Abstract
Teledermatology has become an important tool for expanding access to dermatologic care, especially in geographically large countries such as Saudi Arabia. Saudi Arabia’s digital transformation and the shortage of dermatologists in rural regions have created favorable conditions for the adoption of teledermatology. Several platforms now provide virtual dermatology consultations. This narrative review aimed to explore teledermatology’s current status, acceptance, barriers, and future directions in Saudi Arabia. The literature indicates that both dermatologists and patients are generally receptive to teledermatology, particularly for follow-up care; however, concerns about the lack of physical examination and reduced interpersonal interaction persist. A SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis revealed that Saudi Arabia’s strong digital infrastructure, high smartphone penetration, and alignment with Vision 2030 are major strengths supporting teledermatology expansion. Key weaknesses include regulatory and reimbursement gaps, limited digital literacy, and the lack of dermatology-specific guidelines. Opportunities lie in extending services to underserved areas and integrating artificial intelligence, whereas threats include cultural resistance, cybersecurity risks, and potential inequities in digital access. In conclusion, teledermatology in Saudi Arabia is rapidly developing and shows considerable promise; however, its sustainability will depend on targeted investment, regulatory reforms, and efforts to promote equitable access.
Teledermatology use is expanding in Saudi Arabia, supported by strong digital infrastructure and Vision 2030.
Patients and dermatologists generally accept teledermatology, especially for follow-up care, though limits in physical examination remain a concern.
Priorities include improving regulations, digital literacy, and equitable access while leveraging AI to enhance dermatologic services.
Introduction
Teledermatology, a branch of telemedicine that delivers dermatologic care through digital communication technologies, has become increasingly important in modern healthcare.1,2 Its growth has been accelerated by advances in technology and the COVID-19 pandemic, which encouraged many healthcare systems to adopt remote care models. 3 Beyond serving as a temporary substitute during health crises, teledermatology is now viewed as a long-term solution to improve efficiency, expand access, and support patient-centered models of care. 4
Teledermatology is practiced in several ways. Functionally, it may involve consultation between physicians, triage to determine the urgency of referral, direct care in which dermatologists interact with patients via video or images, or follow-up to monitor treatment progress. 4 From a service-delivery perspective, 3 models are common: store-and-forward (asynchronous review of images and data), real-time (synchronous video consultations), and hybrid approaches that combine both methods.1-4
The advantages of teledermatology are well recognized. It improves access to specialist care in settings where dermatologists are concentrated in urban centers, reducing travel and wait times and enabling earlier diagnosis of serious conditions such as melanoma.5,6 It may also lower healthcare costs by reducing in-person visits and lost work time, 6 while maintaining good diagnostic performance when high-quality images are available. 7 Teledermatology is particularly valuable in managing chronic conditions such as psoriasis and atopic dermatitis, where ongoing monitoring and patient education are essential.8,9
Despite these benefits, limitations exist. Diagnostic accuracy may be affected by poor image quality, 10 and the inability to perform physical examinations remains a drawback, although teledermoscopy shows promise. 11 Concerns also extend to patient privacy and data protection, medico-legal liability, and disparities in access related to digital literacy and infrastructure.12,13
In Saudi Arabia, as of September 2020, a total of 2678 dermatologists were practicing, equivalent to 7.8 dermatologists per 100 000 individuals, a rate that surpasses those of several high-income countries, including the United States (3.4 per 100 000), Germany (around 6.5 per 100 000), and the United Kingdom (1.0 per 100 000).14-17 However, the distribution of dermatologists is strikingly uneven, with the majority concentrated in big cities such as Riyadh and Jeddah. This geographic disparity contributes to health service inequality and underscores the need for innovative solutions to bridge the gap. Teledermatology offers one such solution by enabling remote consultations, allowing patients in remote areas to receive timely care. 14 National strategies under Vision 2030 have already supported the deployment of digital health platforms across specialties, including dermatology.18,19 With smartphone penetration exceeding 95% in 2024 and a largely digitally literate population, especially among younger populations, 20 the infrastructure for scaling teledermatology in Saudi Arabia is strong.
This review aims to discuss teledermatology in Saudi Arabia within the broader context of national digital transformation efforts, highlight the current legal and regulatory framework, and summarize barriers, facilitators, and attitudes reported in the available literature. Furthermore, a SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis is presented to synthesize insights and guide future implementation.
Methods
This study employs a narrative literature review approach to highlight evidence on teledermatology in Saudi Arabia, with particular attention to its implementation, acceptance, regulatory environment, and challenges. Inclusion criteria were: (1) peer-reviewed studies, (2) published in English, (3) focused on teledermatology in Saudi Arabia or telemedicine studies with dermatology-related content, and (4) discussed use, acceptance, barriers, or stakeholder views. Studies were excluded if they did not relate to dermatology in Saudi Arabia or if they were purely opinion pieces without data or policy analysis. Relevant studies were identified through searches of PubMed, Scopus, and Web of Science using combinations of keywords such as “teledermatology,” “telemedicine dermatology,” “digital health,” and “Saudi Arabia.” Reference lists of key articles were also reviewed to find more studies.
Results
Although the available literature is limited, it has identified some key themes, including digital transformation in Saudi Arabia, the legal framework, and issues related to teledermatology acceptance, perceptions, and barriers.
Digital Transformation
Saudi Arabia’s Vision 2030 initiative has accelerated national digital transformation, including in healthcare. With smartphone penetration exceeding 95% in 2024 and widespread digital literacy, especially among youth, the country is well-positioned to expand teledermatology. The Ministry of Health (MoH) has taken the lead in deploying telemedicine services, particularly in underserved regions, by integrating teledermatology into major national initiatives such as the Seha Virtual Hospital and the Seha mobile app. The Seha Virtual Hospital, launched in 2022, is considered one of the world’s largest virtual hospitals, connecting over 130 public hospitals across Saudi Arabia through a centralized digital infrastructure. It provides consultations in more than 35 medical specialties, including dermatology, either in real time or through store-and-forward modalities. 21 In parallel, the Seha app allows individuals to access telemedicine services directly, including dermatology consultations. Patients can book scheduled appointments with licensed dermatologists or, during designated hours, join a virtual queue to consult with an on-call dermatologist. The app also allows users to upload images of skin lesions in advance, facilitating triage and preparation before the video consultation.22,23 Other MoH platforms, such as Sehhaty and Mawid, further support virtual care by enabling appointment booking, laboratory result access, and referrals to virtual clinics.24,25
Beyond MoH initiatives, a range of healthcare institutions also provide teledermatology services. These include academic medical centers affiliated with major universities, private hospitals and clinics, and military and security forces’ health facilities. In the private sector, teledermatology is primarily used to reduce waiting times and support follow-up care for chronic or cosmetic conditions. During the COVID-19 pandemic, however, even more informal tools such as WhatsApp and Zoom were temporarily adopted by clinicians to ensure continuity of dermatologic care. 26
Legal Framework
Teledermatology in Saudi Arabia operates under the broader legal and regulatory framework of the National Telemedicine Guidelines, issued by the Saudi Health Council through the National Health Information Center (NHIC) in 2020.27-29 These guidelines apply across all medical specialties and define telemedicine as the remote delivery of healthcare services via information and communication technologies, with operational definitions for modalities such as teleconsultation, telediagnosis, and telemonitoring. They mandate that all practitioners providing teledermatology must hold valid licenses from the Saudi Commission for Health Specialties (SCFHS), which regulates the scope of practice and professional conduct, and that facilities must be accredited by bodies such as the MoH and the Central Board for Accreditation of Healthcare Institutions (CBAHI). The guidelines also require that all telemedicine activities involving identifiable patient data comply with NHIC protocols and national cybersecurity policies. In addition, they include general provisions for informed consent, patient privacy, malpractice liability, and documentation standards. While this framework has enabled the nationwide expansion of virtual care, it presents regulatory gaps when applied specifically to dermatology. These include the absence of standardized imaging protocols, limited guidance on triaging cases between store-and-forward and real-time modalities, and unclear criteria for dermatology-specific malpractice liability. Addressing these gaps through tailored guidelines would help strengthen quality, safety, and long-term adoption of teledermatology in Saudi Arabia.
Acceptance, Perceptions, and Barriers
While several studies investigated the attitude toward and barriers (Table 1) to applying telemedicine in Saudi Arabia,30-35 a few studies paid particular attention to teledermatology. In a cross-sectional study involving 102 Saudi dermatologists, 78.0% believed they were qualified to use teledermatology, and 67.8% stated they would adopt it once it became available. Of the 102 participants, 59 had experience using teledermatology. Among these, more than half reported satisfaction with the clinical outcomes (65.9%), the system’s framework and reliability (64.4%), and perceived patient satisfaction (78.0%). Among the remaining 43 dermatologists who had not used teledermatology, the reasons cited included concerns that the system was ineffective or unconvincing (23.2%), difficulty reaching a diagnosis remotely (6.9%), potential patient refusal or preference for in-person visits (6.9%), lack of available technology at their facility (2.3%), and multiple combined reasons (60.7%). The results showed no significant variation based on age, sex, or years of professional experience. 36
Barriers to Teledermatology in Saudi Arabia.
Almaziad et al surveyed 107 Saudi dermatologists during the COVID-19 pandemic. More than half reported occasionally using teledermatology for diagnosis (58.9%) and management (55.1%), and two-thirds expressed willingness to use it in the future. The most used platform was image-based teledermatology (40.2%), followed by virtual clinics (32.7%). The perceived benefits of teledermatology included reduced risk of COVID-19 transmission (69.1%), continuity of care (61.2%), flexibility in time and location (55.2%), and shorter waiting times (43.8%). However, key concerns were the risk of misinterpreting transmitted information (79.8%), lack of personal interaction (45.2%), data security issues (29.4%), and the limitation that not all skin conditions can be accurately diagnosed via teledermatology (3.8%). 37 Interestingly, residents demonstrated poorer attitudes and lower acceptance compared to specialists and consultants. 37 This may be due to limited clinical experience, lower confidence in making remote diagnoses, and less exposure to telemedicine training. This finding highlights the need to incorporate teledermatology education into residency programs to build competence and confidence, ensuring future dermatologists are well-equipped to adopt digital healthcare models.
Although these studies consistently reported favorable attitudes toward teledermatology, the evidence remains largely descriptive and based on small, cross-sectional samples. Comparisons between studies show variations in perceived barriers and acceptance levels, likely due to differences in survey design, population characteristics, and the timing of data collection during or after the COVID-19 pandemic.
In a study involving 302 family medicine and general physicians in Saudi Arabia, 95.4% of whom were Saudi nationals, 82.1% reported using telemedicine to manage dermatological cases during the COVID-19 pandemic, compared to just 31.1% before, highlighting the pandemic’s significant role in accelerating teledermatology adoption. The most used tools included phone calls (57.6%), the Sehha application (42.7%), virtual clinics (27.5%), social media messaging (21.4%), and the 937 hotline (8.8%) for diagnosis, management, and follow-up. Despite this increased usage, 79.1% of respondents emphasized the need for dermatologists to be directly involved in telemedicine services for skin conditions. While age and gender had no significant impact, consultants and specialists were more actively engaged in teledermatology. 38
When considered together, physician- and patient-focused studies suggest that acceptance of teledermatology in Saudi Arabia is generally high but context-dependent. The predominance of self-reported satisfaction data, however, limits the ability to evaluate clinical effectiveness or diagnostic accuracy compared with in-person consultations.
In a survey of 1038 people living in Saudi Arabia, of whom 50.7% were students and 76.6% were women, 26.4% identified the availability of remote appointment review services as one of the most preferred factors when choosing a dermatologist. 39 This finding suggests that integrating such services into dermatological care could enhance patient satisfaction and potentially improve access to specialist care.
In a study investigating 166 patients (41.6% women) with various skin lesions (16.8% acne, 9.9% seborrheic dermatitis, and 6.2% atopic dermatitis), different teledermatology features were assessed. Only 10.6% of participants were uncomfortable with having their skin lesions photographed for a consultant’s opinion. 40 On the other hand, 76.4% were satisfied with the medical care received during the online consultation, and 93.8% reported that teledermatology eliminated their need for visiting a consultant. These perceptions did not change across the sexes. 40 However, Saudi nationals tended to have higher acceptance and satisfaction rates than expatriates, 40 suggesting that cultural familiarity, language, and trust in the healthcare system may influence acceptance and satisfaction with teledermatology services. Tailoring teledermatology services to address the specific needs and concerns of expatriates could help bridge this gap and improve overall engagement.
Recently, Alyousef et al assessed utilization, perceptions, and barriers relating to teledermatology health service among 200 patients in an outpatient clinic, of whom 69% were female and 71.5% had a university education or higher. Teledermatology had been previously used by 44.0% of participants, with 81.9% reporting satisfaction with the service. The most reported barrier to teledermatology among both prior users and non-users was the absence of a physical examination by a dermatologist (75.0%76.8%). Those with previous teledermatology experience reported greater comfort discussing dermatological issues virtually (41.0%) and intention to use teledermatology services in the future (59.0%) compared to non-users (25.0% and 28.0%, respectively). In contrast, individuals who had never used teledermatology expressed more concerns about safety and privacy (22.3% vs. 11.4%) and were more likely to lack trust in virtual consultations (21.4% vs. 6.8%). 41 It is worth mentioning that prior use was more common among men (56.5%) than women (38.4%), 41 suggesting concerns about privacy, modesty, and cultural sensitivities around sharing images or discussing skin conditions, especially with male healthcare providers. In focus group discussions about digital healthcare, participants expressed notable reluctance to use cameras during online consultations. This hesitation was deeply rooted in cultural and social norms, particularly among Saudi women, who often viewed the exposure of their faces on video, especially to male clinicians, as inappropriate. Some female participants reported preferring audio-only consultations or having a male relative act as an intermediary during digital consultations to align with cultural expectations. Participants feared that their images or videos could be misused. There was a general distrust in the security of digital platforms. 42
Overall, while the available studies highlight high levels of satisfaction and willingness to use teledermatology, the limited analytical depth, reliance on self-reported data, and absence of outcome-based measures weaken the evidence base. Future research should employ standardized tools, comparative designs, and objective clinical outcomes to evaluate the true effectiveness and sustainability of teledermatology in Saudi Arabia.
SWOT (Strengths, Weaknesses, Opportunities, and Threats) Analysis
The SWOT analysis was conducted by the authors of the current study, who represent different governmental sections within the MoH, based on a workshop involving potential stakeholders of telemedicine (Table 2).
SWOT Analysis for the Teledermatology Ecosystem in Saudi Arabia.
Strengths
A key strength is the alignment of teledermatology with the Saudi Vision 2030 framework, which emphasizes digital health transformation and improved access to care, especially in underserved and rural regions. 43 This strategic alignment is supported by governmental initiatives and funding directed toward health digitization. 43 Saudi Arabia also benefits from one of the highest internet and smartphone penetration rates in the Middle East, which provides a strong foundation for digital health delivery. 44 The country’s healthcare system includes well-equipped tertiary hospitals and dermatology specialists, particularly in major cities, who can anchor teledermatology networks. Additionally, growing interest from private healthcare providers and technology firms in public-private partnerships creates fertile ground for innovation and scale-up of teledermatology services. 16
Weaknesses
The implementation of teledermatology faces significant challenges in Saudi Arabia. Despite the progress, there are persistent regulatory gaps, especially concerning willingness to pay and reimbursement mechanisms for teleconsultations. This includes unclear policies around insurance coverage and provider compensation. In Saudi Arabia, healthcare services are financed through a mixed system. Saudi citizens receive free healthcare in public facilities funded by the government, while private-sector employees and most foreign residents are covered under mandatory employer-based health insurance schemes. However, out-of-pocket payments remain substantial, particularly for those outside these systems, such as the uninsured and dependents not covered by employer policies.45,46 These financial disparities influence the adoption of telemedicine, as individuals without insurance may be less willing or able to pay for virtual consultations. A cross-sectional study of 4232 uninsured individuals in Saudi Arabia showed that only 17.41% were willing to pay for telemedicine services. 47 Another barrier is digital literacy, particularly among older adults and residents of rural areas who may not be proficient in using telehealth platforms.47,48 Clinical standardization also remains a concern. Nationally endorsed protocols and quality assurance mechanisms for teledermatology are still lacking, leading to potential variability in service delivery and medico-legal concerns.3,48 Moreover, maintaining patient confidentiality and cybersecurity poses ongoing risks, especially considering increasing global threats to healthcare data.3,48 Cross-border licensing barriers also constitute a challenge to the expansion of teledermatology. Current medical licensing laws in Saudi Arabia, as in most countries, restrict physicians to treating patients within national borders. Providing teleconsultations to patients abroad generally requires additional licensing, which is rarely in place. Moreover, malpractice coverage and data protection regulations complicate international telehealth delivery, limiting opportunities for regional collaboration and cross-border dermatologic care. 49
Opportunities
Teledermatology can help expand dermatological services to geographically isolated and medically underserved populations. This can significantly reduce waiting times, improve early detection of skin diseases, and enhance continuity of care. 3 Technological advances, particularly in artificial intelligence and machine learning, offer prospects for enhancing diagnostic accuracy in remote consultations, with several pilot projects already demonstrating success globally. 3 There is also a growing regional demand for cross-border teleconsultations, and Saudi Arabia, with its strategic location and advanced healthcare infrastructure, could position itself as a leader in the Gulf and wider MENA region for dermatological care. However, realizing this potential will require addressing regulatory and licensing barriers that currently restrict cross-border teledermatology practice. 50 Furthermore, teledermatology platforms can serve as valuable tools for medical education and training, allowing healthcare professionals in peripheral areas to upskill through remote mentorship and continuous medical education. 3
Threats
Several external threats must be considered. Cultural resistance among healthcare providers, some of whom view telemedicine as inferior to face-to-face care, may hinder adoption. 42 The rapid pace of technological change also risks rendering teledermatology platforms obsolete without sustained investment in software updates and user training. Cybersecurity vulnerabilities are a significant concern, as any breach can lead to patient mistrust, reputational damage, and legal consequences. 51 Additionally, overreliance on telemedicine without appropriate triaging mechanisms may delay necessary in-person evaluations and exacerbate health disparities if digital access is not equitably distributed. 3
Limitations
As a narrative review, the study is subject to potential selection and interpretation bias, since it relied on published English-language sources and did not include unpublished policy documents. Moreover, the reviewed literature reveals notable gaps that hinder a comprehensive understanding of teledermatology in Saudi Arabia. Most available studies were cross-sectional, conducted in limited settings, and focused primarily on satisfaction, perceptions, or short-term feasibility. Few studies compared findings across populations or evaluated the robustness of evidence through standardized methodologies, which limits the ability to assess consistency and generalizability. There is also a lack of longitudinal and interventional research evaluating patient outcomes, diagnostic accuracy, cost-effectiveness, and the impact of teledermatology on healthcare utilization. Critical policy-related aspects, such as reimbursement mechanisms, licensing for cross-border care, and data security frameworks, remain insufficiently addressed. Evidence is equally scarce regarding the perspectives of patients in remote or low-literacy populations, as well as dermatologists’ training and readiness to integrate artificial intelligence into routine practice. The heterogeneity of study designs and outcome measures among the included articles further constrains direct comparison and quantitative synthesis. These limitations collectively underscore the need for robust, methodologically rigorous national research programs that integrate clinical performance assessment, policy evaluation, and technological innovation to strengthen evidence-based teledermatology implementation in Saudi Arabia. In addition, the SWOT analysis relied primarily on expert opinion rather than systematically collected data or external references; thus, each component reflects the authors’ synthesis of literature and stakeholder discussions, which may introduce subjective bias and limit reproducibility.
Conclusion
Teledermatology represents a promising avenue for enhancing dermatologic care in Saudi Arabia by addressing geographic disparities, reducing waiting times, and improving patient satisfaction. The country has made significant strides in developing the infrastructure and regulatory framework required to support teledermatology. However, to optimize the use of teledermatology, challenges such as provider training, image quality, legal clarity, digital inclusiveness, and evidence generation must be addressed. As Saudi Arabia continues its digital health transformation, prioritizing investment in and evaluation of teledermatology will be essential for building a more equitable and efficient healthcare system. Future research should include systematic reviews and longitudinal designs to provide a more comprehensive understanding of teledermatology implementation and outcomes in Saudi Arabia.
Footnotes
Author’s Note
Haytham A. Sheerah is now affiliated with International Collaboration, Chief Executive Office, Public Health Authority, Riyadh, Saudi Arabia. Ahmed Arafa is now affiliated with Department of Public Health and Community Medicine, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt. Yasir Almuzaini is now affiliated with Healthy Environments and Communities Sector, Public Health Authority, Riyadh, Saudi Arabia.
Funding
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The Global Center for Mass Gatherings Medicine in the Saudi Ministry of Health covered the publication fees.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.