Dr. Botto has an active clinical practice in general dermatology and a special interest in allergic contact dermatitis. She is the Director of the Occupational and Contact Dermatitis Clinic, where she brings her expertise in contact dermatitis to patients referred for patch testing and complex inflammatory dermatoses. She is also an Ambulatory Executive Medical Director for UCSF Health. She has served on the board of the American Contact Dermatitis Society and is a member of the North American Contact Dermatitis Group- a patch testing research consortium. 

In addition to her dermatologic academic pursuits, Dr. Botto believes that the relationship between the patient and provider is of vital importance to healing and optimized care. She is interested in enhancing the patient and provider experience. She has organized and led efforts focused on service excellence within the Dermatology Department, and is a member of UCSF's CECH organization, which focuses on improving communication skills among providers throughout the University to better healthcare experiences for patients, families and the healthcare team.

Dr. Botto is also a Co-founder of Vetted Dermlab, a hypoallergenic skin skincare company.