Dermatologist Salary in Texas 2026:
$218,670 Median

The published BLS OEWS May 2025 Texas median is $218,670, or $105.13 an hour, 33.5% below the national median of $328,730. It should not be read as an expected salary: the 25th percentile of $207,000 sits almost on top of the median while the 75th is $349,990, which indicates a sample weighted toward salaried academic and employed practice rather than toward practice owners.

Of the three published, San Antonio-New Braunfels at $336,030, far ahead of Dallas-Fort Worth-Arlington $232,910 and Houston-Pasadena-The Woodlands $207,000. A gap of about a hundred and twenty-nine thousand dollars between two large Texas markets is a sample composition artefact rather than a real pay gradient, and it should not guide a market decision.

Because dermatology has among the highest rates of private and physician-owned practice of any medical specialty, and a wage survey built on employer payroll captures salaried academic and employed dermatologists far more completely than practice owners. Practice profit is not wage income. That is why only about 780 dermatologists are counted statewide and why the published median sits a third below the national figure — it describes the employed segment rather than the specialty.

Not at the personal level — Texas levies no state or local income tax, so a dermatologist owes state tax on nothing, whether the income arrives as salary or as practice distribution. What does apply is the state franchise tax on business entities above a revenue threshold, which is directly relevant to a specialty commonly practised through professional entities, along with property tax at among the higher effective rates in the country.

The published wage data cannot answer that, and this page will not pretend otherwise. What can be said: Texas takes no personal income tax on practice income, its population growth and sun exposure generate substantial skin cancer and general dermatology volume, and access outside the major metros is constrained enough that recruitment there is genuinely competitive. For a practice income benchmark, specialty society compensation surveys sample physicians rather than payrolls and are the better instrument.

Because OEWS measures wages and salaries paid by establishments to employees, and a dermatologist who owns their practice is not an employee in the relevant sense — their income is practice profit, distributed rather than paid as wages. Dermatology has among the highest ownership rates of any specialty, driven by favourable procedure economics and low capital requirements relative to surgical fields. The consequence in Texas is a counted workforce of about 780 and a median a third below the national figure, both of which describe the salaried minority. Reading either as a statement about dermatology in Texas would be a straightforward error, and the metro table — $336,030 against $207,000 — confirms the sample is not measuring what the title suggests.

All of them are real BLS observations and none is a reliable expectation for a practising Texas dermatologist. The sample excludes practice distributions, the counted workforce is small, the three published metros contradict each other by more than a hundred and twenty-nine thousand dollars, and the 25th percentile sits within twelve thousand dollars of the median. Use the page to understand why published dermatology wage data behaves this way; use specialty compensation surveys for a practice income benchmark.

Practice structure first and above all, because it determines whether income arrives as salary or as distribution — and in this specialty ownership is the norm rather than the exception. Procedure mix second: Mohs micrographic surgery and cosmetic dermatology carry economics that general medical dermatology does not, and that is largely what the $349,990 seventy-fifth percentile and $534,030 ninetieth reflect. Payer mix third. Geography contributes something genuine, but far less than this metro table implies — rural and smaller-market Texas dermatology recruitment is competitive precisely because access there is thin.