Why Good Clinics Charge for Consultations
Free skincare consultations are everywhere. They pop up in your inbox, on social media, or as a bonus with your cleanser. Some are offered as a kind gesture. Others are redeemable against treatment. At first glance, it all sounds helpful. But when you step back and examine what is actually being offered, the truth becomes clear. Many of these so-called consultations are not clinical assessments. They are part of a sales funnel. What is being presented as expert advice is often just commerce disguised as credibility.
At Self London, we do not offer free consultations. We do not discount our clinical time or apply it to the price of a treatment. This is a deliberate choice as we do not see the consultation as a sales tactic. Rather, it is a diagnostic process which carries weight, training, and responsibility. That is why it has a cost.
What a consultation is, and what it is not
A dermatology consultation is not a product recommendation. It is not a free sample or a quote. It is a structured medical appointment. At Self London, it includes a detailed history, an analysis of your current skincare and treatment use, a review of past interventions, and an understanding of what has or has not worked before. We consider hormonal factors, stress patterns, lifestyle triggers, and genetic predisposition. We often use VISIA imaging to assess pigmentation, pore structure and vascularity. This allows us to track skin objectively over time, not just by perception. Sometimes the right plan is clear. Other times, it takes multiple steps and a period of observation. Either way, the consultation is where that process begins.
This is fundamentally different from what most people experience through online consultations, beauty retail platforms or aesthetics chains. In those settings, the goal is not diagnosis. The goal is conversion into skincare or a subscription model.
The psychology of āfreeā
Free consultations are persuasive not because they are generous, but because they are designed to trigger certain behaviours. One of these is commitment bias. Once a person books an appointment, shows up, and spends time with a clinician, they are far more likely to proceed with a recommendation, even if they are uncertain. Saying yes feels easier than saying no.
There is also the principle of reciprocity. If someone gives you their time or attention, you are socially conditioned to give something back. In this context, that āsomethingā is often a booking or purchase, made more out of politeness or momentum than informed consent.
Add to this the anchoring effect, where a free consultation lowers the apparent cost of the entire treatment journey. You are led to believe you are saving money. But in reality, what you are buying into is a pathway that may never have been right for you in the first place. These tools are not inherently sinister. They are used across many industries to increase conversion. But they have no place in medicine. Clinical care should not be driven by marketing psychology.Ā
A common scenario
A woman in her twenties came to us after years of struggling with cystic acne. She had seen multiple practitioners, but none were consultant dermatologists. Most of the advice she received came through āfree consultationsā linked to online retailers or aesthetics clinics.
She had been prescribed a long list of āmedical gradeā skincare. She had taken supplements, undergone peels, and spent hundreds on anti-inflammatory facials. At no point had anyone taken a full hormonal history, reviewed her photos over time, or discussed options such as AviClear or isotretinoin. She had never been asked about the emotional impact of her acne or what she actually wanted to achieve.
What she had received was product advice. What she needed was a proper diagnosis.
This is not an isolated story. We see variations of it every week. Patients who have spent thousands chasing recommendations that were never tailored, never sequenced, and never truly explained.
The architect, not the showroom assistant
We often explain the difference like this. Seeing a dermatologist is like hiring an architect. Free consultations, in contrast, are more like visiting a showroom. The assistant can show you popular styles or discounted materials. They can walk you through what is trending. But they are not responsible for your foundations. They are not looking at the structure of your home, or how it will age, or what lies beneath.
An architect is trained to see the bigger picture. To design for safety, longevity and integrity. To guide you based on experience, not inventory. This is what you are paying for when you book a dermatology consultation. The consult is not a sales pitch, it is a tailored clinical plan.
Why we do not deduct consultation fees
We are sometimes asked why the cost of a consultation is not deducted from the price of treatment. The answer is simple. The consultation is not a deposit. It is a clinical process that holds standalone value.
No one expects to see a private cardiologist or gynaecologist and only pay if they proceed with surgery. The consultation is the service. It is the thinking, the expertise, the risk assessment, and the clarity that allows the patient to make an informed choice. Dermatology is no different.
When you see a consultant, you are not just paying for their time. You are paying for their ability to diagnose accurately, to plan safely, and to make sense of complex skin behaviour based on thousands of patient cases. That insight does not come free, nor should it. It protects the patient, respects the clinician, and anchors everything that follows.
Charging for consultations allows us to keep the process neutral. You are not being sold to. You are being assessed. And whether or not you choose to go ahead with treatment, the value of that conversation remains. We take a medical approach to our cosmetic and aesthetic treatments, in the same way we do to skin problems such as acne or rosacea. It does not matter if we are dealing with skin in health or skin in disease, both require an intelligent and rigorous approach.
Experience, not minutes
One of the greatest misunderstandings about professional consultations is the idea that patients are paying for the minutes they spend in the room. That is not what is happening.
What patients are actually paying for is clinical judgement. They are paying for a specialist who has spent decades in training, has seen thousands of skin presentations, and can distinguish between conditions that look similar but behave very differently. They are paying for risk minimisation, tailored sequencing, and the ability to plan several steps ahead.
Time is the medium. Experience is the value.
Why dermatology carries a premium
There are many types of skin professionals in the aesthetics space, but dermatology is a protected medical specialty. A UK consultant dermatologist or specialist dermatology GP has completed twelve or more years of training, hospital placements, postgraduate exams, and often additional academic or research work. This depth of training is not just theoretical. It allows for safer, more precise decision-making across a wide range of concerns, from pigmentation and scarring to medical conditions like rosacea, eczema or acne.
That experience is what patients are investing in when they book a consultation. Not a product or a procedure, but clarity. Good advice saves time, protects the skin, and reduces the risk of complications. It is worth paying for.
Integrity as standard
Self London was founded on the principle that skin deserves to be taken seriously. We are not a trend-driven clinic. We do not run limited-time offers. We do not use sales-based incentives to convert patients. Everything we do is based on a medically rigorous, patient-centred approach.
We charge for consultations because we want to protect the integrity of the process. That includes protecting our clinicians from pressure to sell, and protecting our patients from being nudged into treatments they do not need. Our job is not to convince you. It is to advise you.
Not everyone will choose this model. That is entirely appropriate. But for those who are seeking clarity, strategy, and long-term results, we believe this is the most ethical, intelligent path.
The consultation is the beginning of care
Free consultations are often presented as generous, but they are rarely neutral. They are built for conversion. The model assumes that something will be sold. At Self London, we do not believe in selling credibility. We believe in offering care. That is why our consultations are clinical appointments, not quotes. That is why they stand alone, regardless of what follows. And that is why we do not believe they should ever be free.
