Most Common Skin Diseases in India
Based on the Global Burden of Disease Study 2017 and contemporary Indian epidemiological data, dermatitis (eczema) is the single most common skin disease in India, accounting for the highest years lived with disability (1.40 million), followed by urticaria, dermatophytosis (fungal infections), and scabies. 1
Epidemiological Hierarchy of Common Skin Diseases
The burden of skin diseases in India follows a distinct pattern that differs from global trends:
Top-Tier Conditions (Highest Disease Burden)
- Dermatitis/Eczema represents the highest disease burden, contributing 1.40 million years lived with disability (95% UI: 0.82-2.21 million) in 2017, with a 48.9% increase from 1990 to 2017 1
- Urticaria ranks second with 1.02 million years lived with disability (95% UI: 0.06-1.44 million), showing a 45.7% increase over the same period 1
- Dermatophytosis (fungal infections) has reached "unprecedented epidemic-like" proportions in recent years, with a stark increase in chronic, relapsing, and recurrent cases 2
- Scabies remains highly prevalent, particularly in rural areas, though age-standardized disability rates have decreased 1
Mid-Tier Conditions
- Bacterial skin infections including cellulitis and pyodermas are common, particularly in rural settings 3
- Psoriasis contributes significantly to disease burden with increasing prevalence 1
- Acne and rosacea affect substantial populations, particularly younger age groups 4
- Vitiligo represents a significant psychosocial burden 4
Regional Variations in Disease Patterns
Rural studies demonstrate that infective disorders comprise 59.1% of all skin diseases, with fungal infections being most common (54.52% of infectious cases), followed by eczemas (39.2% of non-infectious cases) 3. The 11-20 year age group shows the highest prevalence (31.4% of cases) 3.
Critical Context: The Dermatophytosis Epidemic
India is experiencing an unprecedented surge in dermatophytosis that warrants special attention 2:
- Clinical presentations are now multifarious with atypical morphology, severe forms, and unusually extensive disease affecting all age groups 2
- Tinea corporis and cruris show disproportionate increases, with extensive body surface area involvement and tinea faciei becoming more common 2
- Trichophyton verrucosum has emerged as the predominant causative organism (26 of 55 culture-positive cases), replacing T. rubrum as the traditional leader 5
- Chronic, relapsing, and recurrent cases have increased dramatically, suggesting changing epidemiology and possible antifungal resistance patterns 2, 5
Important Clinical Pitfalls
Do not assume Western disease patterns apply to India—the distribution differs significantly, with infectious diseases (particularly fungal) comprising a much higher proportion than in high-income countries 3, 1. Global clinical practice guidelines show poor correlation with actual disease burden in resource-limited settings, with only 15.5% of dermatology guidelines originating from Asia despite high disease prevalence 6.
Recognize that standard treatment workflows developed by the Indian Council of Medical Research prioritize 13 specific conditions: acne/rosacea, alopecia, bacterial infections, cutaneous adverse drug reactions, dermatophytosis, eczema/dermatitis, immunobullous diseases, psoriasis, scabies, varicella/herpes, vitiligo, urticaria, and rational corticosteroid use 4. These represent the conditions most relevant to Indian healthcare settings across primary, secondary, and tertiary care levels 4.
The disproportionately low number of dermatologists (with grossly unequal urban-rural distribution) means that ineffective treatment and mismanagement are commonplace, making accurate initial diagnosis by primary care providers critical 4.
Disease Burden Trends
Skin and subcutaneous diseases accounted for 4.02% of total years lived with disability in India in 2017, with an overall increase of 53.7% in age-standardized disability from 1990 to 2017 1. While infectious diseases like scabies and fungal infections show decreased age-standardized rates, their absolute numbers have increased due to population growth 1.