Why Does It Take So Long to See a Dermatologist?

A Dermatologist’s Perspective for People and Families Living with Ichthyosis 

If you or your child has ichthyosis, long waits for dermatology referrals or appointments can be frustrating and worrying. Dermatologists understand how vital specialist care is for managing a lifelong condition that can affect physical health, quality of life, and emotional and social wellbeing for both patients and families. This article explains why waiting times can be long, how the referral system works, and how missed appointments affect everyone waiting for care.  

Key Points 

• Dermatology services are in high demand across the UK and Ireland
• Referrals are prioritised by medical urgency but do try to take in to account impact on daily living.
• Longer appointments are often appropriate / required for patients with ichthyosis due to complexity and impact on multiple areas/factors
• Missed appointments increase waiting times for all patients
• Early appointment cancellation /rearrangement if a patient is unable to attend helps clinics offer slots to other patients 

Demand for Dermatology Services 

Dermatology services in the UK and Ireland are under increasing pressure. Referrals continue to rise for conditions ranging from suspected skin cancer and eczema to rare genetic conditions such as ichthyosis. New treatments, many only available in hospital settings, have also increased demand and waiting times. 

Staff shortages mean some hospitals cannot offer local dermatology care, and referrals are often redirected to nearby centres. Smaller numbers of consultants have experience in rare and paediatric skin conditions. 

Ichthyosis appointments usually need more time than standard clinics. Care often includes detailed skin reviews, support with daily skin care, long-term treatments, and coordination with multiple services such as genetics, eye care, ENT etc. This essential care limits how many patients can be seen in each clinic. 

How the Referral Process Works 

Most people are referred to dermatology by their GP, to either community or hospital services. Hospital dermatology may be local or regional. Referrals are reviewed and prioritised by the dermatology team, often a consultant, based on medical urgency and risk. Suspected skin cancers are seen quickly. Chronic inflammatory conditions are prioritised as urgent only if there are acute complications such as severe inflammation or infection. Without acute problems, they are usually classed as routine, despite their significant impact on quality of life. 

Clear, detailed GP referrals are essential. Information on severity, infections, complications, involvement of other systems (such as eyes or joints), and past or current treatments helps teams decide how urgently someone needs to be seen. 

Why Waiting Times Can Be Long 

Dermatology clinics usually have a fixed number of appointment slots. These are affected by staff availability, training commitments, and unexpected absences. Patients with very complex conditions such as some with ichthyosis often require longer appointments within an appropriate clinic, which reduces the total number of patients who can be seen each week or month. Although some with ichthyosis are seen in general dermatology clinics in District Hospitals, dedicated specialist dermatology clinics e.g. for rare skin conditions, are often only available in regional hospitals, and demand for these services can be significant. 

The Impact of Missed Appointments 

When a patient does not attend an appointment without cancelling and giving adequate notice, there is insufficient time to rebook with another patient and if the appointment needs to be rearranged, this uses a future appointment which could have been used for another patient and prolongs waiting times. Even a small number of missed appointments can have a significant impact on access to specialist care, particularly for rare conditions e.g. a very specialist clinic may only run monthly or less frequently than this if the clinic is jointly held with several different staff (Consultants / Nurse Specialists / Dietetics etc). 

How Patients and Families Can Help 

There are a few practical steps that make a real difference: 

• Keep contact details up to date
• Attend appointments whenever possible
• Cancel early if you cannot attend
• Prepare questions in advance to use clinic time well
• Ensure that you bring a list of current treatments with you
• Let the team know if there are days or times in the week that are difficult or easier for you to attend as they often try to accommodate if feasible e.g. you travel to your appointment from a significant distance away, ask if it is possible to avoid an early morning appointment, or request to avoid exam dates or a late appointment to avoid school hours for a young person. 

If symptoms worsen significantly, such as painful skin splits, infection, or eye problems, contact your GP. If they have concerns, then a referral can be reviewed or prioritised again. 

Working Together 

Dermatologists recognise the daily challenges of living with ichthyosis and want to provide the best possible care. Long waits are not a sign that your condition is unimportant but reflect high demand and limited specialist resources. Understanding the system and working together helps ensure care is delivered as fairly and effectively as possible.