Global Study Maps Wide Disparities in Access to Dermatologic Care
Key Takeaways
- A cross-sectional study spanning 158 countries and 97% of the global population found substantial income-related disparities in access to dermatologic care.
- Mean dermatologist density ranged from 0.37 per 100,000 population in low-income countries to 5.05 per 100,000 in high-income countries; only 17% of countries met the study’s estimated threshold for sufficient workforce density.
- Dermatologists were concentrated in urban areas, while primary care physicians and other health care workers played substantial roles in delivering skin disease care globally.
A global analysis of dermatologic care found substantial disparities in dermatologist availability, training opportunities, and access to specialty services, with lower-resource countries facing the greatest gaps.
The cross-sectional study surveyed dermatology leaders across World Health Organization member states and additional geographic areas using a 47-question, Delphi-derived instrument. Responses came from 158 countries, representing 97% of the global population and a response rate exceeding 80%.
Dermatologist Workforce and Access Vary by Country Income
Mean dermatologist density was 2.66 per 100,000 population but varied considerably by World Bank income level. Low-income countries averaged 0.37 dermatologists per 100,000 population compared with 5.05 per 100,000 in high-income countries. Investigators estimated that 175,633 dermatologists practice worldwide.
Based on countries reporting adequate access to dermatologic care, the investigators estimated that 5.63 dermatologists per 100,000 represented a threshold for sufficient workforce density. Only 27 countries, or 17%, met that threshold.
Workforce location was listed as another significant disparity. An average of 79% of dermatologists were based in urban centers, with greater maldistribution reported in lower-income settings. Overall, 42% of responding countries reported inadequate or extremely poor access to dermatologic care, while access to pediatric dermatology, dermatologic surgery, and dermatopathology also varied by income level.
Training gaps may further constrain the workforce: 21% of responding countries lacked dermatology training programs. Primary care physicians were cited as often as dermatologists as the main clinicians providing skin disease care, with nurses, pharmacists, traditional healers, and other health care workers also assuming substantial roles.
“Achieving skin health equity will require global commitment to expanding and funding training programs, incentivizing decentralization of dermatology practice, and optimizing alternative care delivery including upskilling front-line health care workers,” the authors wrote in the abstract.
Source
Freeman E, et al. JAMA Dermatology. 2026. Doi:10.1001/jamadermatol.2026.3112