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France diagnoses around 200,000 skin cancer cases every year, yet patients across the country are struggling to see a dermatologist. Appointment slots fill within minutes, waiting times stretch for months, and the shortage of specialists shows no sign of easing. Half of all dermatologists in France are over 60 and approaching retirement, while only around 100 new specialists qualify each year.
A System Under Severe Pressure
At a dermatology clinic in Saint-Maur-des-Fossés, southeast of Paris, the waiting room fills before 8am. Jean-François travelled 130 kilometres from Reims, leaving home at 4:30am to secure a slot for melanoma removal. His journey reflects a national problem.
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Dermatologist Romain Prud’homme releases next-day appointments each evening at 6pm. “The day gets booked up within three minutes,” he says. “You could open 10 more clinics like this one, and they would all be just as busy. The shortage is huge.”
The French government has announced 27 additional dermatology trainees per year. However, specialists say that figure falls well short of what the system needs. Dr Pierre Hamann notes that dermatology has not seen the same increase in training places as other medical specialties. “The pressure is huge,” he says. “Patients come to us after having had no help for ages. They’re left without answers, and that can really take a toll on them.”
Some critics accuse dermatologists of worsening the shortage by favouring more lucrative cosmetic procedures. Dr Hamann firmly rejects that claim. He points to independent research by the Jean-Jaurès Foundation, which found cosmetic work accounts for less than 5 percent of dermatologists’ annual activity.
A Delayed Diagnosis With Serious Consequences
Charlotte Canonne noticed a bleeding mole on her foot in 2022. She searched the medical app Doctolib for an appointment but quickly realised none were available. She delayed seeking further help. Months later, the mole bled again and became infected.
Her GP photographed the lesion with a dermatoscope and sent the image to multiple dermatologists. Charlotte was soon seen by a specialist. The diagnosis was stage IV melanoma — the most advanced stage of the disease. “I really wasn’t expecting that,” she says. “To me, it was just a mole that had always been there.”
Physiotherapists Step In
In southern France, around 50 volunteer physiotherapists have trained to use dermatoscopes during routine appointments. The initiative came from dermatologist Georges Bes, who worked with URPS MK Occitanie, the regional body representing physiotherapists, to launch a one-year pilot programme.
“Physiotherapists see patients undressed, and that’s crucial,” Bes explains. “We may spot a lesion the patient wouldn’t otherwise have shown us.” During the pilot, the programme helped identify six skin cancers — four carcinomas and two melanomas. As a result, regional health authorities funded training for an additional 100 physiotherapists.
Can Artificial Intelligence Help?
In the Paris region, one centre uses AI technology to screen for skin cancer. Using 92 high-tech sensors, the system creates a 3D avatar of each patient and generates an initial skin assessment. Dermatologists then analyse the data and make a diagnosis.
Etienne Varlet, head of the France Dermatologie network, acknowledges that AI alone cannot replace a doctor. However, he argues it frees up dermatologists by handling time-consuming classification tasks. The technology costs €84 per screening and is not covered by France’s national health insurance. In its first year, it helped detect 30 melanomas. Five centres have opened nationally.
Despite promising results, no AI screening system has received official approval from the league of dermatologists. Dr Hamann urges caution. “If this technology ends up sending a huge number of patients to dermatologists and overwhelms our clinics,” he warns, “then it would be counterproductive.”
