prevention and amelioration of dynamic wrinkles, hyperhidrosis(excessive sweating)

It is a process of inducing peeling of the superficial surface layers of the skin with various chemicals such as Trichloro Acetic Acid, Glycolic Acid, Lactic Acid, Salicylic Acid, Retinoic Acid, Jessner's Solution, Phenol and recent newer peeling agents (Black peel, Yellow peel, Miami peel etc.) to treat facial hyperpigmentation, acne, freckles, superficial scars, dilated pores, rough texture, dark undereye circles, underarms, back. It can be carried out over the affected area or tulltace.

Facial rejuvenation(rough texture, dyschromia, actinic damage, superficial rhytides, comedonal acne, superficial scars.

Microneedling is form of collagen Induction therapy for atrophic scars, rhytides, aging skin & transdermal delivery of various mesotherapy therapeutics.

Hair restoration surgeries such as Follicular Unit Transplant (FUT) and Follicular Unit Extraction (FUE) using patients own hair from scalp or other body parts are carried out using 1500 to 3000 micrografts (single/multiple/mega sessions) for treating male and female patterned hairloss (common baldness) and cicatricial (scarring) alopecia. FUE is also used for cosmetic correction of leukotrichia (white hair) of eyebrow and eyelashes in vitiligo.

Acne is commonly seen in young adolescents affecting both males and females equally due to hormonal changes occurring at onset of puberty. It not only causes psychological stress to the patient because of its cosmetic disfigurement affecting the face but may also cause withdrawal from social interaction. Long term sequelae include acne scars, keloids, post inflammatory hyperpigmentation, etc, thus wanting an early and detailed workup (medical and surgical) for the same. A detailed interactive patient counseling and medical line of treatment is combined with special surgical procedures which include comedon extraction (clean up, removal of black heads, etc), cryoslush, cryoroller, chemical peeling, microdermabrasion and photodynamic therapy with blue light. Adjuvant hormonal therapy is administered for females having acne, androgentic alopecia, hirsutism, obesity, menstrual irregularities to treat Polycystic Ovarian Syndrome (PCOD). Acne scars (pits on the face) are unsightly and of varied types causing cosmetic disfigurement. Acne scar surgery is dependant on the type of scars and these surgical modalities can only reduce and oblivate them. Acne scar surgeries include - chemical peeling, CROSS (chemical reconstruction of skin scars) technique, subcision and undermining, acne scar revision, microneedling with dermaroller, microneedle radio frequency, microdermabrasion, dermabrasion, lasers (fractional, ablative and non-ablative), fillers and autologous fat transplant.

Direct injection of small amount of an irritating solution into the abnormally dilated blood vessel followed by immediate application of compression to maintain contact of intravascular solution of endothelial cells. Indication are superficial telangiectasias, venulectasias of lower limb, hemangiomas, venous malformation.

Lasers are high tech instruments used in the field of medicine over the past 50 years. Here the light energy is converted into heat energy to treat variety of skin conditions. In dermatology and cosmetology lasers are used to get rid of unwanted hair, to treat acne and its scars, remove birth marks (vascular and pigmented skin lesions), moles, tattoo, facial pigmentation, vitiligo, psoriasis, hypertrophic scars and keloids, striae, warts, benign skin growths (acrochordon), pre-malignant and malignant skin conditions, excisional surgery, resurfacing and non-ablative facial rejuvenation. It is also used for skin tightening and body contouring. Due to its advanced and sophisticated instrumentation with precise technology the results are aesthetically precise with nil or few side effects. Different types of lasers with their indications are : Long Pulsed Nd:YAG : for unwanted hair (laser hair reduction). Q Switched Nd:YAG : for removal of pigmentary lesions (Naevus of Ota, Melanocytic naevus, etc) and tattoo. IPL (Intense Pulse Light) : for Haemangiomas, port-wine stains, venous malformations, rosacea, telangiectasias, acne scars, facial rejuvenation, facial pigmentation, varicose veins. The Carbon Dioxide (CO2) and Erbium:YAG (Er:YAG) Lasers : appendageal lesions (trichoepitheliomas, sebaceous hyperplasia, epidermal naevi), facial scars (acne, chicken pox, traumatic), vascular lesions (lymphangioma circumscriptum, angiokeratoma), stable vitiligo (therapeutic adjuvant and before grafting), hyperkeratotic skin lesions (lichen amyloidosis, porokeratosis, verrucous epidermal neavus), pigmentation (melasma, lentigens), pre-malignant and malignant conditions (actinic keratoses, actinic cheilitis, leukoplakia, bowens disease, extra mammary Paget's diseases, erythroplasia of Queyret's, supercial basal cell carcinoma), photoaging, rejuvenation, rhinophyma, xanthelasma, rhytides and wrinkles.

These are extra tissue growths which are commonly seen after traumatic/ surgical wounding or may follow ear-piercing / idiopathic (keliod only). They are painful, itchy & may get secondarily infected at high recurrence rate. They not only cause cosmetic disfigurement but may also lead to contractures & limb immobility. Surgical modalities include combination techniques such as debulking of tissue with scalpel, Radiofrequency, Liquid Nitrogen Cryosurgery, Laser along with Intralesional injections & silicone pressure dressing / garment.

1) Podophyllin - for condyloma accuminata, plantar warts, superficial epithelioma & keratoses. 2) Trichloroacetic Acid - warts, pyogenic granuloma, molluscum contagiosum, xanthelasma, skin tags, seborrhoeic warts, actinic keratoses, freckles, lentigines, stable vitiligo, post inflammatory depigmentation and icepick / pitted scars. 3) Phenol / Carbolic Acid - As local cauterant for warts, molluscum contagiosum, lichen simplex chronicus, prurigo nodularis, xanthelasma palpebrum, pyogenic granuloma, epidermal cysts, steatocystoma multiplex, earlobe repair (split ear), angiokeratomas, mucous cyst, ingrown toe nail. - As a spot peelant (focal chemical peeling) acne scars, freckles, lentigine, lichen simplex chronicus, stable vitiligo, alopecia areata.

Nail surgeries are carried out on nail unit and consist of nail avulsion that is nail plate removal (for treating underlying warts, glomus tumours), lateral nail matrix phenolization (for treating ingrowing nails), nail matrix and bed biopsies (for diagnostic purpose), intra-matrix injections (for treating psoriasis and lichen planus), drainage of paronychial as subungual abscess or haematoma, pincer nail surgery, myxoid cyst removal. Nail avulsion is also carried out as an adjuvant therapy along with medical treatment for dermatophyte infection that is fungal infection of nail.

Vitiligo is a condition in which pigment is lost from part of the skin seen as depigmented (white) patches. Vitiligo has a psychosocial impact in India. Beginning with explanation of the disease and varying treatment modalities available patient counselling and reassurance form an important spectrum management of vitiligo. Medical line of treatment is combined with Ultraviolet A, Narrow Band Ultraviolet B, targeted Narrow Band Ultraviolet B irradiation, Excimer Lamp along with advanced lasers for complete and faster recovery. Non-responsive stationery patches are surgically treated with basic miniature punch grafting, suction blister, therapeutic wounding (needling, phenolization, laser ablation and manual dermabrasion), tattoing to advanced surgeries like Thin Thiersch Skin Grafting, Ultra Thin Skin Grafting, Melanocyte & Keratinocyte cell suspension and follicular unit extraction.

Minute dosages of nutrients (vitamins, minerals, amino acids, plant extracts), enzymes and hormones are introduced into the affected areas either manually (micro-injections) or by mesoguns. It is used for facial rejuvenation, (mesoglow), skin tightening (mesolift), hair loss (male and female pattern alopecia), hyperpigmentation (melasma, undereye dark circles) and to treat localized excess fat deposits and cellulite.

Skin is abraded that is scraped and removed layer by layer over small areas (spot dermabrasion) or full face to treat facial acne scars, fine wrinkles, ageing face (rejuvenation), genodermatosis (trichoepitheliomas, facial angiofibromas, darriers disease, xeroderma pigmentosa), papular lichen amyloidoses, stable vitiligo, tattoo removal and hypertrophic lichen planus.

Electrical energy is used in the form of electrofulguration / desiccation / coagulation for treating warts, skin tags, milia, seborrheic keratosis acne and its scars and small benign growths. Radiosurgery it is a sophisticated electrosurgical method where radio-frequency waves are used to treat – skin conditions as mentioned in electrosurgery. It also has got additional electrosectioning mode which is used for cutting the tissue and removing moles and small skin tumours with superior aesthetic results.

Various drugs (corticosteroids, 5 flurouracil) are directly delivered into the skin lesions through injections. It is used for lichen simplex chronicus (chronic thick eczema patches), cystic acne, alopecia areata (localised hair loss), hypertrophic scars and keloids, hypertrophic lichen planus. Drugs can also be injected into the nail matrix.