Skin surface microscopy first started in 1663. The very first dermatoscopic study was done by Johan Kolhaus who first looked at nail fold vessels in a living being with a microscope. In 1878 Abbe improved the technique of skin surface microscopy by using immersion oil between the lens and the skin to improve the image clarity. Later, Unna published a paper in 1893 entitled ‘‘Diaskopie,’’ which described how immersion oil was actually used together with a microscope for skin surface microscopy.

The German dermatologist, Johann Saphier, was the first to add a built-in light source to the dermatoscope instead of relying on an external light source. In 1920 and 1921 Saphier published several papers using his invention and used the term “dermatoskopie” for the first time. In the 1950s, Goldman was the first dermatologist to coin the term "dermascopy" in the English language. He was also the first to use a dermatoscope to evaluate melanocytic nevi and melanoma pigmented lesions – which is the primary use for dermatoscopes today.

However, dermatoscopy took a long time to really catch on and it wasn’t until the 1970s when dermatoscopy and the use of dermatoscopes found a following among a number of dermatologists. In 1971 Mackie reported on the improvement of the preoperative diagnosis of pigmented lesions with the use of surface microscopy. Following from this several authors, including Fritsch, Pechlaner, Pehamberger, and Soyer, published articles on dermoscopy in the 1980s and how dermatoscopes could be used in routine diagnosis in a dermatology clinic.

In 1989, a consensus conference was held by the Committee on Analytical Morphology in Hamburg, Germany, to develop standardized terminology for the dermatoscopic technique with the results published in 1990. From the 1990s onwards several dermatology research groups developed several different diagnostic methods for analyzing dermoscopic images. At the same time hand held dermatoscopes became widely commercially available for purchase enabling an increased uptake in their use around the world.

In 2001, the California medical device manufacturer 3Gen eliminated the need for an immersion fluid with the introduction of a dermatoscope with a polarized light source. Now several dermatoscopes with polarized light sources are available and this has greatly increased their use. The results of the Consensus Net Meeting on Dermoscopy were then presented at the First World Congress of Dermoscopy in Rome in February, 2001. This meeting further refined the definitions used for dermatscopic structures and validated a two step procedure to classify pigmented skin lesions.

Since 2001, the dermatoscope has gained more popularity and can be found in many larger dermatology clinics around the word. There is still some resistance to the “new” tool and some older dermatologists still prefer to examine the skin without using a dermatoscope. It must also be said that dermatoscope use is more prevalent in Europe than it is in North America. Gradually though the dermatoscope is becoming more popular.