Background <p>Contributions to global dermatology from the Arab World in general, and Palestine in particular, have been limited. The protracted conflict-related challenges and the fragile health system are barriers to development in national dermatological practice and research. This commentary discusses these challenges and proposes contextual solutions.</p> Main body <p>The healthcare system has failed to provide affordable, accessible, and effective dermatological services. Limited patient access to health services can be ascribed to disorganized primary care and inadequate referral coordination across levels of care, leading patients to seek private dermatological services. This is exacerbated by a shortage of dermatologists and poor dermatological practices among healthcare professionals. Moreover, the limited production of dermatological research is attributed to the shortage of specialized human resources, the poor research infrastructure, and the lack of interest in dermatological research. However, two educational developments have been introduced, but are unlikely to result in significant overall progress in dermatological practice and research: a new dermatology residency training and a skincare academy with a bachelor’s program affiliated with a major Palestinian university.</p> Conclusions <p>Efforts to strengthen local dermatological care should capitalize on the recent developments to build capacity in primary care, enhance coordination with specialized services, and improve the new residency program design.</p>