A sweeping new study has put numbers on a problem most holidaymakers never think about: skin disease is everywhere, but the doctors trained to treat it are not. Research published in JAMA Dermatology, drawing on input from experts in 158 countries, describes a global access crisis - and the gaps track almost perfectly with wealth.
In Europe there are roughly six dermatologists for every 100,000 people. Across Africa, the figure drops to 0.26. Comparing countries by income, the richest group has 5.05 skin specialists per 100,000 people; the poorest group has 0.37. The starkest comparison: Australia and Niger each have around 27 million people, yet Australia has more than 600 dermatologists while Niger has 18.
The scale of the problem is enormous. The World Health Organization counts more than 3,000 distinct skin conditions - acne, scabies and skin cancers among them - affecting about one in three people worldwide, with 4.69 billion new cases in 2021 alone. Skin conditions rank among the top ten causes of disability globally. Yet only one in six countries meets the study's benchmark of 5.63 dermatologists per 100,000 people, and none of those countries are in Africa or Southeast Asia - regions that also carry higher levels of skin disease, what lead researcher Dr Esther Freeman of Harvard Medical School calls a "double hit".
Where specialists are missing, patients improvise. In Kenya, patient advocate Noel Mudibo spent four years with undiagnosed pemphigus vulgaris, a rare autoimmune condition that began as severe blisters in his mouth and on his legs in 2017. Antibiotics did nothing. Traditional medicine did nothing. He lived on soft, bland food and strong painkillers until finally getting the right diagnosis and treatment in 2021. Along the way he faced whispers that his symptoms were caused by drug use, HIV - or witchcraft. Forty-two per cent of respondents across the study said access to skin care in their country was inadequate or extremely poor.
Why does this matter to travellers? Skin problems are one of the most common health issues people pick up abroad - sunburn, heat rash, fungal infections, insect bites, and in sunny destinations, skin cancers that often go unnoticed until later. In much of the world, a traveller who develops a serious skin condition may find the local clinic has no dermatologist at all, relying instead on nurses, medical assistants or traditional healers. That makes prevention and travel insurance with medical coverage genuinely important, and it means travellers should get odd moles or persistent rashes checked at home rather than hoping to sort them out on the road.
There's a glimmer of movement. In 2025, countries at the WHO's annual assembly agreed skin disease should be a global health priority, and study funder L'Oreal Dermatologic Beauty says it will fund training and education for health workers in poorer countries. The study's authors suggest the realistic fix isn't just recruiting more specialists but training GPs, nurses and even traditional healers to recognise and treat common conditions. Governments, Dr Freeman argues, have long treated skin health as cosmetic - a luxury - when the evidence says otherwise.