Dermatology’s Carbon Footprint Under the Microscope

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The intersection of dermatology and environmental sustainability is increasingly recognized as a critical area for clinical, ethical, and scientific advancement. In the review titled "Environmental Impact of Dermatology and Action Towards It," Niebel et al. explore the ecological footprint of dermatological practice and provide a comprehensive overview of current efforts to mitigate its impact while advocating for broader integration of sustainability principles into the specialty.¹

Background

Health care accounts for approximately 4–6% of global greenhouse gas (GHG) emissions.² Within this framework, dermatology presents a distinct environmental challenge due to its reliance on topical agents, cosmeceuticals, and procedural interventions.³ The review noted these features, along with high patient throughput and dependence on single-use materials, contribute significantly to carbon emissions, water usage, and waste generation.

Results

A pivotal study referenced in the review examined a high-volume dermatology clinic in the US and found that the bulk of its emissions (51.1%) stemmed from indirect scope 3 activities—namely, purchased goods and patient travel—followed by energy use (46.3%) and direct emissions (2.5%). The total carbon footprint was 323.6 tons of CO₂ equivalent—comparable to 145 round-trip flights between New York and London. Researchers stated this underscores the need for scrutiny of not only clinical practice but also procurement, supply chains, and patient engagement models.

Topical treatments—central to dermatology—pose unique sustainability challenges. Many formulations include petrochemical-derived ingredients and microplastics that are resistant to biodegradation and harmful to aquatic ecosystems. The study noted both leave-on and rinse-off products contribute to pharmaceutical pollution, and sample packaging, often single-use and plastic-heavy, has an outsized environmental cost relative to product volume.

Niebel et al. further outline the efforts by major dermatological associations to tackle these issues. Six prominent organizations—the AAD, ACD, BAD, EADV, DDG, and ISD—have formed working groups dedicated to climate change and sustainability. These groups facilitate education, advocacy, and research, while also producing resources such as sustainability audits, green awards, and low-carbon practice guidelines.

Importantly, the review differentiates between climate adaptation (preparing for the impacts of climate change, such as heatwaves and extreme weather) and climate mitigation (actively reducing GHG emissions). Dermatology can play a role in both areas. Adaptation strategies include patient education on heat-related skin conditions and emergency preparedness, while mitigation may involve transitioning clinics to renewable energy, reducing procedural waste, and selecting environmentally preferable treatment options.

Despite growing awareness among clinicians—evidenced by surveys indicating high concern about climate change—the review identifies a critical gap: individual efforts are not yet systematically translated into institutional or policy-level change. Barriers include limited infrastructure for sustainability metrics, fragmented leadership, and inconsistent integration of environmental considerations into clinical guidelines.

To close this gap, the authors propose a roadmap for dermatological societies: define an environmental policy, identify country-specific action points, integrate sustainability into research and education, and ensure regular review of institutional practices. They stress the importance of international collaboration to amplify impact, share best practices, and maintain accountability across borders.

Conclusion

The review found the environmental impact of dermatology is multifaceted, spanning product use, procedural practices, and institutional operations. As climate change continues to affect human health—especially skin-related conditions—dermatology must evolve from reactive awareness to proactive leadership in sustainability. The review by Niebel et al. offers a timely and evidence-based foundation for clinicians, policymakers, and educators committed to integrating environmental stewardship into dermatological care.

References

1. Niebel D, Tso S, Parker ER, et al. Environmental impact of dermatology and action towards it: A narrative review. Int J Dermatol. April 25, 2025. doi:10.1111/ijd.17810
2. Tennison I, Roschnik S, Ashby B, et al. Health care's response to climate change: a carbon footprint assessment of the NHS in England. Lancet Planet Health. 2021;5(2):e84-e92. doi:10.1016/S2542-5196(20)30271-0
3. Gotschall JW, Silva GS, Grant-Kels JM. Balancing patient benefits and environmental impacts of emollient ingredients: An ethical argument. J Am Acad Dermatol. 2025;92(2):379-380. doi:10.1016/j.jaad.2023.11.006