No appointment, no waiting room: Utah tests AI-issued acne prescriptions

A patient opens an app, answers a 10- to 15-minute questionnaire, scans their face and receives an acne prescription within minutes. There is no appointment to schedule, no front desk check-in and no exam room.

That is the model Nolla Health launched Oct. 5 in Utah, where the company says it has become the first organization in the country to receive regulatory approval for artificial intelligence (AI) to issue initial prescriptions. Its Nolla Derm app is open to Utah residents 18 and older, starting at $4.99 a month, according to a company news release.

"AI will matter most in health care when it helps people get care they otherwise would not receive," Nolla Health co-founder and CEO Luis Wenus said in the news release.

For practice leaders evaluating AI tools, the Utah pilot offers a detailed look at how one company built physician review, escalation and patient support around software that makes the first prescribing decision.

Who reviews the prescriptions

Nolla Health said physician oversight is built into each stage of the program, but the level of review changes as more patients enroll:

• For the first 100 patients, a licensed physician reviews and approves every AI-generated prescription before the patient receives it.
• Through the first 500 patients, the AI issues prescriptions on its own, and a physician reviews them each day after they go out.
• After that, a physician reviews a sample of prescriptions once a week.

The system cannot write open-ended prescriptions or come up with its own treatments, according to the company. It selects from pre-approved treatment pathways using structured clinical data and analysis of the patient's facial scan. If it cannot confidently choose a treatment, the patient is sent to a licensed physician instead.

"People are right to worry about AI in medicine that nobody can control. This program was built to be the opposite," Nolla Health Chief Medical Advisor Zaid Fadul, M.D., said in the news release. "The AI can't improvise. It can only choose from a short list of physician-approved topical treatments."

"The moment a patient falls outside those limits, it stops and hands them to a doctor," said Fadul, who is part of the physician team overseeing the Utah pilot.

What the patient experience looks like

Patients download the app, opt into the program and complete an informed consent process before the intake questionnaire and face scan. They receive a personalized treatment plan and prescription through the app, then choose home delivery or pharmacy pickup.

The follow-up work is built into the app as well. Patients complete daily skin scans to track their progress, and treatment plans are updated monthly based on how each patient responds, the company said.

When patients have questions, a person answers. Patients can message a licensed physician through the app at any time, and they are never speaking with AI when they reach out for support, according to the release.

How the approval came together

Nolla Health said it secured approval for the AI system after months of work with the Utah Office of Artificial Intelligence. The company also met with the Utah Medical Board before launch so the board's feedback would be reflected in the final program. Practicing physicians, dermatologists, key stakeholders and members of Utah government reviewed the pilot in multiple rounds before it went live, according to the release.

"The Nolla Health pilot program represents a significant step forward in leveraging AI to improve health care access for Utahns, while maintaining rigorous oversight and safety. Our Office facilitates innovative AI solutions while ensuring that public health and patient safety remain paramount," Office of Artificial Intelligence Policy Director Zach Boyd said in the news release.

The company said licensed clinicians agree with the AI's treatment recommendations in more than 96% of real-world cases. In the rest, clinicians made minor adjustments, such as changing the strength of a topical medication, rather than disagreeing with the treatment itself, according to Nolla Health.

The wait times behind the pilot

Nolla Health pointed to long waits and thin coverage for dermatology care in Utah. The company said the average wait for a dermatology appointment in the state is 61 days, nearly double the national median, and 11 Utah counties have no dermatologists at all.

An estimated 100,000 Utah residents have active acne at any given time, yet only 10% ever see a dermatologist, according to the release. Patients who do get an appointment can pay up to $300 per visit. Untreated acne can lead to permanent scarring while patients wait, which raises treatment costs further, the company said.

Nationally, more than 80% of U.S. counties are considered health care deserts, affecting more than 120 million people, or about one in three Americans, according to the release.

Nolla Health described acne as a well-understood, low-risk condition with decades of clinical evidence behind it. The company said the pilot is meant to complement physicians, not replace them, by handling routine, low-acuity cases, meaning conditions that are less severe and less urgent. That frees dermatologists to focus on complex, high-risk patients, including those at risk for skin cancer, according to the company.

"The real test for AI in health care isn't how smart it is. It's whether someone other than the company can shut it off," Fadul said. "In Utah, the state can, and physicians can — that's the standard every AI in medicine should meet."

About Nolla Health

Nolla Health is headquartered in New York and operates in 44 states, where its Nolla Derm app has been downloaded by more than 175,000 people, according to the company.

When the company launched in the United States in September 2025, it described its acne treatment as clinician-reviewed treatment plans prescribed asynchronously, meaning clinicians reviewed cases without a live visit, according to a company blog post at the time. That expansion was backed by a $4.5 million pre-seed funding round led by venture capital firm General Catalyst.