If the experts behind the newly formed Lancet Commission on Skin Health have their way, the sun will never set on effective, efficient, and equitable dermatologic care.

This is the first-ever global focus by a Lancet Commission on the prevention, diagnosis, and treatment of skin diseases for the world’s population. The initiative aims to reach underserved communities, reverse workforce shortages, call attention to the majority of World Health Organization (WHO) designated neglected tropical conditions involving the skin, and judiciously incorporate AI into diagnosis.

Ensuring health officials worldwide embrace and address the seriousness of skin conditions is another of the commission’s goals, said Esther Freeman, MD, PhD, co-chair of the Lancet Commission on Skin Health and vice-chair of the International Foundation for Dermatology within the International League of Dermatologic Societies (ILDS).

The formation of the commission comes on the heels of the May 2025 WHO World Health Assembly passing a landmark resolution calling skin disease a global public health priority. Lancet Commissions and World Health Assembly resolutions have an impact because “we know that international stakeholder governments really pay attention to these initiatives. These can be agenda setting and policymaking going forward,” said Freeman, who is also the L'Oréal/CeraVe Endowed Chair in Global Health Dermatology at Massachusetts General Hospital in Boston.

An Action Plan

In addition to accelerating global dermatology priorities, Freeman and others are working on an action plan. The aim is to increase the chances these efforts will make a positive difference in the day-to-day lives of patients around the world. Promoting actionable change is “a really nice opportunity to both have the big vision but also the practical side of how this is actually going to happen,” Freeman told Medscape Medical News. The plan will offer guidance on training, diagnosis, and other strategies.

“We’re trying to align our work with the WHO agenda in terms of the whole action plan, so it’s an exciting time where all of the doors are kind of open at the same moment,” she said.

These initiatives build on decades of efforts by the ILDS and others to get health officials across the globe to take skin health more seriously. “Often, places and people will think of skin as more of a cosmetic issue. So a lot of the advocacy that we’ve been doing around skin disease as a serious medical health issue, I think, has contributed,” Freeman said.

The worldwide focus includes the US. “Sometimes when we think about global health, we think about it happening somewhere else across an international border,” Freeman said. “But global health and global health dermatology really mean caring for individuals and underserved communities wherever they are,” and, she added, “in many cases in the US, that is right next door.”

Dermatologist Density

In many areas of the world, there are not enough dermatologists to treat the population in need. For example, one study that surveyed 194 countries found that 79% of dermatologists globally are found in urban centers and up to 91% in resource-limited countries. 

For example, there are half a dozen dermatologists in the East African nation of Burundi. “It’s really hard to imagine that six dermatologists can provide a sufficient level of care for a population of 14 million people. There’s a big population of people living with albinism who are dying from very severe and preventable skin cancers,” Freeman said. “So early diagnosis is the key and saves lives.”

Scenarios like this are one reason the commission is focusing on workforce training issues.

A Real Take on AI

Another commission focus is the prudent use of AI to diagnose melanoma and other serious skin conditions. “It’s both an exciting opportunity, but also a potentially scary time,” Freeman said.

The commission hopes to promote equitable use of AI. The technology could represent an incredible opportunity in global health, but it could also reinforce structural racism and evoke colonial history, she said. “Historically, the images AI has been trained on are from White individuals who have conditions that are prevalent in North America. The problem is, you’re taking a tool that was not developed with or by people living in low-resource settings, certainly not with or by people living in sub-Saharan Africa,” she noted.

“We really like to think that AI could democratize health, but I think we are also in a slightly dangerous place where AI can actually make some of those inequities worse,” Freeman added.

A Commission With a Mission

Time will tell how the World Health Advisory, the Lancet Commission on Skin Health, and the action plan advance skin health priorities worldwide. “The Lancet Commission allows us to elevate that work to the next level” and is “highly regarded as a way to communicate with the world,” Freeman said.

“This as an opportunity not just for the global or international audience, but for American dermatologists also to take advantage of the fact that the Lancet Commission on Skin Disease means that one of the leading journals worldwide is putting their stamp on it, saying skin disease is serious and matters.”

Freeman disclosed being a co-author for UpToDate, receiving grant support from the ILDS for the Skin Observatory study, and being the section editor of the British Journal of Dermatology-Global Health and Equity section.

Damian McNamara is a freelance contributor to Medscape Medical News. He worked full-time for Medscape and WebMD from 2018 to 2024. Damian has a BA in chemistry and an MA in science, health, and environmental reporting/journalism.