Expert consensus on the management of acne in India

Acne, a common cutaneous disorder, is estimated to affect a significant proportion of the population at some point in their lifetime. It is one of the most common presentations reported in dermatological consultations in India. Treatment options for acne include topical, oral and procedural therapies. Patients with mild acne can be treated with topical therapies; however, those with moderate to severe acne require systemic cure. Oral antibiotic treatment, hormonal therapies and isotretinoin are the mainstay systemic therapies for acne. Additionally, procedural therapeutic modalities in dermatology include chemical peels, laser therapy, micro needling techniques, to name a few. Scientific advances are continually improving knowledge of acne and contributing to refinement of treatment options. Hence, it is vital for clinicians to regularly update their clinical practice patterns to reflect current standard. An experts’ panel discussion involving dermatologists from across India was conducted, to outline a practical approach for the management of acne. The present consensus document focuses on the assessment of acne, use of topical treatments, role of systemic therapy and procedures in treating acne and post-inflammatory hyperpigmentation. It also emphasizes the role of patient education and counselling on prophylactic and treatment strategies in acne management

Simplifying injectables for volumetric rejuvenation of face

Volumetric rejuvenation with fillers is a minimally invasive technique used for facial volume restoration. Volume restoration demands adequate knowledge of fat pads and vascularity of the face and the understanding of the depletion patterns. Volumetric restoration with injectable has witnessed a paradigm shift in the last decade with a global rejuvenation, acquiring a predominant emphasis over focal wrinkle filling to restore the depletion pattern of facial fat layers. The techniques used to achieve optimal restoration of facial volume revolve around zonal lifting and tenting, and the impact of treatment on one zone of the surrounding zones is crucial. A face mapping performed for filler technique has thus evolved, with many experts advocating varied techniques from global restoration to point lifts at key areas, to improve the outcome of filler injections, albeit safely, thus simplifying the process. A systematic approach to various techniques and the point lifts in various zones pertaining to the face structure in the Indian skin are highlighted in this article

Medical management of melasma: A review with consensus recommendations by Indian pigmentary expert group

Melasma is one of the most common hyperpigmentary disorders found mainly in women and dark-skinned patients. Sunlight, hormones, pregnancy, and genetics remain the most implicated in the causation of melasma. Although rather recalcitrant to treatment, topical agents such as hydroquinone, modified Kligman's Regime, azelaic acid, kojic acid, Vitamin C, and arbutin still remain the mainstay of therapy with sun protection being a cornerstone of therapy. There are several new botanical and non botanical agents and upcoming oral therapies for the future. There is a lack of therapeutic guidelines, more so in the Indian setup. The article discusses available evidence and brings forward a suggested treatment algorithm by experts from Pigmentary Disorders Society (PDS) in a collaborative discussion called South Asian Pigmentary Forum (SPF)

Chemical peels in melasma: A review with consensus recommendations by Indian pigmentary expert group

Melasma is a notorious dermatosis, often resistant to treatment. Chemical peeling constitutes an acceptable option of management of melasma (of any type and duration). In this article, as a group of experts from Pigmentary Disorders Society (PDS) in collaboration with South Asian Pigmentary Forum (SPF), we have tried to elaborate the various chemical peeling agents for the treatment of melasma. Besides, we have reviewed the indications, mechanism of action, rationality and the detailed procedure of peeling. The evidence in favor of various peeling agents have been summarized as well

Lasers in melasma: A review with consensus recommendations by Indian pigmentary expert group

Lasers have come up as the newest therapeutic modality in dermatological conditions including melasma. In this article, as a group of experts from Pigmentary Disorders Society in collaboration with South Asian Pigmentary Disorders Forum (SPF), we have tried to discuss the lasers which have been used in melasma and formulate simple consensus guidelines. Following thorough literature search, we have summarised the rationale of using the lasers and the supporting evidences have also been provided. It is clear that laser cannot be the first line treatment for melasma. However, it can be used as an adjuvant therapy in resistant cases, provided the selection of patient and counselling has been done properly