A commentary published online on 10 October 2026 in the Journal of the American Academy of Dermatology takes aim at a structural contradiction in dermatologic publishing: open access is widening the reach of clinical research while shifting the cost of publication onto authors who often have no funding to pay it.

Written by İsmail Hakkı Ünal and Jane M. Grant-Kels, the piece — titled "The Open Access Paradox of Unfunded Authorship in Dermatology" — frames the problem as one of equity within the specialty's own research pipeline. The authors' central term, "unfunded authorship," describes investigators, clinicians and trainees who produce publishable dermatologic work without institutional, governmental or industry grant support.

What is the paradox the authors identify?

The paradox sits at the intersection of two publishing trends. Open access removes subscription paywalls, making dermatology research freely available to clinicians, patients and researchers worldwide. But most open access journals recover their costs through article processing charges billed to authors. For funded investigators, those charges come out of grant budgets. For unfunded authors, they come out of pocket — or the work does not get published at all.

The consequence, as the title implies, is that the dissemination model designed to democratize access to dermatologic science may simultaneously restrict who can contribute to it. Residents, early-career dermatologists, clinicians in low-resource settings and investigators at institutions without publication subsidies face the sharpest version of this barrier.

Why does this matter for dermatology specifically?

Dermatology publishes a substantial share of its literature through the major society journals, and JAAD itself carries the imprimatur of the American Academy of Dermatology. A commentary appearing in the specialty's flagship journal signals that the leadership of dermatologic publishing is treating the economics of authorship as a field-level concern rather than a peripheral administrative issue.

Grant-Kels, a longtime JAAD editor and frequent contributor to the journal's editorial pages, has repeatedly used that platform to examine publishing ethics and the forces shaping how dermatologic evidence reaches the clinic. This latest piece, co-authored with Ünal, extends that editorial line to the question of who bears the financial burden of open dissemination.

What questions does the commentary raise for the field?

The article's framing invites several practical questions for dermatology departments and journal publishers:

• How do article processing charges affect the composition of authors — and the topics they study — in the dermatology literature?
• Do waiver and discount programs at dermatology journals reach the unfunded authors who need them most?
• Should specialty societies absorb publication costs for members without grant support, and under what criteria?
• Does the current open access economy systematically favor well-funded academic centers over community clinicians and international researchers studying inflammatory skin disease, skin cancer and other conditions relevant to their populations?

The authors do not present these as rhetorical concerns alone. By naming the problem explicitly in the title — a "paradox" — they position it as a contradiction that publishers, funders and academic dermatology departments will need to resolve deliberately rather than one the field can outgrow on its own.

What happens next?

The commentary's appearance in JAAD on 10 October 2026 places the economics of authorship on the agenda of dermatology's publishing establishment. Whether journal publishers, specialty societies and academic departments respond with structural fixes — broader charge waivers, institutional subsidies or society-funded publication pools for unfunded investigators — will determine whether open access in dermatology fulfills its access promise for authors as fully as it already does for readers.