Key takeaways:
- Most dermatology surgeons reported experiencing musculoskeletal injuries in 2020.
- Experts encourage dermatologists to practice injury prevention both in the office and at home.
Dermatologists are experiencing increasing rates of musculoskeletal injuries comparable to that of physicians in predominately surgical fields, according to a study.
“Dermatology, traditionally considered an office-based specialty, has not historically been as prone to ergonomic injuries as more surgically inclined fields,” Ophelia Pilkinton, BS, a medical student at the University of Tennessee Health Sciences Center, and colleagues wrote in JAAD Reviews. “However, the landscape of dermatology is evolving, with more procedural emphasis.”
According to the authors, the increasing frequency of these procedures has led to the rise of musculoskeletal injuries (MSIs) among dermatologists. A 2020 study in Dermatologic Surgery found that 90% of dermatology surgeons reported MSIs with pain in the neck (65%), lower back (63%), shoulders (61%) and upper back (53%) being the most common problem areas.
The study also found that 50% of these dermatologists continued to work despite the pain and 91% have not undergone an ergonomic evaluation. In comparison, approximately 30% to 40% of orthopedic surgeons reported MSIs, with 69% reporting an improvement in their symptoms after implementing ergonomic improvements, signaling a need for ergonomic interventions among dermatologists.
Ergonomic recommendations with a surgical focus
There are plenty of steps plastic surgeons and surgery-focused dermatologists can take to avoid MSIs, with prevention being the first, according to Lara Devgan, MD, MPH, FACS, attending plastic surgeon at Lenox Hill Hospital.
Lara Devgan
“Prevention begins with intentional setup and active recovery,” Devgan told Healio. “In the [operating room], I prioritize neutral neck alignment using ergonomic loupes, maintain proper foot positioning and wear supportive athletic footwear and compression stockings to promote circulation.”
According to the study, other preventive measures include positioning the patient as close as possible to the edge of the exam table to avoid the need to lean forward, angling the table so that the neck is not bent more than 15° and taking frequent breaks throughout the day to safely stretch strained muscles.
“Breaks are essential,” Devgan said. “Brief, structured pauses help reset posture, restore perfusion and prevent the microtrauma that accumulates during long procedures. There is compelling evidence that surgeons who take short breaks report lower rates of pain and higher cognitive stamina — both critical for safety and performance.”
The 2020 study in Dermatologic Surgery supports this claim, finding that dermatologic surgeons that took 1.5- to 2-minute targeted stretching microbreaks at 20- to 40-minute intervals reduced their postprocedure pain scores and increased their physical performance and mental focus.
According to Devgan, there are also out-of-office preventive measures surgeons can take to minimize MSI risk.
“At home, I emphasize spinal mobility, scapular stabilization and cross-dominance exercises,” Devgan said. “For example, I use my nondominant hand for tasks like brushing teeth or using chopsticks to promote neural plasticity and muscle symmetry. I also incorporate trapezius neuromodulator injections to reduce chronic shoulder tension — a common compensation pattern in surgeons.”
Devgan also told Healio that it is important for surgeons, especially women, to use the right tools.
“The surgical instrument industry has long defaulted to a one-size-fits-all model based on male anthropometry, even though a growing number of skilled surgeons — including a rising proportion of women — have smaller hands and different ergonomic needs,” said Devgan, who has a surgical instrument line for women. “Thoughtful modifications like slim handles, textured grips and balanced weight distribution can enhance both performance and physical well-being.”
Making these adjustments both at home and in the office can help preserve longevity in procedure-focused and surgical careers as well as promote personal excellence.
Ergonomic recommendations with an office focus
According to the authors, dermatology may be headed to a more procedural-based profession, but all dermatologists still spend significant time working at a computer and on their feet.
According to Rachel Day, MD, FAAD, chief medical officer of the teledermatology platform, Zest Health, and founder of OneSkin Integrative Dermatology, this comes with its own set of challenges.
“In traditional practice, dermatologists see a high volume of patients and spend much of the day performing repetitive tasks like suturing or leaning over during skin exams — motions that lead to neck, shoulder and back stress,” Day told Healio. “In teledermatology, the challenge flips: prolonged sitting, static posture and lack of movement can trigger similar issues, especially in the neck and lower back. Whether in person or remote, ergonomics matter.”
Dermatologists should ensure they are using an ergonomic chair that is well padded with adjustable lumbar support. The back should be reclined at a 110-degree angle and lowered to a level where both feet can rest comfortably flat on the floor, according to the study.
Additionally, keyboards should be placed beneath monitors and computer screens to allow the shoulders to relax and elbows to lay against the body.
“If done correctly, these ergonomic interventions… will be catalytic in decreasing the prevalence rates of MSI,” the authors wrote.
Day also recommended that dermatologists prioritize regular exercise as a part of MSI prevention.
“Strength training can help build a strong core,” Day said. “Foam rolling and other myofascial release techniques also help when I feel an area getting tight or strained before it leads to an injury.”
As dermatologists and dermatologic surgeons continue to experience increasing MSI risk with the rise of procedural interventions, both Day and Devgan stress the importance of caring for one’s personal health.
“A sustainable career requires not just technical mastery but physical mindfulness,” Devgan said. “Ergonomic innovation, inclusive design and proactive musculoskeletal care are not optional — they are foundational to excellence in modern surgery.”
Day agreed.
“Prioritize taking care of your own body just as thoughtfully as you care for your patients,” Day said.
For more information:
Rachel Day, MD, FAAD, can be reached at [email protected].
Lara Devgan, MD, MPH, FACS, can be reached at [email protected].
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