A new global study has found that Africa has 23 times fewer dermatologists than Europe per 100,000 people, highlighting a major disparity in access to specialist skin healthcare and the capacity of health systems to manage skin diseases.

The Global Access to Skin Health Observatory Study, published in JAMA Dermatology, found that countries in the World Health Organisation (WHO) African Region have an average of only 0.26 dermatologists per 100,000 people, or about one dermatologist for every 383,000 people.

This compares with a global average of 2.66 dermatologists per 100,000 people and an estimated workforce benchmark of 5.63 needed for adequate care.

Conducted by the International League of Dermatological Societies (ILDS), in collaboration with L’Oréal Dermatological Beauty, the study examined dermatologist distribution, access to dermatological care and specialist training across 158 countries representing 97 per cent of the global population.

It found that 91 per cent of dermatologists in responding African countries practise exclusively in urban areas, compared with 79 per cent globally, leaving rural and remote communities with fewer opportunities to access specialist care.

The capacity of African health systems to manage skin diseases is also limited. The study found that 94 per cent of African countries reported insufficient healthcare provider capacity for treating skin disease, while none met the estimated dermatologist workforce benchmark.

The disparity is also evident among countries with comparable populations. Australia and Niger, each with about 27 million people, have more than 600 and about 18 dermatologists, respectively. Similarly, Japan and Ethiopia, with populations of roughly 130 million, have more than 7,000 and about 200 dermatologists respectively.

Globally, dermatologist density ranges from 0.37 per 100,000 people in low-income countries to 5.05 per 100,000 in high-income countries. Only one in six countries has sufficient dermatologists to meet population needs, while 42 per cent reported poor or extremely inadequate access to dermatological care.

The shortage has increased reliance on non-specialists, including primary care physicians, nurses, pharmacists and community health workers, to manage skin conditions.

However, the study noted that many frontline providers receive little or no formal dermatology training.

Training capacity is also a major constraint in Africa, with 46 per cent of countries in the region having no dermatology training programme, limiting opportunities to expand the specialist workforce.

The gaps are significant given that more than two billion people globally live with skin disease. The study described skin diseases as among the world’s most common health conditions and among the top 10 causes of disability, while 74 per cent of countries reported that skin health is not a national government priority.

The Principal Investigator, Vice Chair of the International Foundation for Dermatology and Associate Professor of Dermatology at Harvard Medical School, Dr Esther Freeman, said the findings provided a data-driven picture of disparities in access to skin health services.

She said the research showed that where people live continues to influence access to skin healthcare, underscoring the need for collective action to address gaps.

The study identified regional dermatology training, upskilling frontline healthcare workers, telemedicine and artificial intelligence as potential approaches to expanding access to specialist expertise in underserved communities.