Dermatologists tackle climate change via telehealth services for carbon emission reduction

19 Sep 2022 --- Dermatologists are being urged to engage more thoroughly in climate issues and go beyond discussions of the effects of climate change on the skin. This is according to a commentary published by US-based researchers in the International journal of Dermatology.

The authors note that diagnosing, treating, researching and mitigating the health effects of climate change are their professional responsibilities. Dermatologists must also consider that healthcare is one of the most carbon-intensive service sectors in the world.

“Our research, advocacy and policies must be ambitious in scope, reaching beyond the cutaneous disease to integrate the impact of climate change on social determinants of health and support resiliency and social justice in vulnerable populations,” the study authors say.

“We have an ethical imperative to act. The time is now for dermatologists and our medical societies to collectively rise to meet this crisis.”

Additionally, the study authors point out that increasing telehealth services, virtual medical consultation and residency interviews can easily result in significant reductions in carbon emissions in dermatology.

“Decarbonizing” dermatology sector
The skin is the largest organ and primary interface with the outside world. As a result, many dermatologic diseases, such as allergic and inflammatory dermatoses like atopic dermatitis, autoimmune bullous and connective tissue diseases, cutaneous malignancies, infections, vector-borne diseases, photoaging, nutritional deficiencies and pigmentary disorders are climate-sensitive.

Dermatologists should prioritize funding for a climate-health research plan to fill current knowledge gaps and leverage technology.The authors note that dermatologists ought to prioritize climate-health research funding to enhance healthcare sustainability and decarbonize the sector.

“We call attention to the urgency of now by endorsing this editorial and highlighting the need for dermatologists to proactively work toward understanding and mitigating the adverse health effects of climate change,” the authors explain.

“Human reliance on the combustion of fossil fuels has released mass quantities of air pollutants and greenhouse gases (GHGs), triggering unprecedented global warming with widespread current and future impacts on the planetary, community and individual health.”

Investigating skin-related effects
A collective editorial from 233 international medical publications was published in September 2021 and demanded immediate action to stop climate change-related harmful health impacts and global warming. Dermatology was not represented, despite the unprecedented scale of this collaborative effort.

The researchers stress that climate change is the most serious health threat “we face in this century. Dermatology can no longer be a bystander – we must engage in more meaningful discussions about key climate issues, going beyond simply discussing the skin-related effects of climate change.”

The researchers add that dermatologists should prioritize funding for a climate-health research plan to fill current knowledge gaps and leverage technology to improve healthcare sustainability and rapidly decarbonize our profession.

Atopic dermatitis, photoaging and pigmentary disorders are climate-sensitive.“We are under no illusion; unraveling the immense complexities and far-reaching consequences of climate change on specific diseases, regions, or groups extends beyond dermatology and necessitates broad action and global participation, yet no one-size-fits-all solution exists.”

The researchers add that previous studies have revealed that most dermatologists are equally concerned about how climatic changes may affect their patients’ cutaneous health and feel they should take a stand on this subject.

In addition to the less than seven million deaths worldwide from air pollution, the WHO estimates that climate change will cause an additional 250,000 deaths annually between 2030 and 2050, with direct health costs expected to reach US$2 to US$4 billion annually by 2030.

Beyond the skin: Climate change
Marginalized groups like communities of color, those with lower socioeconomic status and indigenous peoples disproportionately bear the burden of climate impacts despite producing the least greenhouse gas emissions. Climate change affects vulnerable populations, such as children, pregnant women and the elderly.

Children of today will live in a world with significantly higher average temperatures and more frequent extreme weather events, highlighting the intergenerational injustices of the climate issue.

Healthcare is one of the most carbon-intensive service sectors in the world, contributing 4.6% to global GHG emissions. However, it is our professional responsibility to diagnose, treat, research and mitigate the health impacts caused by climate change.

Everyday practices can significantly impact decarbonization. Increased use of telehealth services in dermatology can easily result in significant reductions in carbon emissions, as isotretinoin, a medication used to treat severe cystic acne, has shown in return visits.

Such savings in costs and emissions might be easily generalized to other regular follow-up visits for disorders including rosacea, actinic keratosis field treatment, biologic monitoring in well-controlled diseases and postoperative wound checks.

Edited by Nicole Kerr