There are an increasing number of our patients on antiplatelet and anticoagulant medications. In the absence of clear guidelines for the perioperative management of these patients presenting for operative dermatological procedures, we undertook a pilot survey of the current practices of dermatologists in the United Kingdom. The aims of our study were to determine whether there was uniformity of practice and whether the modes of practice differed from those outlined in the literature for other related specialities, and to debate whether there is a need for national guidelines with this regard. A postal survey of 185 dermatologists was conducted. The response rate was 50%. Overall, most respondents (61%) stated that their practice was primarily based on personal preference and only 30% stated that it was based on the local Unit policy. Only 34% of the Consultants based their practice on evidence-based medicine. There appeared to be significant variations in current practice amongst dermatologists. Some aspects of practice were found to vary from those recommended in the literature. The findings of this study emphasise the importance of national guidelines for the use of anti-platelet and anti-coagulant medications in cutaneous surgery specifically and in surgery in general.