“Dermatology deserts”: Billions lack access to crucial skin care

An ongoing study from the Skin Observatory has revealed that at least one billion people lack access to essential skin care treatments, and two billion people living with a skin disease need urgent care.

The organization has called for member states of the WHO and stakeholders to invest in the “global skin care crisis,” primarily affecting low and middle-income countries.  

Personal Care Insights speaks with Esther Freeman, study leader and director of Global Health Dermatology at Massachusetts General Hospital and associate professor at Harvard Medical School, US. 

“It’s critical to recognize that we are in an access to care crisis. One thing we are doing is to try to define the scale of the problem and where the biggest gaps are. This data will give us a road map to action. Access to health care functions more like a privilege than a human right,” Freeman says.

Freeman points to Tanzania as a crucial location for skin care access, where 90% of patients with albinism will die a premature death before the age of 30 if they don’t have access to sun protection.

The study is a collaboration between the International League of Dermatological Societies, L’Oréal Dermatologic Beauty, and WHO team members. It assesses access to skin health across all 194 WHO member states and covers 95% of the world’s population.

In Burundi, people with albinism use petroleum jelly for UV protection as they cannot access sunscreen.Obstacles in obtaining care

In the Democratic Republic of the Congo, an essential moisturizer is the same price as twice some people’s monthly salary. Meanwhile, in Burundi, people with albinism are using petroleum jelly for UV protection as they cannot access sunscreen, the data shows.

“Most affected by lack of access to care for skin disease are low and middle-income countries, where there are few practicing dermatologists,” stresses Freeman.

The new findings add that sunscreen access is severely limited, mainly because there is no local manufacturing in many countries, driving up prices and having fatal consequences.

Freeman says prior data has shown that there are zero to three dermatologists per one million people in sub-Saharan Africa. In the US, there are 34 dermatologists per one million residents, and in Europe, there are 50 per one million. 

“It’s also important to note that even high-resource countries in Australia, North America, or Europe have what I call ‘dermatology deserts,’ including rural or remote areas that are underserved,” adds Freeman.

“In Australia, dermatologists are also inaccessible to most people due to their location. Six dermatologists are available in rural parts of the country, while 44 are in the same urban shopping mall.”

“We also know that vulnerable population groups have a hard time accessing care. This includes people experiencing homelessness, native or aboriginal populations, refugee and migrant populations, and urban inner city minority groups,” Freeman continues.

According to Freeman, skin disease contributes to morbidity because it significantly impacts quality of life. Since many skin diseases are clearly visible, they are stigmatized, affecting work and family life. In addition, symptoms associated with skin disease, such as severe itching from atopic dermatitis, can affect sleep, school, and work.

The WHA highlighted the urgent need to improve care for the more than two billion people globally living with skin diseases.Presented solutions

Freeman believes that “people closest to the problem are also closest to the solution.”  She says that programs teaching citizens how to negotiate with governments or build projects would increase access. 

“Last week, the 78th World Health Assembly (WHA) passed a resolution on ‘Skin Disease as a Global Public Health Priority,’ which will promote access to skin disease,” she says.

Its recommendations call for member states to dedicate adequate resources and prioritize skin diseases by strengthening national surveillance, data collection, and mapping of skin diseases to promote targeted interventions.

The WHA highlighted the urgent need to improve care for the more than two billion people globally living with skin diseases.

Freeman details how part of the solution is supporting and uplifting organizations and individuals working to increase access to care in underserved areas, particularly the International Alliance for Global Health Dermatology.

“Companies in the skin care industry can play their part, as there is a lot of opportunity to partner with NGOs like the International League of Dermatological Societies to make a significant impact,” adds Freeman.