Owing to the inherently visual nature of the field of dermatology, advances in imaging and communication technology have resulted in wide-spread application of teledermatology since its introduction in the mid-1990s. In the last 20 years, studies have repetitively shown that teledermatology provides effective and efficient quality care for patients. It also increases access to underserved patients and reduces traveling costs, wait times, and unnecessary referrals. In this letter the authors seek to analyze implementation of a direct patient to dermatologist model in a Veteran Health Administration (VHA) patient population, referred to as patient-assisted teledermatology. This population is largely over the age of 65 and a significant portion are either without internet or have the minimum technology necessary to participate in the studied model. Owing to these observations and personal experiences, the authors found the implementation process of a patient-assisted model to be challenging in this population.