Introduction: Pediatric dermatology access is limited. Pediatric teledermatology (TD) opens the opportunity to explore diverse dermatological pathology promptly. Different TD modalities and providers may influence the consulting population. This study compares a synchronous TD from a private provider with the asynchronous TD of the public sector in Chile's health care system. Methods: A descriptive and inferential analysis of 168 synchronous and 239 asynchronous pediatric teleconsultations, responded from January 2023 to August 2023. Results: Pediatric teleconsultations accounted for nearly one-fifth of all consultations in both models. The synchronous group was significantly older (p = 0.0065; 10.18 years +/- 5.43 [0-18 years]) than the asynchronous group (8.65 years +/- 5.74 [0-18 years]). June marked the highest and lowest teleconsultation volumes in synchronous and asynchronous platforms, respectively. The most frequent diagnostic group in both modalities was the noninfectious inflammatory pathology. Significant differences were noted within this group (p < 0.0001), with acne and dermatitis being predominant in the synchronous model. Significant differences also emerged within the infectious inflammatory group (p = 0.002), with bacterial and fungal infections being more common in the synchronous modality, whereas chronic viral infections predominated in the asynchronous group. Discussion: Pediatric TD is an emerging tool that optimizes access, manages the demand, and reduces waiting times. Seasonal variations may influence caregiver preferences for a specific attention model. The consulting population using synchronous and asynchronous modalities differs significantly in age and diagnostic distributions. Understanding these differences is crucial for effectively addressing specific practice gaps in each attention model.