Artificial intelligence in dermatology: Clinical promise and environmental impact.

Artificial intelligence (AI) is reshaping dermatology through diagnostic image analysis, clinical documentation, and patient communication tools. However, AI's environmental costs remain largely invisible to clinicians. Because training large AI models requires substantial energy, data center electricity use has risen alongside AI adoption, and cooling AI infrastructure centers increases water demand. These environmental burdens disproportionately affect resource-constrained communities. This creates an urgent priority for dermatology. Climate change directly threatens dermatologic health through global warming, increased UV exposure, air pollution, microplastics, expanded ranges of infectious dermatoses, exacerbation of inflammatory dermatoses, and more. The American Dermatological Association's 2025 Policy Statement on Climate Change commits the specialty to environmental stewardship. Accordingly, AI implementation must align with this commitment, not undermine it. Dermatology can minimize AI's environmental footprint through the following strategic choices: selecting computationally efficient models, sharing datasets to eliminate redundant training, implementing AI selectively where clinical benefit justifies environmental cost, and partnering with vendors committed to transparent reporting. Professional organizations can establish sustainability standards, require environmental impact reporting in research, and advocate for regulatory frameworks mandating vendor accountability. By demonstrating that technological innovation and climate responsibility are compatible goals, dermatology can serve as a model for sustainable AI integration across medical specialties.