As we strive to deliver the highest level of care to our patients, we also have a responsibility to be intentional in our practice choices, recognizing their direct and indirect contributions to healthcare waste (HCW). Within dermatology, HCW is generated through daily clinic operations and both the consumption and disposal of procedural waste; this is in turn associated with greenhouse gas emissions and other environmental impacts with potential downstream health harms. There are multiple mechanisms by which we can optimize dermatology waste management, ranging from modifying clinic workflows to being scrupulous with procedural supplies and intentional with waste disposal.

The "Superfund" program was established in 1980 to manage the cleanup of hazardous waste sites across the United States. Proximity to these sites has been associated with an increased risk of autoimmune, inflammatory, and neoplastic skin conditions. Climate change poses a growing threat as warming temperatures and natural disasters threaten to destabilize waste sites. Vulnerable populations such as low-income and minority groups are more likely to live near a Superfund site, highlighting the environmental health disparities linked to pollutants and toxic exposures. Further research is warranted to better understand the mechanistic role that environmental toxins play in cutaneous disease development.

Biologic medications have revolutionized the treatment of many dermatologic diseases, but they also necessitate unique packaging and shipping requirements to maintain their stability, typically involving temperature-controlled environments, polystyrene, and single-use plastic injector pens, contributing significantly to medical waste and carbon emissions. It is essential to consider the environmental impact of these treatments. Collaborative efforts among pharmaceutical companies, specialty pharmacies, insurance companies, health care providers, and patients are essential to reduce waste and promote sustainability. Dermatologists, in particular, have a critical role in addressing the environmental impact of biologic therapies, by advocating for systemwide changes.

In the context of the climate crisis, persons experiencing homelessness face a disproportionately increased risk of dermatologic disease. Contributing epidemiologic factors include increased baseline health susceptibilities, increased environmental exposures, and systemic barriers to climate resilience. Migrant populations, while distinct, can face overlapping challenges, with climate change acting as a housing crisis multiplier in both groups. Addressing these dermatologic impacts requires a coordinated approach from dermatologists globally.

Sustainable dermatology and high-value care are closely connected, both prioritizing evidence-based practices that improve patient outcomes, minimize waste, conserve time, and lower costs thereby improving overall efficiency. Key approaches include preventive medicine, personalized monitoring, optimized dermatologic practices, and reduced resource consumption. Incorporating sustainability measures, such as effective waste segregation and eco-friendly procurement, complements these strategies. This article underscores the importance of updated guidelines, systemic reforms, and education to ensure lasting benefits for patients, health care providers, and the environment.

The scope of procedural dermatology encompasses practices such as skin surgery, energy devices, medical and cosmetic injectables, and chemical peels performed with a wide range of dermatological and aesthetic indications. Procedural dermatology is a significant contributor to global carbon emissions with an estimated annual footprint of 2.76 million tons CO2e. This narrative review synthesizes current literature up to 2025 on sustainable lower carbon practices across procedural dermatology, drawing from guidelines and life cycle analyses.

Recent climate science trends have identified that extreme weather events, including heat waves, wildfires, and flooding, are becoming more frequent and intense worldwide. These climatic events have negative impacts on dermatologic health, particularly on multiple inflammatory and infectious skin diseases. It is increasingly important for dermatologists to be knowledgeable about these impacts in order to appropriately diagnose, treat, and prevent these illnesses for their patients.

Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disease driven by immune dysregulation and skin barrier defects. This article summarizes the impact of climate change on AD outcomes, focusing on articles published since April 2023. Climate change amplifies environmental stressors, temperature extremes, altered humidity, and rising air pollution, that can trigger or worsen AD symptoms by increasing oxidative stress, disrupting the skin's microbiome, and weakening barrier function. Studies suggest associations between climate variables and AD outcomes, although findings are inconsistent. Strategies such as patient education, indoor air filtration, and broader policy measures to reduce pollution may mitigate climate-related risks.

Human activities have led to climate change, resulting in global warming, ocean warming, and more frequent extreme weather events (EWEs). Each of these has the potential to amplify infectious diseases with skin manifestations. Alterations in the skin microbiome due to rising temperatures and humidity may increase infection risk. Global warming has led to expanding geographic ranges of vector-borne diseases. Warming waters have similarly increased the risk of waterborne diseases. EWEs are associated with increased incidence of cutaneous infections. Land-use change, both a cause and effect of climate change, increases the risk of zoonotic spillover.

Climate change is reshaping the epidemiology of dermatologic diseases in the Global South through rising temperatures, UV radiation, extreme weather events, and shifting ecosystems. These environmental stressors exacerbate thermal injuries, infectious and inflammatory dermatoses, and neglected tropical diseases such as cutaneous leishmaniasis, mycetoma, and scabies. Vulnerable populations-including displaced communities, persons with albinism, and outdoor workers-face disproportionate risk. This article highlights the dermatologic impacts of climate change, emphasizing the need for integrated surveillance, accessible care, and climate-resilient health systems. Addressing these challenges requires urgent, interdisciplinary action to protect skin health and equity in an increasingly warming and unstable world.

Children's health is disproportionately impacted by the burning of fossil fuels and the subsequent production of greenhouse gases and air pollution. This is due to their developing physiology, unique behavior patterns, greater body surface area to volume ratio, and reliance on adults for their essential needs. Importantly, increases in air pollution and global warming negatively influence the skin health of children, including increasing the risk of inflammatory dermatoses, climate-sensitive infections, and psychocutaneous disease.

Climate-driven increases in temperature, air pollution, UV radiation, and extreme weather (including floods and storms) harm the skin through direct and indirect mechanisms, causing exacerbations of common and rarer inflammatory skin disorders. Here, we comprehensively review and summarize studies that assess the effect of climatic factors on psoriasis, acne, seborrheic dermatitis, and lupus.

Microplastics and nanoplastics are found ubiquitously in the environment and might pose risks to skin health. Some particles can penetrate the skin, especially if the skin barrier is compromised. In-vitro studies show that micro-plastics and nano-plastics (MNPs) may cause oxidative stress, trigger inflammation, and induce senescence in fibroblasts. Dermatologists should consider the potential impact of MNPs on skin homeostasis and promote adequate use and disposal of plastics in their personal and occupational settings. This article calls for research on the topic and advocates for plastic-free or bio-degradable alternatives that do not exert adverse effects to mitigate potential risks.

The intersection of dermatology and drug discovery represents a dynamic field of research aimed at addressing the growing burden of skin-related diseases. Recent advances in molecular biology, genomics, and pharmacology offer improved outcomes for patients. This review highlights the current state of drug discovery in dermatology, focusing on identification of new therapeutic targets, role of personalized medicine, and application of artificial intelligence in drug development. By providing an overview of the latest innovations, challenges, and future directions, this review aims to inform and inspire researchers and physicians in the quest for more effective therapies utilizing emerging technologies for dermatologic diseases.

Artificial intelligence (AI) has the potential to revolutionize the field of medicine including dermatopathology. A rapidly growing body of research supports a promising role for AI in various aspects of dermatopathology, particularly when used in conjunction with human pathologists. This article reviews the current state of AI in dermatopathology, its use in the diagnosis and prognostication of cutaneous diseases (particularly skin cancer, a focus within the field), as well as the challenges and ethical considerations critical for the integration of AI into clinical practice.

Although most applications of artificial intelligence (AI) in dermatology to date have focused on diagnostic use cases (eg, computer vision algorithms for the diagnosis of pigmented skin lesions), the advent of highly sophisticated generative AI algorithms may potentially enable more creative use cases for AI. In cosmetic and procedural dermatology, AI has begun to be used by consumers and dermatologists to visualize treatments ahead of time or highlight opportunities for improvement.

This article explores the transformative role of artificial intelligence (AI) in dermatology education, emphasizing the need for dermatologists to develop AI literacy alongside clinical expertise. It reviews AI's capabilities and limitations, as well as strategies for evaluating research, industry partnerships, and clinical applications. Additionally, it provides guidance on navigating AI use by patients and offers resources to help patients engage safely with these technologies. This article aims to prepare dermatologists for the AI era and to keep pace with the evolving landscape of AI-enabled dermatology and learning health systems.

The rise of advanced transformer-based generative artificial intelligence models represents one of the most profound changes to the medical landscape of the past century. Given the potential to impact everything from medical education to surgical decision-making, it is important to appreciate fundamental aspects of how these systems work and understand the ways in which they can be used responsibly to improve patient care. Prompt engineering provides the most obvious opportunity for clinicians to tailor these systems to their needs, but appreciating possible risks, including direct and indirect effects, is of profound importance for the clinician, educator, and researcher.

Artificial intelligence (AI) is increasingly being used in dermatology, particularly for image-based diagnostics. However, a number of regulatory and legal challenges remains unanswered. This article reviews the UK regulations for AI-driven medical devices with reference to international comparisons. We have also highlighted some liability concerns with clinical examples to illustrate the complexity. As AI deployment continues to rapidly expand, it is critical that health care practitioners ensure not only that these technologies are implemented with patient safety and ethical considerations at the forefront but that they are also aware of the importance of regulatory compliance and liability issues.