Red scars or Post inflammatory erythema

Post acne erythema are also called post acne erythema or macular erythema.

They are persistent pink to red marks that occurs in acne patients during the course of acne treatment and persists for sometime even after the acne subsides.

They are more commonly seen in patients with lighter skin (FST I-III), but PIE can also be seen in Indian skin type FST III & IV as well.

PIE is a relatively new term, which is different from post inflammatory hyperpigmentation (PIH) i.e the brownish black scars that follows an acne eruption.

Difference between PIH and PIE

How and why does PIE occurs?

  • Still not clearly understood. Potential explanation is that during the process of inflammation, some pro-inflammatory cytokines that are released causes dilatation of the small blood vessels present in the superficial most part of the dermis.
  • The epidermis while still being in the process of maturation, is thinner, more transparent and can thus more incident light is reflected from the underlying vasculature
Possible mechanism for development of PIE

How to manage PIE?

  • So far, there is not much options for treating PIE.
  • The best approach is to minimise the risk of developing PIE in the first place.
  • As blood vessels will dilate during the process of healing, so some amount of erythema (redness) is expected. However as persistent inflammation is the driving force for long lasting erythema seen as PIE, addressing the factors that causes the inflammation will help minimise the chances of developing persisting PIE.

You do not need to buy products with these individual ingredients separately. Just look for products formulated with these ingredients together either in your moisturiser or sunscreen

Treatment that have been tried for PIE

For most individuals with acne, PIE subsides spontaneously after a few weeks to months just with gentle, supportive care in the form of sunscreens, moisturisers +/- ingredient to help with the inflammation.

However for some, PIE can be persistent even with the above measures. Medical management that have been tried include topical creams and different types of LASERS.

There is still no standard treatment for PIE and large scale studies are still lacking

So far, LASER treatment is still the best option for persistent PIE

Cracked feet, Corns and Calluses

Be it cracked feet, corns or calluses, everyone of us has suffered from either of these conditions at least once in our lifetime.

Corns and calluses

Corns and calluses are common issues arising on the feet. They are keratotic skin lesions that occur as a results of repeated pressure and friction leading to thickening of the skin as a protective mechanism to prevent ulcerations.

How corns and calluses form?

Corns and calluses

Cracked feet/ Heel fissure

How to take care of your feet?

All factors that contribute to cracked feet, corns and calluses such as friction, pressure and hyperkeratosis (thickened skin) needs to be addressed accordingly.

Reference : AAD

Products available in India

Available at either amazon (for indian products) or shopmyshelf (for international recommendations) your local pharmacy

When to see a dermatologist?

If the above measures fails to provide the desired response, visit your dermatologist for in office procedures.

Atopic eczema: On the rise

Atopic dermatitis or eczema is a chronic inflammatory skin condition characterised by recurrent acute flares of erythematous (red) itchy skin rash with all without some oozing.

Atopic eczema (AE) usually starts in infancy (< 1 year) or during childhood. Some children outgrow the disease while for maturity it may persist into adulthood. AE can also present for the first time in adulthood

It is estimated that approximately 2.3 million people worldwide suffers from AE. The number of cases is increasing globally including in Asia. Though AE has a lower prevalence in India compared to other Asian countries, the prevalence has consistently increase over the years.

How does one develop AE?

AE is cause by numerous factors interplaying with each other.

How does Atopic eczema presents?

Itching is a hallmark feature of atopic eczema. Itching can worsen the rash or even trigger the onset of eczematous rash.

For this reason atopic eczema is rightfully termed as an “itch that rashes

Itching in atopic eczema patient can become chronic, lasting for >6 weeks. Scratching to relief the itching can set in motion a viscous itch scratch cycle.

Atopic dermatitis is more than just skin deep?

The damaged skin barrier in patients with atopic dermatitis/eczema allows various allergens (proteins able to mount an immune response in the skin, body) to penetrate the skin, thereby sensitising an individual and causing allergic immune response seen clinically as red itchy rash.

Similar process can occur in the lining of the nose, pharynx predisposing patients to be sensitised to inhaled allergens such as pollen, pollution, dust etc resulting in Allergic rhinitis and or Bronchial Asthma.

A follow up article on the treatment and skin care measures for atopic eczema will be posted in the next blog post.

Atopic eczema in skin of colour

Prevalence of atopic eczema has been reported to be higher in individuals with skin of colour. However the clinical presentation of AE in darker skin tone is different from AE in Caucasians.

Erythema (redness) is usually masked in darker skin tone individuals. Other presentation or associated features are hyperlinear palms, prurigo nodularis, peri orbital melanosis (dark circles), lichenified lesions (thickened hyperpigmented skin) etc.

Denie Morgan line

Pityriasis alba

A skin condition better known as “Khaid” in my mother tongue : Khasi.

Pityriasis alba is a common skin condition mostly seen in children & adolescents between 3-16 years of age

Pityriasis” refers to the fine scales and “Alba” refers to the pale hypo-pigmented patches.

These pale patches are mostly seen on the cheeks, arms, chest, or back.

What causes P.alba?

The aetiology is still unknown. However there are some factors that have been implicated in the development of P.alba:

How does P.alba present?

P. alba evolves through different stages:

  • First stage : Starts as areas of mildly erythematous (red) patches on the cheeks or chin, or arms. It may be itchy at this stage. This stage is commonly more noticeable in fair skin individuals and often missed in darker skin individuals.
  • Second stage : The erythematous patches subsides leaving behind pale hypo-pigmented patches with the fine scaling on the surface. This is more prominent in darker skin tones and it is usually at this stage that parents seeks medical attention for the patches.
  • Third stage: The pale patches spontaneously subsides in a few months to years leaving no scars

Variants of P.alba

Should I be worried that my child has P.alba?

No, P.alba is a benign self resolving condition. The patches subside spontaneously within a few months or years for some without any sequelae.

It is important to remember that it may take years to complete resolution of the patches of P.alba in few patients.

Why do you need to see a dermatologist?

P. alba can mimic many other skin conditions, therefore getting an expert to examine the skin lesions for a proper diagnosis is of utmost imporatance.

You dermatologist can help conduct certain bedside test on the skin to help rule out the above mentioned conditions.

Once the diagnosis of P. alba is ascertain, the dermatologist will advised on your skin care and treatment accordingly depending on the stage of the condition.

How is P. Alba treated?

What one can do to help improve the appearance of the skin lesions:

  • Avoid excessive bathing and excessive washing and scrubbing of face
  • Use moisturisers, it helps improve the appearance of the dry scaly patches
  • Always use a broad spectrum sunscreen which will help prevent further tanning and darkening of the surrounding skin, thus minimising the contrast between the pale patches and the neighbouring tanned skin.

What your dermatologist may prescibe?

  • A Short course of mild topical steroids especially during the first stage of the disease when the rash erythematous and itchy.
  • Topical calineurin inhibitors such as tacrolimus or pimecrolimus during the second stage.

Christmas gift guide

Do you have loved ones who enjoys a skincare or even just trying out as a beginner? Or are you looking for skincare products to treat yourself with this Christmas?Are you confused with the endless amount of products available in the market?

Being the dermatologist who writes about all things dermatology, skin, hair and nail care, I thought I’ll share of my top favourites skin care products I’ve enjoyed using throughout this year 2020 and help narrow down the search for a Christmas gift for you this year.

1.Cerave hydrating facial cleanser

This non foaming creamy mild cleanser has been every dermatologist’s favourite and for good reasons.

This cleanser effectively removes dirt from your face without stripping it dry. It’s perfect for dry winter months, it’s fragrance free and is perfect for people with sensitive skin, or individuals using active ingredients such as right to know it’s salicylic acid to help with the acne.

It’s currently available in India on Amazon.

It’s more on the expensive side, but the cleanser doesn’t last for at least 6 to 12 months depending on the size and in my opinion, it’s completely worth the money spent.

Price : ₹3219 /355 ml

2. Neutrogena extra gentle facial cleanser

This cleanser is easily available in India, more affordable and is also a great gentle, hydrating cleanser.

It also does not leave the face try after cleansing. This is currently available either on or at

This would be a great alternative to the above mentioned cerave cleanser.

Price: ₹ 600/ 200ml

3. Vichy 89 mineral serum

This hyaluronic serum is the best HA I’ve tried so far. It’s very light weight, spreads easily on the skin, and it gives an instant dewy hydrated look to my skin.

It’s a little of a splurge but the product does exactly what it says and you only need a drip of it and it lasts for at least 4 months even with twice daily use. I’m definitely going to buy more of it.

It is available at amazon currently

Price: ₹ 3990/100 ml

4. Bioderma photoderm max 50+ in the shade teinte claire

A tinted sunscreen containing iron oxide, provides additional protection against visible light. Its a great addition for someone who is prone to pigmentation.

A tinted sunscreen can also work as a foundation. I don’t need any makeup over this anymore.

It has a fluid like texture, it can feel too heavy for some especially if one has oily skin. A trick is to apply a base sunscreen one is comfortable with and layer a light layer of this tinted sunscreen on top.

Available on amazon, nykaa or local pharmacies

Price: 1575/ 40 mL

5. Ekran soft spf 50 sunscreen

This matte finish sunscreen is a chemical sunscreen by an Indian pharmaceutical pharmacy. It’s my favourite matte finish sunscreen. It’s best during the summers, or hot humid days when one sweats a lot.

It provides both UVA and UVB protection and is suitable for oily acne prone skin as well.

Available at amazon or local pharmacy

Price : 650/ 50 gm

6. Taiyu sunscreen spf 50

Another sunscreen by Indian pharmaceutical company, Festival was developed based on Japanese company formula.

What is the broad spectrum sunscreen, with ingredients such as are arbutin and liquor rice extract that helps with pigmentation. It’s perfect for people with pigmentation issues.

Pregnant women should avoid using the sunscreen due to the presence of arbutin and it’s formula.

It has a fluid like texture yet light and does not feel to have you on the skin. Even acne prone patients would enjoy using the sunscreen especially during the winters when a matte finish sunscreen would feel too dry.

Price: 550/ 60 gm

7. Neutrogena lip balm with spf 15

I always have a lip balm with me especially during the winters, it helps keep my lips hydrated and not chapped.

I particularly love this one since it doesn’t have colour to it.

Available at amaxon, nykaa, L’épicerie store in Shillong ( @lepicerie.shillong)

Price: 175

8. La Roche Posay toleraine sensitive cream

This is by far my favourite moisturiser. I purchased this during my trip to Europe but sadly it’s not easily available in India.

This moisturiser is enriched with glycerine, ceramides and nice niacinamide. Its fragrance free and is also great for people with sensitive skin.

Keep an eye out for this one on your next travels you might be able to get it at the pharmacies in the international terminals at the Airport. My advice is grab few of them while you can. This 40 ml pack will last for ~4 months for once a day use.

Price: 1200-2000/ 40 ml

9. E Dew cream

This is another moisturiser with ceramides, and niacinamide. It

has a light fragrance so may not be ideal for people with sensitive skin.

It does feel a little thick but I wasn’t too bothered with the overall texture especially during the winters when my skin gets a little too dry.

People with oily skin may not prefer it especially during the summers when it’s hot and humid. But overall a great moisturiser for a very reasonable price.

Available at amazon or local pharmacy

Price: 269/ 50 gm

9. Hydronic cream

This is another Indian pharmaceutical company moisturiser which is made for individuals with very dry sensitive skin.

It contains aloe vera extract, allntoin, shea butter, glycerine.

Its fragrance free and non comedogenic which means even patients with acne prone skin can use it especially to combat the dryness caused by topical acne creams such as salicylic acid, BPO or retinoids.

Available at amazon or the pharmacy

Price: 299/ 50gm

Merry Christmas


Happy Holidays

Winter skin care

I recently visited my hometown, Shillong in the north eastern part on India during the last few days of November and it was already cold especially at night. The water was freezing cold as well.

The first thing I noticed was my skin felt extra dry, with visible patches of dry spots. My lips were constantly chapped and I could literally write on the skin on my legs. These skin changes were happening with everyone. My family members and I had patients from back home that all complaint that their skin felt tight.

So why does this happen in winter?

To understand this, we will have to do a deep dive into how our skin functions in an optimal environment.

As you can see the protein filaggrin plays an important role in hydrating the skin, protection against UV rays and maintaining a healthy skin barrier. Individuals with mutation in the gene encoding filaggrin protein are more predisposed to developed eczemas and other allergic conditions such as asthma. Studies have found that low humidity and low temperature causes a decrease in the amount of natural moisturising factor (NMF) in the stratum corneum and this causes decrease in skin hydration. This results in the subjective feeling of dry flaky skin during winters.

Animal studies also show that when the skin is exposed to low humidity, a reactive pathway favouring pro inflammation is activated within 24 hours. What this means clinically is that, the skin maybe more sensitive to ingredients present in skin care products during winters.

Certain skin conditions can worsen during winters. Individuals suffering from eczema, psoriasis, rosacea, cold urticaria should be careful not to be exposed to cold weather, water and to aggressively take care of the skin by moisturising and being gentle with their skincare.

Skin changes associated with using radiation heaters during winters

Homes in Shillong do not have central heating and rely on the use of radiation heaters or coal stoves to keep them warm. There are certain skin changes that can be associated from exposure to such infrared radiation.

Erythema ab igne/ Toasted skin syndrome/Fire stains

Reticulate (lacy pattern) erythema (redness) and pigmentation on the skin caused by chronic and repeated exposure to infrared radiation from heaters, wood or coal stoves. This has recently been described to be seen on the thighs of people with prolonged contact with laptops.

Though the condition is benign and resolves when the heat source is removed, the pigmentation can be permanent for some and in rare instances skin cancers such as squamous cell carcinoma or merkel cell carcinoma can develop.

Avoid sitting too close to the heat source (heater or stove)

Wear protective clothing to prevent direct exposure of the skin to the heat radiation

Remove the most heat source the moment redness develops on the skin

Seek a dermatological examination if a non-healing ulcers or wound develops over the skin where the pre-existing erythema or pigmentation was.

Worsening of Melasma

A multi centric cross-sectional study from India found a significant and positive association with the duration of heat exposure and the severity of melasma

If you suffer from melasma, avoid sitting too close to the heat source and always remember to wear a broad-spectrum sunscreen even when indoors.

Illustrations done by Alexandra Kristin Mawlong

Paraben in skincare and cosmetics

Parabens have been been used since the 1920s safely as preservatives in skin care products, cosmetics and various other toiletries items used in our every day life. Parabens are also present in certain food such as blueberries, strawberries, grapes, barley etc though in small quantities. Parabens are also used in pharmaceutical companies in various medications. Even though they’ve been around for 70 years, parabens still remains a controversial ingredients in the skin care industry. They were first victimised as sensitisers that are able to cause contact allergic dermatitis. In the recent years, parabens are again under scrutiny as potential endocrine disruptors acting as the hormone estrogen. They have also been falsely linked to breast cancer and infertility.

Now let’s see if all these claims are true! Before we dive into the research available on parabens, let’s understand a little background on these molecules and how the processed inside our body.

Background on paraben

Parabens are esters of parahydroxybenzoic acid (PHBA). There are different classes of parabens: methyl, ethyl, butyl, and propyl – paraben are the four most commonly used ones with a good track record.

Metabolism of parabens

Why are parabens present in skin care products and cosmetics?

  • Effective antimicrobials at even low concentrations hence acts as preservatives.
  • Minimal toxicity
  • Chemically inert
  • Odourless
  • Low cost
  • pH neutral
  • They have been used safely since the 1920s as have been extensively studied for the safety profile in humans

With such advantages properties, a number of skin care products, cosmetics contain paraben as the choice of preservative.

Parabens as sensitisers

Parabens were labelled as contact sensitiser i.e Able to cause contact allergic dermatitis when applied to the skin. However, cases of paraben allergies have been consistently low with parabens being the culprit in only ~0.6 to 1% of the individuals with contact allergic dermatitis.

Most of these paraben allergies occurs in individuals with compromised skin barrier such as when products containing parabens were applied on eczematous or wounded skin.

An interesting observation called “PARABEN PARADOX” in which the same above individuals who reacted to paraben when applied to compromise skin, didn’t have any problems with the same paraben containing cream was applied to normal skin.

Parabens were even named the contact non-allergen of the year in 2019 by the American contact dermatitis society. Parabens are also the least allergenic preservative present in the market

Parabens as endocrine disruptors

It has been shown in vitro studies (lab studies) that parabens are able to bind to estrogen receptors. Amongst the various parabens, butyl paraben has the highest oestrogenic activity but overall has a weak oestrogenic potential and is 10,000 times less potent than the naturally present hormone estradiol. When lab animals was subcutaneously injected with high dose of paraben it was shown to cause increase in the size of the uterus. Though these findings may seem alarming, they do not represent the effects of parabens in humans.

Though parabens may act as endocrine destructors in vitro, there is no evidence that they are endocrine disruptors in humans.

Paraben linked to breast cancer

As paraben and can mimic estrogen and bind to estrogen receptors, there is a theoretical risk that they could increase the risk of breast cancer. However as stated earlier, parabens have only a weak oestrogenic activity. Even if they can bind to these estrogen receptors, there is no evidence that it can produce any effects in humans. Another reason why parabens are linked to breast cancer is because some studies were able to isolate parabens from cancerous breast tissues. But most of the studies came that came to this conclusion did not assess the presence of parabens in normal breast tissue.

One study found that parabens were present in the adjacent normal breast tissue as well.

One epidemiological study reported no increased risk of breast cancer incidence in patients using antiperspirant or deodorants. However details on the composition of these products were lacking from this study.

So far, there is still no convincing evidence that parabens increases the risk of breast cancer.

Parabens and infertility

Consequences of demonising parabens

  • With companies being forced to cater to a market that embraces “Paraben free“, alternative preservative with lesser known properties and effects on humans are being used instead.
  • Avoiding the use of preservatives in cosmetics and skincare products is dangerous as this provides a favourable environment for micro organisms to grow which can result in various skin infections.
  • Skin care marked as “paraben free” are more expensive due to the use of other more expensive preservatives and because “paraben free” is a great marketing strategy. This would prove to be too expensive for patients who depend on moisturisers or other products to help maintain a healthy skin especially in countries like India.

For these reasons use of parabens have not been banned from cosmetics or skincare products as the benefits of these molecules far out weighs their theoretical in vitro or animal studies risks

I am not saying that parabens are 100% safe, and completely risk free, because nothing on earth is risk free. The best approach in such situation is to try to understand the available data and to weigh the benefits against the risk.

So who should use “paraben free” products?

Individuals with a known allergy to parabens should opt for paraben free products. or if paraben free is your personal choice.

Michelle from Lab Muffin, who talks about the science of beauty, wrote such a great blog posts on this topic as well. Do check that out for an even detailed read.

Do pimple patches work?

Do you often get your breakouts just before one event? Have you ever used Pimple patches? What is these patches made of? Do they even work? Can they work for all types of pimples?

What are pimple patches?

These patches are hydrocolloid dressings which were traditionally used for treating acute or chronic wounds. They’ve also been used for the management of post surgical wounds.

Hydrocolloid are hydrophilic (water loving) substance composed of gelatin, pectin, carboxy-methylcellulose. As these substances are attracted to water, they are they can absorb water, and pus from the wounds and then forms a gel which provides a moist environment for the wound.

How do hydrocolloid help in wound healing?

How do hydrocolloid dressings work for acne?

Which type of acne are they best used for?

Single or limited acne

Perfect as an SOS solution for those pimple that always pop up before an event.

Acne which is inflamed (red, painful, with or without pus)

Pimple patches are not ideal for severe, cystic acne.

How to use pimple patches?

  • Wash face clean before application
  • Apply the patches over the acne on dry, clean skin
  • The patches can be left overnight or longer (12-48hrs)
  • Dispose used patches. Do not reuse them
  • Skip using face serums, moisturisers oven the active acne before applying the patches
  • The patches are transparent so they be used during the day.

These patches do not replace the regular acne medications such as benzoyl peroxide, adapalene etc. They serve as rescue treatment for those once in a while acne breakouts.

Are there any concerns regarding these patches?

Well as great as they seem in theory as the emergency acne rescue option, there have not been much research done for their use in acne. I would love to see more studies comparing these to spot application with benzoyl peroxide or salicylic acid.

Some individuals may even be allergic to either the adhesives used in these patches or other ingredients.

So in conclusion:

If spot application of benzoyl peroxide works for you, continue it. There is no need to buy spend extra money on these patches. But if your skin gets too irritated or dry with actives such as benzoyl peroxide or salicylic acid, or you’re the type that just can’t control picking on your acne, then these patches could be a great option for you.

Pimple patches available in the Indian market

Pimple patches are available as either pre cut patches or as single sheets for a customisable size. One can make heat shapes or star shapes or whichever fun shapes out of these sheets.

Some pimple patches also contains active anti acne ingredients such as salicylic acid, tea tree or cantella asiatica which helps in calming and soothing the skin.

These are available at either amazon or on flipkart

Are antiperspirants and deodorants safe?

Aluminium has been shown to possess some undesirable biological effects on human body and exposure to high doses of aluminium has been linked to an increased risk of breast cancer and Alzheimers’s Disease.

Why did the controversy exist between breast cancer and antiperspirant?

As a majority of breast cancer occurs in the upper outer quadrant of the breast it was theorised that regular use of underarm cosmetics such as antiperspirant could potentially contribute to the increasing number of breast cancer detected in this site.

  • It was also shown in some studies that a concentration of aluminium was found in breast cancer tissues.
  • In vitro ( laboratory) studies have shown that aluminium can cause DNA instability and can promote cellular proliferation thus could potentially cause cancer.

What do the recent human studies say?

Many studies support the fact that the higher amount of breast tissue present in the upper outer quadrant of the breast is the reason for the increase number of breast cancer detected in this area and not because of it being in close proximity to the axilla (under arm).

Other studies have also shown that aluminium was found to be equally present both in the cancerous tissue as well as normal breast tissue.

The absorption of aluminium present in antiperspirant through the intact skin is very minimal and not significant enough to cause breast cancer.

Systematic analysis of two case-control studies has found no association between the use of antiperspirant and increase risk for breast cancer.

Does aluminium in antiperspirant cause Alzheimer’s disease?

A possible link between aluminium and Alzheimer’s disease was questioned when laboratory studies of high doses of injected aluminium was shown to cause neurofibrillary tangles (characteristic of Alzheimer’s disease)in rabbit brains i.e aluminium is neurotoxic to animal brains. This finding dates back to 1965, and years later it still remains a controversy.

Studying the association between aluminium and Alzheimer’s disease (AD) has been difficult due to the ethical issues in obtaining brain tissue for biopsies. The study so far have been based on autopsied brain specimens from patients with AD. This does not answer whether the increase aluminium concentration found in these specimens were the cause of the disease or a consequence of it.

As Alzheimer’s disease is a chronic disease, prospective studies aiming to determine the association between exposure to aluminium and the disease are met with many hurdles. AD Causes significant memory loss (dementia), studies relying on patients account of their history of exposure to aluminium in the past for example use of aluminium-based antiperspirant are biased, as patients are unable to recall correctly such exposures. Few studies have relied on the accounts given by the patient’s partners who may not have a correct idea of such exposures.

Therefore the association between aluminium exposure be it from our diet or water or underarm cosmetics and Alzheimer’s disease will always be a controversy yet to be proven.

What we know so far?

As stated earlier aluminium present antiperspirant is not significantly absorbed through the skin. The minimal amount that is absorbed is effectively excreted via the kidney before reaching the brain.

Therefore antiperspirant use is not likely to cause Alzheimer’s disease.

Presently there is no strong scientific evidence linking exposure to aluminium (including aluminium in anti-perspirant) as a causative factor To the development of Alzheimer’s disease

How to achieve the best results with your skin care regimen?

How many times have you tried an anti-aging or anti-acne creams or a brightening serum but failed to see it work on you?

Your constant breakouts never stopped, the mirror reflects back new wrinkles and your pigmentation is stubborn enough to never fade.

I’ll be the first to admit, I’m definitely guilty of the above!!

I grew up with acne as a teenager which continued into my adulthood. I’ve tired over the counter creams and in the early 2000’s “Erytop” (clindamycin – an antibiotic cream) was widely available. All my friends were using it. It would work for the existing pimple but news ones were popping up constantly. My mum did take me to a dermatologist then, I would get prescribed one cream- benzoyl peroxide and was advised “apply it once at night” and that was it. I was never explained how long I should be using it for, what cleansers I should be using, nor was I explained about the potential side effects or the expectations one should have with such topical medication.

And it seemed quite normal then, go for that one time consult for acne and the dermatologist would assure my worried mum that “your daughter will grow out of it, the acne will subside when her teenage years have passed”.

This might have been true for older generations but now with the changes in lifestyles, acne persisting into adulthood is quite common. Teenagers suffer from a more severe form of acne with the potential for permanent scarring.

The same holds true for pigmentation issues particularly melasma. Women, though bothered by the facial pigmentation, DIY remedies or creams suggested by their friends were enough to make them feel like they are actively taking care of their skin.

Things are different now. Individuals are more aware through social media about how to care for their skin. Educational content are more accessible about the various skin or hair issues. And skin care products are easily available at the touch of a button.

I personally love to see this change.

How to achieve the best from your skin care?

Skin care is actively caring for your skin (be in for acne, pigmentation, ageing or just general measures) to maintain a healthy looking skin.

Some people can follow multiple steps layering different skin care products both day and night for their skin and this may work wonders for them, but a simple basic routine is also not wrong.

If you have a particular concern I strongly advised seeing a dermatologist for any skin problems.

Before seeing a dermatologist, prepare yourself with the questions you would like to ask. Do not be afraid to clear your doubts. I always advised my patients who are already on treatment for some other condition or who are already on some form of skin care regimen to bring all the medications (both oral-tablets, capsules and topical- creams, ointments, serums) during their consultations.This is because few medications may be contraindicated with the medications that I may prescribe, or maybe the skin rash is actually associated with the medication they are taking. And in India, it is very common to see patients applying the wrong cream for the wrong reason or to the wrong site.

Always remember to tell your treating doctor if you are allergic to any medication or if your skin is sensitive to any skin care product.

Once a diagnosis of your condition is made, try to understand the condition, either by asking your doctor or reading up more about it yourself. Its always helpful to know why it happens, is it curable? how to manage it? how to prevent it from recurring? etc.

Skin care routine is not a static process. It changes depending on the response, the season, the tolerability of a person to an ingredient in a product, the availability of the products, the age or pregnancy status or according to the money and time one is willing to invest in it.

Once a diagnosis is made and a skin care routine is advised, understanding the ingredients in the products is just as important. Its good to know how a product works, how you need to be using it, how to minimise side effects and how long it takes for the product to work.

Most times when people blindly follow the doctor’s advise or a beauty influencer without understanding the product, it either leads to development of side effects, lack of results, pre-mature discontinuation of the product or maybe even worsening of the condition.

Always follow up as and when your dermatologist advised or earlier if needed. Follow up consultations are as important as your first visit. This is when your dermatologist can assess how you are responding to the treatment and if the products need to be changed based on your response. Your dermatologist will even be able to help you manage the side effects if any.

Be patient. Consistency is the key with skin care. Avoid doctor and product hopping too early and frequently. Most ingredients in skin care products take at least 4-8 weeks to start showing effect.

Avoid using too many active ingredients at once especially if you are a newbie.

Be gentle, go slow, skin care is a personal journey and not a competition.

Try to have more realistic expectations. One may never be acne free forever, even with the right skin care, you may get the occasional breakouts, and thats OKAY. Pigmentation can slowly fade with time and anti ageing cream can help reduce those fine lines but your skin will never go back to the skin you had in teenage years.

Lastly, change your perspective about skin care. Do not see it as a burden and a waste of your time. Instead keep in mind that you are actively taking care of your skin and enjoy doing it.

Hope these tips help you achieve the maximum with your skin care routine.