Devon, UK For many, living with a chronic skin condition like eczema can feel like a never-ending nightmare. This is the reality for 19-year-old Elle Jones, whose experiences highlight the plight of thousands of patients across the UK waiting in agony for much-needed dermatological care. Jones, an office worker from Devon, recently shared her harrowing journey, stating, "It's taken a big toll on my life."

Elle Jones suffers from severe eczema, enduring debilitating episodes of pain and relentless itching. She often finds herself bedridden for days at a time, struggling not only with the physical symptoms but also with the emotional toll of feeling "trapped" and "hopeless". Tragically, she is among countless individuals who face waiting times of up to 18 months for NHS treatments due to overwhelming demands on dermatology services, exacerbated by a surge in urgent skin cancer referrals and a critical shortage of specialist doctors.

Ive missed out on work, school, and college, Jones said, reflecting on how her condition has affected every aspect of her life. The impact of eczema is not merely physical; it has led to deep emotional scars as well. "I spent a long time hating myself," she added.

Statistics from the National Eczema Society reveal that eczema affects approximately one in ten people in the UK and one in five children, often becoming a lifelong struggle. Jones recounted a particularly dark period during a severe flare-up in college in 2021, describing it as a "never-ending tunnel with no light." Her skin was perpetually red and bleeding, leaving her feeling nearly unrecognizable. The emotional pain was as immense as the physical. "Its soul-destroying," she said, highlighting the profound impact of her condition.

Despite trying various steroid creams and moisturizers prescribed by her GP, Jones found no relief, prompting her referral to a dermatologist. However, even after a year of waiting, she still had no appointment. Following her move from college back to Devon, she faced an additional 12-month wait for light therapy, alongside an 18-month wait for skin allergy patch testing scheduled for the summer of 2024.

Jones underwent patch testing that revealed several skin reactions, prompting her to eliminate various makeup, hair, and nail products from her routine in hopes of finding relief. Unfortunately, these adjustments provided no respite. In north Devon, NHS data indicates that the longest wait for dermatology treatment can stretch up to two years, with overall waits extending beyond the national average.

Currently, Jones is trying out an immunosuppressant drug, which she claims leaves her feeling fatigued and sleeping through weekends. Despite the ongoing challenges, she remains determined to find effective treatment, emphasizing the importance of maintaining a positive outlook and continuing to fight her battle against the disease.

Meanwhile, the situation for other patients is equally concerning. According to Dr. Toby Nelson, a consultant dermatologist practicing in Cornwall and Devon, many patients suffering from inflammatory skin diseases are being overlooked. He explains that the rising number of skin cancer referrals, which constitute the highest category of NHS urgent cancer referrals, often takes precedence over those seeking treatment for non-life-threatening conditions like eczema, psoriasis, and acne. This has created a stark imbalance in the care provided to patients like Jones.

Dr. Nelson characterized these patients as "the forgotten many," expressing his concern for those who feel they are enduring a "living hell." Many have turned to private healthcare options, sometimes spending hundreds of pounds out-of-pocket, only to discover that some of the latest transformative medications can only be accessed through the NHS. For those stuck on waiting lists, he advises adopting a healthy lifestyle, as factors like sleep, alcohol consumption, and smoking can significantly influence skin conditions.

Ben Varco, 24, from St Austell, shares a similar story. He has been grappling with severe acne and was referred to dermatology through the NHS in July 2024. Now, nine months later, he has yet to receive any communication about his appointment. Varco expressed feelings of neglect, stating, "I feel kind of ignored, like its not really taken seriously." His pursuit of private treatment has already cost him over 1,000.

Liam Garner, 19, also turned to private care after experiencing a severe eczema flare-up in 2024. The teaching assistant from Cornwall recounted his struggle, stating, "The itch leads to bleeding... It keeps me up at night. I was off work for two months and had horrible anxiety." Both young men found it necessary to rely on family support to fund their treatments.

Research conducted by the All Party Parliamentary Group on Skin has shown that skin conditions can severely impact mental health, with 98% of those surveyed indicating that their emotional and psychological well-being is affected. Andrew Proctor, chief executive of the National Eczema Society, voiced concerns over the treatment disparities faced by patients with eczema and other inflammatory skin conditions, describing them as being treated like "second-class citizens" by the NHS.

In September 2024, the British Association of Dermatologists (BAD) released a workforce report highlighting the alarming situation in dermatology services. The report stated, "It is clear that demand for our services is outstripping the capacity of our workforce to deliver care," while an NHS dermatology report from 2021 pointed to a severe shortage of dermatology training posts as a contributing factor.

The Department of Health and Social Care has acknowledged the crisis, with a spokesperson stating that it is "unacceptable that patients have been left waiting in pain." They noted that efforts have been made to expedite two million appointments sooner than expected, some of which were in dermatology. Plans for workforce improvements are set to be published in the coming summer.

Dr. Carolyn Charman, clinical vice-president of BAD, emphasized the need for the NHS to build upon innovative diagnostic schemes for skin cancer to alleviate the strain on dermatology services. She pointed to opportunities to leverage digital technology, patient imaging, and artificial intelligence to improve care. Patients enduring long waits are encouraged to communicate with their hospital teams and seek guidance from reputable online resources, such as the BAD website.

Efforts to innovate care delivery include the introduction of "super clinics" at the Royal Cornwall Hospitals Trust, where one specialist oversees multiple resident doctors and specialist nurses. Additionally, a community imaging service operated by healthcare assistants has been implemented to help manage the growing demand.

In the age of social media, some patients are finding solace and support through online communities. Katie Mackie, 28, and Maia Gray, 30, both from London, have emerged as "skin positivity influencers," advocating for awareness and support for those struggling with skin conditions. Mackie, who has campaigned for the charity Changing Faces due to her own battles with eczema, encourages others to share their experiences. "Tell people what you're going through, don't isolate yourself," she advises, also noting the availability of free therapy and charity support resources. Gray, who has lived with acne for 17 years, adds, "Many people are struggling mentally with this. Whatever your skin condition is, continue to live life."

As the stories of Jones, Varco, Garner, and countless others reveal, the need for timely and effective dermatological care is more pressing than ever. With the system under strain and patients feeling forgotten, it is crucial that the NHS addresses these challenges to ensure that those suffering from skin conditions receive the care and understanding they deserve.