This cross-sectional survey assessed global access to dermatological care across 194 WHO member states and 3 additional areas, using a 47-question Delphi-derived instrument distributed to dermatology leaders from August 2024 to October 2025; outcomes included dermatologist density, training program availability, workforce distribution, and perceived care access, stratified by World Bank Income level and WHO region.
Mean global dermatologist density was 2.66 per 100,000 (range: 0.37 in low-income countries to 5.05 in high-income countries); only 17% of countries (27/158) met the estimated sufficiency threshold of 5.63 per 100,000; 42% of countries reported inadequate or extremely poor access; and an estimated 175,633 dermatologists exist worldwide (95% PI: 173,598–177,668).
- Data reliability varied: only 64% of responses were informed by formal data sources, and self-reported estimates from country leaders may not reflect ground-level reality. - The survey captured country-level averages, potentially masking within-country rural/urban disparities beyond the urban concentration metric. - Non-response from 36 countries (including some low-income settings) may introduce selection bias toward better-resourced health systems.
Only 1 in 6 countries meets the estimated threshold for adequate dermatology workforce density, with the greatest gaps in low-income settings where primary care physicians, nurses, pharmacists, and traditional healers shoulder most skin disease care. Clinicians and health systems should prioritize upskilling frontline workers and advocating for decentralization of dermatology training to address these disparities.
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