Indian Dermatologists Research Articles

A Survey on Neonatal and Infant Skincare: Indian Dermatologists, Pediatricians and Cosmetologists' Perspective on Product Prescription Pattern and Parents’ Awareness

Objective: Newborn skin is incredibly delicate and vulnerable to issues like dermatitis and infections, which are prevalent in infants in India. To ensure optimal care and results, parents and caregivers must know about infant skincare products and implement a targeted and comprehensive skincare routine. This study aimed to gain insight into the best baby skincare practices as per dermatologists, pediatricians and cosmetologists (Healthcare Professionals [HCPs]), on product prescribing patterns in India and parent’s awareness of the neonatal skincare armamentarium. Methods: An online survey was conducted to assess the best baby skincare practices as per HCPs on product prescribing patterns in India and parent’s awareness of the neonatal skincare armamentarium. Here, a total of 59 HCPs participated in this survey on Cetaphil baby products range (Galderma) conducted to find out the prescribing pattern for baby skincare products and to record parents’ awareness of the available products. Results: The survey showed that dry skin (29%), atopic dermatitis (28%) and diaper rash (15%) were the most encountered skincare problems by HCPs in newborns. The HCPs reported that liquid cleansers (26%) and syndet bars (25%) are some of the most prescribed products and were deemed fit for the majority of the newborns (49%), owing to their gentle and non-irritating properties. A complete skincare regime (cleanser, lotion, diaper cream) was also prescribed to most infants (69%). Moreover, most parents were aware of liquid cleansers for newborns (63%) and the majority of them (62%) knew the difference between syndet bars and normal soaps. Conclusion: Proper product prescription and utilization by HCPs and parents is key to ensuring healthy skin development in newborns. Following an extensive skincare regime inclusive of gentle cleansers, moisturizing lotions and barrier creams from an early stage is essential to protect newborn skin and achieve the desired results.

Role of skin circadian rhythm and the effect of day and night cream: a survey on Indian dermatologists’ and cosmetologists’ views and patient experiences

Background: The skin plays different functions during the day and night to adapt to the changing environments. Various specialized creams are available to meet these skincare needs. The present study was conducted to explore the perspective of Indian dermatologists and cosmetologists on skin’s circadian rhythm and assess the effectiveness of a particular day and night cream formulation. Methods: A non-interventional, questionnaire-based study was conducted as part of a survey series on multiple dermatology products across India. Every month, a product-specific survey link was released to these registered doctors, and each doctor could take up to 10 surveys for a maximum of two products. A total of 379 healthcare professionals (HCPs) took the survey on the day and night cream and reported experiences of 2085 patients regarding the use of these products. Results: The doctors believed that for majority of the patients (1997, 97%), required day and night cream to maintain their skin’s circadian rhythm. Most patients (1440, 70%) were compliant with day and night care cream regimens. Most patients (966, 47%) were highly satisfied with the use of day and night cream, with majority of the patients (1028, 49.4%) experiencing considerable reduction in dark spots and uneven skin tone. Most patients (971, 47%) felt that the application of day and night cream left their skin moisturized and rejuvenated. Conclusions: The use of day and night cream improved skin condition and hydration, addressing circadian rhythm imbalance. Indian HCPs understand the impact of skin circadian rhythm imbalance and promote a comprehensive skincare regimen to patients.

Niacinamide and sea daffodils-based bright healthy radiance product range for dark spots: a survey of Indian dermatologists' views and patient insights

Background: Niacinamide has demonstrated its ability to treat dark spots in various studies. The present study evaluated the perspectives and experiences of healthcare professionals (HCPs) and patients with the niacinamide and sea daffodils-based bright healthy radiance product range for dark spots. Methods: This study was part of a survey series focusing on various dermatology products across India. The study involved over 1000 registered HCPs including dermatologists, pediatricians, and cosmetologists nationwide. A total of 203 HCPs participated in the survey on the niacinamide and sea daffodils-based product range. A well-structured questionnaire with 15 questions was used to collect the data and the responses were recorded by the HCPs. Results: Out of the total of 1086 individuals who participated in the survey, majority were females (774, 71.2%). Most HCPs reported that nearly 15-30% of their patients present with dark spots. A vast majority of individuals reported extreme satisfaction with the use of niacinamide and sea daffodils-based bright healthy radiance product range (493, 45.5%) and rated its effectiveness as excellent (511, 47.2%). HCPs reported that most patients showed major improvement in skin brightness (529, 48.7%), while the rest of them (418, 38.4%; 137, 12.6%) experienced good and satisfactory improvement respectively. Importantly, an even skin tone was achieved in most of the patients (492, 45.8%) after the application of the product range. Conclusions: A personalized approach of using niacinamide and sea daffodil-based products according to the patient's skin types and skin conditions is essential to remove blemishes and dark spots and improve skin brightness.

Deciphering the landscape of hereditary angioedema in India: Perspective for Indian dermatologists.

Deciphering the landscape of hereditary angioedema in India: Perspective for Indian dermatologists.

Place in therapy of topical amorolfine in the management of onychomycosis and tinea pedis: A survey to understand Indian dermatologists’ perspective

Place in therapy of topical amorolfine in the management of onychomycosis and tinea pedis: A survey to understand Indian dermatologists’ perspective

A Survey of Treatment Practices in Management of Chronic Urticaria Patients among Dermatologists of India

Abstract Introduction: Chronic spontaneous urticaria (CSU) is a frequent problem encountered by dermatologists where treatment response is often unsatisfactory. This exerts a heightened responsibility on dermatologists to tailor their treatments according to each patient. Aims: The aim of the present study was to evaluate the therapeutic, diagnostic approaches of Indian dermatologists to CSU patients and the need to further generate a base for the creation of Indian urticaria guidelines. Materials and Methods: A questionnaire-based survey was conducted among practicing dermatologists of India. Conclusions: At the end of this questionnaire-based study, we concluded that there is a wide variation in the treatment practices among practicing dermatologists of India.

Prescription Practices Regarding the use of Systemic Drugs in the Management of Patients with Chronic Pruritus amongst Indian Dermatologists - A Questionnaire Based Survey.

Chronic pruritus poses a significant challenge to treating physicians due to multitude of underlying causes and varying treatment strategies. Several topical, systemic, and physical modalities have been tried with variable success. Prescription practices in chronic pruritus are influenced by differential knowledge and experience of physicians, patient-related factors, and resource availability. The purpose of this survey was to observe the current pattern of practice in Indian dermatologists in the management of chronic pruritus and to identify practice gaps particularly regarding the use of various systemic agents as antipruritics. A previously validated questionnaire was sent to consultant dermatologists across India between January 2020 and July 2020. The questionnaire was comprised of six questions (multiple-choice questions as well as open-ended questions) regarding the use of antidepressants, cyclic gamma-aminobutyric acid (GABA) analogues, opioid antagonists, antihistamines, and alternate therapies in the management of chronic pruritus. A total of 700 dermatologists completed the questionnaire (response rate 70%). Overall, antihistamines were the most common drug prescribed in chronic pruritus (more than 95% respondents). Other systemic agents such as opioid antagonists, gabapentinoids, and antidepressants were prescribed by 22.42%, 71.85%, and 75.29% respondents, respectively, in chronic pruritus as either monotherapy or in combination with antihistamines in specific types of itches. Among antidepressants, tricyclic antidepressants (TCAs) (69.29%) were prescribed most often, followed by selective serotonin reuptake inhibitors (SSRIs) (32.29%) and serotonin and norepinephrine reuptake inhibitors (SNRIs) (9.14%). Other treatment options such as omalizumab, thalidomide, ondansetron, ursodeoxycholic acid (UDCA), and rifampicin were used by 10% respondents to alleviate pruritus in special situations. This survey revealed the redundant practice of prescribing antihistamines in chronic pruritus irrespective of etiology among Indian dermatologists. It also revealed a differential approach regarding use of systemic agents such as gabapentinoids, opioid antagonists, and antidepressants, in academic and non-academic institutions. The survey emphasized a barrier in writing prescription of systemic agents such as opioid antagonist and SNRIs due to lack of knowledge and experience, fear of side effects, and inadequate available evidence.

Fellowship and mentorship opportunities in allergic skin disorders for Indian dermatologists

Fellowship and mentorship opportunities in allergic skin disorders for Indian dermatologists

Guide for an Indian Dermatologist to Plan Their Future in the United Kingdom

The United Kingdom (UK) is nowadays a sought-after destination to relocate for work. However, the path is confusing and unclear. This article aims to guide the Indian dermatologists who wish to work in the UK national health service.

A multicentric, prospective, observational study evaluating the use patterns of Sebium night peel for acne-prone skin and associated conditions

Background: Acne is a common skin disorder that affects both adolescents and adults and is categorized as an inflammatory dermatosis. Persistent adult acne is prevalent in more than 80% of cases. Chemical peels are widely used in acne therapy due to their various benefits, including exfoliation, acne lesion reduction, complexion radiance improvement, and scar repair. The procedure, consisting of 2 to 8 sessions, is ideal for adult women with oily skin, acne breakouts, and concerns about photoaging and complexion radiance. Methods: A cohort of Indian dermatologists were provided a questionnaire related to the quantum of weekly acne patients seen and their clinical expertise regarding the use of Sebium Night Peel containing 15% glycolic acid, the Fluidactiv™ patented complex & D-panthenol. These results were later analyzed using a standardised visual analogue scale. Results: The study enrolled 826 patients, and complete responses were received from 73 dermatologists practicing clinical and aesthetic dermatology across major cities in India. The study revealed that 97% of dermatologists would recommend the Sebium Night Peel as a chemical peel for patients with acne and acne-related complications. The majority of dermatologists rated the peel's tolerability and safety as "good" across various evaluation criteria. Additionally, 97% of dermatologists reported no safety concerns associated with the Sebium Night Peel. Conclusions: This study establishes the Sebium Night Peel as a preferred and effective chemical peel for managing acne-prone skin and associated conditions, as endorsed by dermatologists across India.

Therapeutic Inertia in the Management of Psoriasis: A Quantitative Survey Among Indian Dermatologists and Patients.

PurposeThe primary objective of the study was to understand the therapeutic inertia in treatment and management of plaque psoriasis among dermatologists, along with determining the preferred treatment choices for management of plaque psoriasis; it also included the resulting treatment satisfaction among patients. The secondary objective was to identify the gaps in terms of knowledge and attitude among dermatologists and the expectations of patients.Patients and MethodsA multicentre, cross-sectional quantitative survey was conducted among dermatologists and patients with moderate to severe plaque psoriasis across India. The interviews were conducted either face to face or via telephone between September and November 2020, using structured and validated questionnaires based on specific themes. The data obtained were statistically analysed, wherever applicable.ResultsOverall, 207 adult patients with moderate-to-severe plaque psoriasis and 303 dermatologists were interviewed. Post experiencing symptoms, 44% of the patients visited general physicians for treatment and there was an average 7.8-month delay by the patients to consult a dermatologist. Approximately one-fourth of patients used home remedies before seeking medical help. One-third of dermatologists used the Psoriasis Area and Severity Index (PASI) for assessing the disease severity. Majority of dermatologists preferred combination therapy for their patients. The lack of quick resolution and side effects were the major reasons for changing the treatment. Overall, only 35% of the patients complied to current treatment. Satisfaction with existing forms of therapies was highest for mild plaque psoriasis (62%) as confirmed by dermatologists, while 52% of the overall patients were satisfied with their therapy. Majority of the patients (64%) affirmed living with plaque psoriasis impacted their lives.ConclusionThis first-of-its-kind survey in India highlighted the gaps in terms of the disease journey between dermatologists and patients. The survey emphasises the need for shared decision-making and may benefit dermatologists in suggestive modifications of the treatment algorithm and disease management in clinical settings.

Teledermatology in the Era of COVID-19, Perspective from a Developing Country

Background: With the advent of the COVID-19 pandemic, the medical fraternity across the world, including India, is facing unprecedented challenges, and to cope with this, creative solutions are required. During this COVID-19 crisis, telemedicine has emerged as a weapon to reduce disease transmission while continuing with non-COVID care. Objectives: The purpose of this study is to highlight the changes and challenges in dermatology practice, to explore the usefulness of tele-dermatology during the pandemic, and to understand the dermatologist's perspective. Materials and Methods: An online cross-sectional survey was done among Indian dermatologists to evaluate the changes in their practice, impact of telemedicine, and their experience, during COVID-19. Results: A total of 177 responses from qualified Indian dermatologists were analyzed. Teleconsultation was done by 20.5% of consultants before lockdown which increased up to 82% after lockdown. Most commonly preferred device was mobile phone (83%), and the most common format was chat applications (WhatsApp/Messenger) (55.7%). Discontinued consultation was due to technical issues, patient's misbehavior, and poor-quality clinical photographs. Only 13.5% of practitioners were satisfied with teledermatology. Conclusion: With the onset of the COVID-19, the shift of clinical care to telemedicine practice has hastened. However, continuous investment in systems and technology as well as refinement of regulations for telemedicine is needed to sustain its widespread adoption.

Expert opinion on current and emerging treatment options in androgenetic alopecia and telogen effluvium: an Indian perspective

<p class="abstract">The diagnosis and management of hair loss needs an organized and systematic approach for recognizing pattern of hair loss and identification of hair loss etiology. Early and specific diagnosis is essential to initiate appropriate treatment in the early phases of hair loss. Topical minoxidil and oral finasteride are the only approved drugs for androgenetic alopecia (AGA). Various other treatment options are widely used but have limited clinical evidence. Similarly, there are no specific treatments recommended for telogen effluvium (TE). However, the treatment may become challenging with increasing availability of new formulations and drugs with no substantial evidence to support them. Multiple focused group discussions were conducted among Indian dermatologists to gain expert opinion on appropriate management of AGA and TE in the current scenario. This article summarizes the consensus clinical viewpoints for topical and oral medications, role of nutritional supplements, and other adjunctive therapies in managing AGA and TE. The panel highlighted that the choice of treatment for AGA and TE depends on the individual hair loss pattern and response to medications. A brief discussion on the use of shampoos and procedures has also been highlighted. </p>

The impact of superficial dermatophytosis on quality of life: A cross-sectional observational study

: The Indian dermatologists are witnessing an epidemic of sorts when it comes to superficial dermatophytosis cases in the last decade. At the receiving end of this epidemic are the patients who are suffering due to impaired quality of life. We tried to assess the impact of tinea on quality of life (QoL) of the patients.: To assess the impact of superficial dermatosis on quality of life using the Dermatology Life Quality Index (DLQI) questionnaire.: Cross-sectional, Observational study.: All patients between the age group of 18 to 70 years presenting with superficial dermatophytosis of more than 3 weeks duration were included after confirming the diagnosis with KOH mount. The patients filled in the DLQI after which scores were calculated and the effect on QoL was assessed. : Out of the 170 patients included in the study, majority of them (77, 45.3%) felt that tinea had a very large effect on their QoL and a very few patients (7, 4.1%) felt that tinea had a small effect on their QoL. Out of the 36 (21.2%) patients who felt that their condition had an extremely large effect on their QoL, majority of the patients had tinea corporis et cruris et faciei.: Superficial dermatophytosis has a very large effect on the Quality of Life of the patients and it impacts their lives adversely leading to psychological, social and financial problems.

Pattern of use of biologics in psoriasis among Indian dermatologists - A cross sectional survey.

Background and Aims Biologics are a relatively new class of highly effective drugs in the management of psoriasis. They act on specific immune processes, achieve rapid and sustained clearance and do not cause target organ damage unlike conventional systemic therapy. It appears that their use in our country is not as widespread as in developed nations despite these benefits ; their prohibitive cost may be a major factor for the limited usage. This survey aimed to find out the extent of use and factors hindering usage of biologics for the management of psoriasis by Indian dermatologists. Methods It was a cross-sectional questionnaire based study. The questionnaire was designed after a focussed group discussion, followed by validation. The survey was sent in the form of a link to Indian dermatologists. The responses were recorded in excel-sheet and the data was analyzed by SPSS ver 25. Results Of the 310 participants who took part, 287 completed the survey. Two hundred (70%) were users of biologics, while 87 (30%) had never used them. Cost was the major factor which prevented biologic use. Majority of the respondents used biologics in less than 2 cases per month. Secukinumab was the most common biologic used followed by etanercept. The factors which determined choice of biologics were convenience, cost, previous experience, co-morbid conditions and recommendations by an expert. Limitations A small sample size was the limitation of the study. Dermatologists who do not use biologics may be under-represented in the study. Conclusions Biologics are not used optimally by Indian dermatologists for management of psoriasis. The cost, fear of adverse effects, lack of awareness and inadequate felt need are major factors which prevent their regular use.

Awareness of psychodermatology in Indian dermatologists: A South Indian perspective.

This study was aimed to survey the awareness, knowledge, practicing patterns, and attitudes of dermatologists toward psychocutaneous disorders in a South Indian State. The questionnaire-based study was performed from August 1 to October 31, 2019. Study participants included 123 dermatologists. The questionnaire consisted of nine multiple-choice questions and two open-ended questions regarding knowledge, practicing patterns, and attitude to psychodermatology. Forty five (36.6%) dermatologists completed this online survey. Out of them 73% were women and 40% were trainees. Nine respondents (20%) had frequent experience with psychodermatology, but only 6 (13.3%) were very comfortable in diagnosing and treating psychodermatology patients. Vitiligo was the disease with maximum respondents reported encountering >10 patients monthly with psychologic co morbidities (30, 66.7%). The most common diagnoses which required psychiatric referral were delusion of parasitosis (22.2%), trichotillomania (20%) and neurodermatitis (8.9%). Thirty six respondents (80%) were unaware of any patient or family resources on psychodermatology. Thirty-nine respondents (86.7%) expressed interest in attending educational events on psychodermatology. Survey results showed high need of liaison clinics of dermatology and psychiatry. Many dermatologists lack proper training in treating psychodermatology cases while they may be the sole service provider to the patients. We propose incorporation of psychodermatology curriculum in residency training programs.

Impact of COVID-19 Pandemic on Dermatology Practice in India.

Background:COVID-19 pandemic has disrupted healthcare systems throughout the globe. It has affected dermatology practice to a great extent. Since most of the consultations (except emergencies) in dermatology are deferred as a precautionary measure, dermatologists have taken the route of virtual appointments in order to continue treating patients in the present lockdown state. However, the concept of telemedicine is quite new for doctors as well as for patients in India.Material and Methods:An online questionnaire was circulated among Indian dermatologists which included participant demographics, changes in their practice and teaching during COVID-19, use of virtual or e-health technologies, and attitudes/opinions on their experiences. We also wanted to understand doctor perspectives on their own roles, wellness, and hospital responses to the pandemic.Results:A total of 260 responses from qualified dermatologists of different parts of India were received between 1st and 8th April 2020 and were analyzed. Two-thirds of the respondents were within 10 years of starting practice. Virtual consultations have increased by almost three-fold during the pandemic, which is a major change noticed in the practice when we compare before and during the pandemic. Earlier the focus of teledermatology (TD) was mainly for follow-up care (85%), whereas during the pandemic, both new and follow-up patients were provided virtual consultations. The number of patients coming to them for a consultation has drastically reduced. Only 2% of the responders are still performing minor procedures with proper care. Almost two-thirds do not have systems in place to train their residents and fellows due to the disruptions caused by the pandemic. The rest of them have started to take the virtual route of teaching through webinars, virtual rounds, and providing access to online journals to continue their teaching. Only 18.6% of dermatologists at work were provided with personal protective equipment. TD has opened new doors to virtual consultation and it was evident that 54.4% of doctors are willing to continue it in the future even after the pandemic is over.Conclusion:TD platforms hold great promise to improve access to high-quality dermatologic care in the future. Results from this survey of Indian dermatologists suggest that TD is the future of dermatology as it will be accessed by patients in remote areas and it is a cost-effective move for the patients.

Indian Dermatologists Wield Technology to Combat COVID-19!

Indian Dermatologists Wield Technology to Combat COVID-19!

Management of aging skin: A questionnaire-based study among Indian dermatologists.

With increased life expectancy, the desire to look younger has increased. Hence, many patients approach dermatologists for antiaging treatment. However, data regarding management of skin aging in India are scarce. To understand management patterns for skin aging among dermatologists in India. Overall, 147 Indian dermatologists were administered a questionnaire-based survey about patient characteristics, signs of skin aging, treatment options, and cost. Among all the patients coming for dermatologists' consultation, 10%-40% were for antiaging treatment. About 70% dermatologists opined that majority of patients aged 30-40years consulted for antiaging treatment, and the male to female ratio was 3:7. Approximately 46% of dermatologists felt that antiaging treatment should be initiated by the age of 30. Common signs of aging were wrinkles, pigmentation, dull skin or complexion, and dry skin. Based on patient's age and sex, dermatologists prescribed a combination of 2-4 products, which included antioxidants, retinoids, growth factors, and moisturizers. Improvement was assessed by photographic and clinical evaluation, and by patients' satisfaction (55%). Effect of the antiaging products was evident within 4-6months. Earliest improvement was noted in dry skin and dull complexion. Average extent of improvement noted by 6months was approximately 20%-30%. The average monthly expenditure on antiaging treatments was 2000-4000 INR. Both men and women seek clinical treatment for skin aging in India. Dermatologists prescribe a combination of 2-4 products, including antioxidants, retinoids, growth factors, and moisturizers. Available antiaging therapies show an average improvement of up to 30% by 6months.

Synchronizing Pharmacotherapy in Acne with Review of Clinical Care.

Acne is a chronic inflammatory skin disease that involves the pathogenesis of four major factors, such as androgen-induced increased sebum secretion, altered keratinization, colonization of Propionibacterium acnes, and inflammation. Several acne mono-treatment and combination treatment regimens are available and prescribed in the Indian market, ranging from retinoids, benzoyl peroxide (BPO), anti-infectives, and other miscellaneous agents. Although standard guidelines and recommendations overview the management of mild, moderate, and severe acne, relevance and positioning of each category of pharmacotherapy available in Indian market are still unexplained. The present article discusses the available topical and oral acne therapies and the challenges associated with the overall management of acne in India and suggestions and recommendations by the Indian dermatologists. The experts opined that among topical therapies, the combination therapies are preferred over monotherapy due to associated lower efficacy, poor tolerability, safety issues, adverse effects, and emerging bacterial resistance. Retinoids are preferred in comedonal acne and as maintenance therapy. In case of poor response, combination therapies BPO-retinoid or retinoid-antibacterials in papulopustular acne and retinoid-BPO or BPO-antibacterials in pustular-nodular acne are recommended. Oral agents are generally recommended for severe acne. Low-dose retinoids are economical and have better patient acceptance. Antibiotics should be prescribed till the inflammation is clinically visible. Antiandrogen therapy should be given to women with high androgen levels and are added to regimen to regularize the menstrual cycle. In late-onset hyperandrogenism, oral corticosteroids should be used. The experts recommended that an early initiation of therapy is directly proportional to effective therapeutic outcomes and prevent complications.