More than 80,000 Canadians are diagnosed with skin cancer every year. But across the country, people who need to see a dermatologist for a mole check, eczema treatment, or psoriasis care are often waiting months, sometimes much longer. Meanwhile, cosmetic appointments at the very same clinics can be booked within days.
That gap is not accidental, and a new CBC investigation lays out exactly why it exists.
Why Getting a Dermatologist Is So Hard
Canada has about 800 dermatologists in practice, according to the Canadian Dermatology Association (CDA). That works out to roughly 1.9 specialists per 100,000 people — a number the CDA says is far too low. The association estimates Canada needs approximately 465 more dermatologists by 2033 to keep pace with an aging population and a growing demand for medical skin care.
One factor behind the shortfall is the small number of training spots available. In 2023, there were only 29 first-year dermatology residency positions across the entire country.
The other factor is economics. Medical appointments billed to a provincial health plan typically pay a dermatologist around $80 to $90 per visit. Cosmetic procedures like Botox, laser treatments, and skin resurfacing are billed directly to patients, with consultations often starting between $200 and $400. The CDA's president, Dr. Mark Kirchhof, says the financial pressure is real: "A large percentage of our membership are just trying to survive economically in the system that we live in."
CBC News called several dermatology clinics in Toronto, Windsor, and Edmonton and found that Botox appointments were available within a day or a few weeks at every location, while medical appointments were either fully booked, unavailable indefinitely, or months away.
What This Means for Patients
Carole McArthur, a 67-year-old from Ottawa, had been managing basal cell carcinoma for decades with regular dermatologist check-ups. When her dermatologist retired and she moved to Ottawa, she spent months trying to get referred to a new specialist. Eight months later, when she finally got in, the cancer had grown significantly. She needed multiple layers of skin and cartilage removed from her face.
McArthur is not an outlier. Across Canada, patients with family histories of skin cancer, chronic inflammatory conditions like eczema and psoriasis, and suspicious lesions are all facing similar barriers. The combination of a dermatologist shortage, low public billing rates, and the financial pull of cosmetics is creating a two-tiered system where your access to medical skin care depends heavily on where you live and whether you can pay out of pocket.
Dr. Kirchhof also pointed to the ethical dimension: dermatologists receive publicly subsidized medical training with the expectation they will serve their communities. When a significant portion of practice hours shift to private cosmetic work, that public investment goes partly unrealized.
What the CDA Is Proposing
The Canadian Dermatology Association has outlined several potential solutions, including increasing the number of domestic dermatology training spots, recruiting more internationally trained dermatologists, and raising the medical appointment fees that provincial governments pay. Dr. Kirchhof also suggested return-of-service contracts that would require dermatologists to offer medical care in underserved communities.
In the meantime, if you have a concerning skin change, a family history of melanoma, or a skin condition that is affecting your quality of life, starting with your family doctor or nurse practitioner is your best path forward. They can refer you, assess urgency, and in some cases manage conditions directly. You can find a family doctor, walk-in clinic, or dermatology referral near you at medimap.ca.
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