The direct-to-consumer (DTC) telemedicine industry, including teledermatology, has seen rapid expansion in recent years, partly because of the COVID-19 pandemic. The shortage of dermatologists and the visual nature of dermatologic conditions attracted DTC companies to dermatology. As more patients continue to seek medical consultations and prescription medications from these for-profit companies, we must approach their growth with healthy skepticism. Shortcomings of DTC teledermatology include concerns about conflicts of interest (COIs), overdiagnosis, and overprescribing. Although DTC teledermatology is certainly here to stay, an appropriate understanding of this industry will allow dermatologists to advise patients and advocate for best practices.