Most skin problems get treated the same way: look at the skin, prescribe something for the skin, come back when it flares again. That works for a while. But it doesn’t answer the question most people eventually ask: Why does this keep happening?

Integrative dermatology starts with that question. At Vitality, we combine conventional dermatology with functional medicine training to treat the skin you can see and look for what is driving it underneath. Same clinic, same providers, both approaches.

What integrative dermatology is

Integrative dermatology uses two sets of tools together.

Conventional dermatology is the medicine you expect from a skin clinic: diagnosis, skin cancer screening, biopsies, prescriptions, and in-office procedures. It is fast, proven, and sometimes exactly what you need.

Functional medicine looks at the body as a connected system. Skin is an organ, and it reacts to what is happening elsewhere: digestion, hormones, thyroid, adrenal function, immune activity, sleep, stress, and genetics. Functional medicine asks what those systems are doing before deciding how to treat what shows up on the surface.

Together, you get a plan that calms the flare now and addresses why it keeps coming back. For chronic conditions like eczema, psoriasis, rosacea, acne, and melasma, that second part is often where the lasting progress is.

Who this is for

Integrative dermatology is a good fit if any of these sound familiar:

• A skin condition that improves on treatment and returns as soon as you stop
• Eczema, psoriasis, rosacea, or acne that has outlasted several prescriptions
• Skin changes that showed up alongside digestive, hormonal, or thyroid symptoms
• A preference for understanding the cause, not just managing the symptom
• A wish for longer appointments and a provider who reads the whole chart

It is also fine to come for conventional care only. We do skin checks, biopsies, and mole, wart, and skin tag removal here without any functional medicine workup unless you want one.

About Erin Bishop, NP, DCNP, IFMCP

Erin has practiced as a dermatology nurse practitioner since 2007 and holds the Dermatology Certified Nurse Practitioner credential. She then spent about two and a half years in additional training to become an Institute for Functional Medicine Certified Practitioner. She is the only provider in Central Oregon with that combination, and Vitality is the region’s only integrative and functional medicine dermatology practice.

In 2025 she completed the Clinical Weight Management certification through the American Academy of Anti-Aging Medicine, training that shapes how she approaches GLP-1 and medical weight loss care.

She is a nurse practitioner, not a dermatologist, and she will tell you that herself. What the credentials add up to is conventional dermatology training plus a whole-body way of working through a problem, in a 75-minute first appointment instead of a rushed ten.

Vitality opened in 2017 and is a small, woman-owned practice. Erin was recognized as a Women of Distinction honoree in 2019.

Conventional dermatology at Vitality

Erin provides:

• Full skin cancer screenings
• Skin biopsies
• Removal of moles, warts, skin tags, and milia
• Diagnosis and treatment of eczema, psoriasis, rosacea, acne, and melasma
• Prescription management and follow-up

Vitality does not perform surgical excisions. If a biopsy shows skin cancer, we refer you to a Mohs surgeon or another qualified specialist and stay involved in your care. Melanoma runs in her own family, which is part of why she takes screening seriously.

What happens at an integrative dermatology appointment

Before you arrive. New patients complete a detailed medical history through the patient portal at least 24 hours before the visit. It is long on purpose. We read it before you walk in.

At the visit. Your provider reviews your history with you, examines your skin, and talks through what they see. Depending on the condition, they may order labs or specialized testing, such as hormone or gut health panels, to look at the systems that affect skin.

Your plan. You leave with a written care plan. It usually combines conventional skin treatment with changes to nutrition, movement, supplements, or medication aimed at the underlying driver. During the visit, you’ll receive prescriptions, lab orders, and lab reviews, if applicable.

Follow-up. Chronic conditions typically require monthly visits until things stabilize, then longer gaps between appointments. Oregon patients can get telehealth visits through teledermatology.

Cost and insurance

Vitality is in-network with PacificSource commercial plans, Regence BlueCross BlueShield, Moda (Connexus, Synergy, and Affinity), Aetna, and Providence. Office visits are usually covered for in-network plans. Procedures such as biopsies and lesion removal generally apply to your deductible. Vitality is not in-network with Medicare or Medicaid.

Self-pay patients, including anyone whose plan isn’t accepted, receive 20 percent off, and Vitality can provide a superbill for out-of-network reimbursement.

Self-pay pricing, after the 20 percent discount: new patient integrative dermatology visit from $276, follow-up visit from $216, skin cancer screening from $186 for new patients (45 to 60 minutes) or from $140 for established patients (30 to 45 minutes). Procedures performed during a visit are additional.

Specialized functional medicine testing is billed separately by the lab, and we will tell you the cost before anything is ordered. Full details are on the insurance page.

Frequently Asked Questions