Patients are increasingly going without medically necessary dermatological care, the head of the Consumers Health Forum said, as new report reveals the rising cost of the specialty in Australia.

Dermatology is expensive and getting pricier, with an average first visit now costing an adult patient without concessions $230 out-of-pocket, while follow-up appointments cost almost $190, the report from health directory Cleanbill found.

Cleanbill collected information on the pricing, services and locations of Australia’s dermatology clinics in 2024, and again in late 2025.

The results, published on Sunday and based on data from 322 clinics, show that the cost of a first appointment rose nationwide by an average of almost $18 in one year, and a follow-up by almost $20.

Rises were steeper in smaller states including Western Australia, South Australia, and Tasmania.

“Specialist care is becoming something you have to budget for, plan for, and in too many cases, go without,” the CEO of the Consumers Health Forum, Dr Elizabeth Deveny, said.

“That is especially true for dermatology, where ongoing care is often not optional, it is medically necessary.

“The gap between what Medicare covers and what specialists charge has been widening for years. People feel it every time they get a bill. No one should have to weigh up whether they can afford to follow up on a skin cancer check.”

Dermatology is a small workforce, with just under 700 specialist dermatologists and about 130 trainees nationally, while demand for their services rises, in part driven by high skin cancer rates. Psychiatry by comparison has 6,500 qualified psychiatrists and more than 2,500 trainees.

Many in the profession are also being driven to more lucrative cosmetic work performed outside of Medicare, leaving fewer specialists available for essential treatment as waiting lists grow longer and out-of-pocket costs rise.

There are also limited trainee places, which are government funded. According to the Australasian College of Dermatologists, the number of training positions is constrained by funding and capacity within public hospitals and public outpatient clinics, which the college says remain under‑resourced relative to demand.

The chief executive of Cleanbill, James Gillespie, said while some repeat patients may have arrangements with their specialist that see them being charged lower fees, these arrangements are not usually available to first-time patients.

“Cleanbill is focused on providing insight into the general billing policies of clinics and practitioners so that patients can be aware of costs before booking in for an appointment for the first time,” he said.

The report reflects findings from the Australian Bureau of Statistics, Gillespie said, with the most recent available data from 2024-25 estimating almost 810,000 Australians aged over 15 didn’t see a specialist when they needed to because of cost.

A spokesperson from the Australasian College of Dermatologists said dermatology care can often be time‑intensive due to doctors managing chronic disease, cancer surveillance, and increasingly complex patient needs.

On top of this, the college says rebates have not kept pace with practice costs such as staffing, rent, medical indemnity insurance, equipment, and compliance requirements.

“Current funding settings are placing pressure on affordability and equity,” the spokesperson said, adding that without reform to Medicare rebates and investment in public dermatology services, “there’s a risk that patients with fewer financial resources, or those living in regional and outer metropolitan areas, will experience longer wait times or limited local access to care”.

“Ensuring equitable access to dermatology care requires sustainable Medicare funding and adequate resourcing of public hospital dermatology clinics, rather than placing the burden on patients or individual specialists.”