precise technique for removing skin cancer — most commonly basal cell carcinoma and squamous cell carcinoma. The surgeon removes thin layers of tissue and examines them under a microscope in real time until all cancer cells are gone. Mohs has the highest cure rate of any skin cancer treatment (up to 99% for certain cancers) while preserving as much healthy skin as possible.

The American Academy of Dermatology recommends annual full-body skin exams for most adults, and more frequent screenings for those with a personal or family history of skin cancer, significant sun exposure, or many moles. If you notice any new, changing, or unusual spot, don't wait for your annual exam — schedule a visit promptly.

A skin biopsy is a quick in-office procedure where a small sample of skin is removed and sent to a lab for analysis. The area is first numbed with local anesthetic, so discomfort is minimal. Results typically come back within 7–10 business days, and Dr. Puyana personally calls every patient with their results.

We offer a full range of treatment options, from topical corticosteroids and moisturizers to newer biologic medications that target the immune pathways driving these conditions. Treatment is personalized based on the severity, affected areas, and your lifestyle. Many patients see significant improvement within weeks of starting the right treatment plan.

Botox typically lasts 3–4 months, though results can vary depending on the treatment area, the dose used, and individual metabolism. With consistent treatments, some patients find their results last longer over time as the muscles gradually relax. We recommend scheduling a follow-up appointment when you notice the effects beginning to fade.

Botox (botulinum toxin) relaxes the muscles that cause dynamic wrinkles — like forehead lines, crow's feet, and frown lines. Dermal fillers, on the other hand, add volume to areas that have lost fullness over time, such as the cheeks, lips, and under-eye area. Many patients benefit from a combination of both for a balanced, natural-looking result.

Laser treatments can address a wide range of concerns, including sun damage, brown spots, redness, texture irregularities, and unwanted hair. Whether a laser is right for you depends on your skin type, tone, and specific goals. Dr. Puyana will evaluate your skin during a consultation and recommend the most appropriate laser or light-based treatment for your needs.

The number of sessions depends on the type and severity of your acne and the treatment chosen. Some patients see significant improvement after a single chemical peel, while others benefit from a series of 4–6 laser or light therapy sessions. Dr. Puyana will create a personalized treatment plan during your consultation, including a realistic timeline for results.

After your visit, you will receive a summary of your treatment plan and any instructions via our patient portal or by email. Biopsy and lab results are personally communicated by Dr. Puyana by phone. If you have follow-up questions after your visit, please contact our office during business hours and we will be happy to assist.

Return sooner if you notice a biopsy site that is not healing properly, signs of infection (increasing redness, warmth, swelling, or discharge), an allergic reaction to a medication or treatment, or any new skin change that concerns you. When in doubt, call us — we would rather you check with us than wait.

Yes, we offer telehealth appointments for select concerns, including follow-up visits, prescription refills, and minor cosmetic consultations. Telehealth is available for established patients and certain new patient consultations. Contact our office to find out if a telehealth visit is appropriate for your specific concern.