Natural beauty, expert care

Dr Shuba Dharmana discusses facial treatments and concerns in conversation with Shriyal Sethumadhavan highlighting how aesthetic physicians in India are renowned for personalised care, advanced techniques, and holistic approaches that prioritise natural results and effective solutions.

How do you see the role of aesthetic physicians evolving in India in addressing facial concerns?

Aesthetic medicine is developing as a distinct branch of medicine and people are realising this. An Aesthetic physician that is practising this field of medicine needs to have the training and skills necessary with several years of experience to become an expert. Doctors that dedicate their entire careers to this field and practice this exclusively whilst regularly updating their educational needs will have the skills to become experts in the field. This field is developing in India, and the role the aesthetic physicians play is vital.

What are the most frequent facial concerns that clients approach you for, and as a cosmetologist, how do you prioritise treatments for such concerns?

The concerns vary depending on age demographics. Younger clients usually seek help for acne, acne marks, acne scars, pigmentation, and tan removal. People in their 30s to 40s are more concerned about ageing signs and preventive treatments. Every year, more people are opting for injectables to rejuvenate and prepare their skin, even before visible signs of ageing appear. Common concerns include acne, pigmentation, acne scars, sagging skin, and hair fall.

How do you personalise facial treatments to suit different skin types and concerns, especially for sensitive or problem-prone skin?

For sensitive or problem-prone skin, we address the primary issue first. For instance, if a client has acne, it must be treated before starting aggressive procedures. This often involves prescription ointments and an appropriate skincare routine. Once the skin is prepared and adequately protected with sunscreen, we progress to treatments.

We start with basic facials like HydraFacials, which are suitable even for sensitive skin, to unclog pores and hydrate the skin. Gradually, we move to treatments such as chemical peels and mild microneedling. Microneedling requires careful attention to depth, especially for acne-prone skin. If laser treatments are needed, we ensure pre-treatment protocols to minimise post-treatment reactions, such as pigmentation.

Preparing and hydrating the skin is key to achieving better outcomes.

Which new techniques in facial treatments do you find most promising or effective, and why?

Thread lifts are a promising technique, especially for Indian skin, which tends to have thicker soft tissue. Unlike fillers, which can sometimes lead to over-volumising, thread lifts effectively lift the skin without adding volume. Additionally, laser treatments like Ultherapy, M-FU, and HIFU are excellent for skin tightening and narrowing the jawline, countering the effects of gravity as we age. Regenerative medicine, such as PRP and exosome-based treatments, is another exciting area. These procedures are gaining popularity, with clients actively inquiring about them.

How about basic facial treatments for rejuvenation, such as carbon facials or photo facials?

While major procedures address specific skin issues, basic facial treatments like HydraFacials, carbon facials, and photo facials are excellent for maintaining skin health. These treatments provide hydration, address minor concerns, and prepare the skin for events or parties. Although their effects are temporary, they are great for upkeep between larger treatments.

With the growing demand for natural treatments, how are you incorporating these trends into your practice?

We prioritise natural-looking treatments. For instance, PRP and advanced PRP treatments for hair loss and vampire facials for the skin use the client’s own plasma, making them natural. Similarly, thread lifts offer a lifted appearance without adding volume.

Achieving a natural look with fillers depends on proper technique, placement, and experience, which only comes with years of practice and an aesthetic eye.

How important is combining different treatments to achieve better results, and what are your recommendations?

Combining treatments is essential for holistic rejuvenation. For example, addressing only the cheeks with fillers while ignoring the jawline can result in an unnatural look. Treatments should target different skin layers and concerns. Chemical peels improve the outer skin’s texture, while lasers stimulate collagen and address specific issues like acne scars or pigmentation. Facials help hydrate the skin, enhancing the effectiveness of other treatments. A wellrounded approach ensures better, more natural results.

What advice or product recommendations do you typically provide to clients for maintaining the results of facial treatments at home?

Sun protection is the most crucial recommendation. Without sunscreen, clinic treatments will not yield optimal results. Beyond that, product recommendations depend on the client’s specific concerns. For pigmentation or melasma, we prescribe treatments that suppress melanin production. For acne, prescription-strength ointments paired with a tailored skincare routine are essential. Basic skincare products like a Vitamin C serum, sunscreen, and a good face wash are staples for most clients.

How do you perceive the role of a cosmetologist as distinct from that of a dermatologist when addressing facial treatments and concerns?

The distinction lies in skills, training, and experience. A dermatologist or an aesthetic physician can excel in this field if they dedicate sufficient time and effort to aesthetic medicine. Practical experience, comprehensive training, cadaveric courses, and injectables training are essential. Additionally, attending national and international conferences and staying updated with medical journals is crucial for staying at the forefront of aesthetic medicine.