Several countries have introduced transparency databases since the last assessment of conflicts of interest (COIs) in dermatology randomised controlled trials (RCTs) in 2004. We assessed the prevalence of financial COIs in dermatology RCTs and quantified payments from study sponsors to academic/clinical authors using transparency databases. Transparency databases are available in the US, France, Australia, Belgium, and the Netherlands. The UK has a non-compulsory database. We included RCTs from the top seven general medical journals and top ten dermatology journals published in 2019. The study included 83 RCTs, and COIs were identified in 69%. The highest prevalence was in exclusively industry-funded trials (46/47, 98%), which consisted of personal payments to an academic/clinical author (96% of trials) and employees/stockholders as authors (96%). Payments were identified for 31/56 (55%) academic/clinical first/final authors (median payment $28 746 US dollars, maximum $597 299, interquartile range $128 570), and 24/31 payments (77%) payments totalled >$10 000.