Articles on laser medicine

10 Myths About Laser Treatments You Should Stop Believing!

Dr. Atul Taneja, Dermatologist
1. Myth: Lasers expose you to radiation.Truth: Lasers are safe since they use light and not harmful ionising radiation. In fact, normal sunlight contains more radiation that triggers cancer than most modern medical lasers. 2. Myth: Lasers are harmful to health.Truth: Laser light penetrates only 1-4 mm into the skin. That is why during laser hair removal procedures only superficial hair roots are destroyed since light cannot reach even till the deeper hair roots. And therefore, certainly, cannot reach or affect any deeper organ in the body.3. Myth: Lasers can cause burns.Truth: All modern lasers use the theory of selective photo-thermolysis formulated at the famous Harvard medical school. This basically means that laser light acts likes magic bullets and specifically searches and destroys only the intended target. Thus, for example, lasers using green light will be absorbed only by the red colour in blood vessels. Abnormal blood vessels in birth marks, in broken veins or even within the eyes in diabetics can thus be removed very safely. Just like with any other technology, side effects can happen but chances of burns are minimal with good machines in expert hands. 4. Myth: Laser hair reduction hurts.Truth: With proper use of scientific methods, during treatments, there is only a feeling of a bit of warmth or of a pin prick sensations. A very occasional patient, especially for sensitive areas like bikini or underarm areas, requires the use of topical anaesthetic cream before treatment.5. Myth: Lasers cause thinning of the skin.Truth: Lasers actually causes thickening of skin after treatments. Skin is living tissue and the controlled gentle heating in the dermis due to laser treatment induces new collagen and elastin formation, replacing the older damaged tissue. That is why lasers have a rejuvenating effect, reducing wrinkles and causing the skin to become plumper. Of course, your laser physician should have a thorough knowledge of laser physics to achieve the desired results. 6. Myth: Lasers are expensive.Truth: In the long run, it costs more to use razors, waxing, foams, etc. To keep your skin smoothing traditional hair removal methods. Moreover, these methods need to continue lifelong and are tedious and painful. In contrast, with just a few painless sessions over a few months, permanent hair reduction can be achieved with lasers.7. Myth: Lasers are unnecessaryTruth: There are many medical problems for which lasers are indispensable. There are no medications or creams which can permanently remove unwanted hair, remove scars, birthmarks, tattoos, varicose veins, port-wine stains. Laser technology is similarly indispensable for many other internal medical conditions.8. Myth: Lasers cause cancers.Truth: Lasers are actually used to remove skin and other cancers. Laser light does not contain wavelengths which trigger cancers.9. Myth: Stopping laser treatment can cause skin to deteriorate.Truth: Lasers actually cause skin rejuvenation. By aligning and tightening tissue they make the skin appear younger. Of course, the ageing process will continue each year. That is why even after a few sessions, some persons opt for long-term regular maintenance treatment to keep the skin youthful.10. Myth: All laser treatments are the same.Truth: No two lasers machines are exactly the same. Also, no two lasers experts are exactly the same. For optimal results, the laser machines have to be reliable. More importantly, your dermatologist should not only have in-depth knowledge of human skin but also needs to have special expertise and sound knowledge of lasers physics.

Is Laser Hair Removal The Right Thing To Choose?

Dr. Dhwani Shah (Vakta), Dermatologist
Frequently Asked Questions(FAQ)Excessive hair growth can be caused by the hormonal shifts of puberty, pregnancy or menopause. You may also have unwanted hair growth patterns caused by heredity, medication, hormone replacement therapy, diseases or other reasons. In any case, hair growing where you don’t want it to is a problem, no matter what the cause!No matter what way you may use to remove unwanted hair, be it waxing, threading, bleaching, plucking or shaving, laser treatment for hair removal is permanent, safe and easy!Not just women, even men are walking in for laser Hair removal for Beard Shaping, Unwanted hair on ears, chest etc.1. What is LASER hair removal?It is non invasive treatment of removing unwanted hair by using laser machines. which are specifically designed for it.2. How does it work?The laser gets absorbed in the melanin of hair follicle (the growth centre of hair) and it increases the temperature to destroy follicular cell permanently.3. How does the DIODE LASER  works?The High Speed DIODE  is a laser that produces a larger beam of highly concentrated light. The light emitted is well absorbed by the pigment located in the hair follicles. During the procedure, the laser pulses for a fraction of a second, allowing the hair to absorb the light and heat up, without damaging surrounding skin.As it heats up, the hair shaft and bulb are damaged which significantly impedes its ability to re-grow.4. Is LASER painful?You may feel a tingling or snapping sensation like a rubber band. It is definitely less than waxing and Electrolysis.5. Why multiple treatments are required?Laser hair removal requires multiple treatments. This is because the laser works best when hairs are in an early growth stage (referred to as anagen), and all the hair are not in this phase at the same time.6. How much time is there between sessions?Subsequent sessions are scheduled when the hair begins to regrow. The timing for this can range from four to eight weeks, depending on hair type and the part of the body being treated. On average, appointments are scheduled 4-6 weeks apart.7. What are the advantages over electrolysis?It is invasive technique and has side effects, as well as very time consuming because single hair is removed at a time. 8. Is is beneficial to alternative treatment?The primary benefits of laser hair removal include:Larger areas may be treated with less discomfort than with electrolysis, waxing or tweezing.It offers you a long term reduction in both the amount of hair, and also in many cases a reduction in thickness.It is safest and fastest amongst all methods of permanent reduction.9. Is treatment Economical?Considering the life long 4-6 weeks visits to parlours, investment of time, energy, money for nearly 18-20 years. Laser treatment is most economical.How?Saving time and energy:As you probably have to visit 3-12 sessions depending on response. Some will get 80-90% results in three, some in 5, average is 6-7.Patients with hormonal imbalance, post electrolysis, resistant follicles etc. needs more sessions.you are almost saving 17 years of your 3-4 weekly visits to parlours .Saving of money: Spending small amount of money every 3-4 weeks for 18-20 yrs would mount to huge total, spending little more just for few sessions will definitely be less than any treatment available today10. Are there any possible side effects?The appearance of the treated area immediately following treatment will vary from patient to patient depending on the extent of the procedure and skin type.Side effects, if any, are usually minor.There may be some redness and swelling around the treated hair follicles; this is a desired clinical result indicating that the follicle has responded to treatment.This reaction typically disappears within hours. Most people return to normal activity right away.   Limiting sun exposure before and after each treatment will minimize the risk of complications.11. What areas of the body can be treated?All parts of body can be treat with hair removing Laser.Laser Hair treatments work best in lighter skinned, darker haired patients. Because the primary target in hair follicles is melanin pigment (the “color” in skin and hair), less laser energy is absorbed by the skin and more by the hair follicle. The darker and thicker the hair, higher the chances of removing it. Lighter hair will be reduced but may not go away completely.Treatment areas in women: Face, Upper lip, Side lock, Chin, Forehead, Nose, Arms, Forearms, Legs, Thighs, Full body, Back, Chest, Abdomen.Treatment areas in men: Beard shaping, Shoulder, Back, Ear lobes, Brow separation .12. Are there restrictions of activity?You can go directly to work after treatment. Only avoid direct sunlight.

Laser in Dentistry

Dr. Rajat Sachdeva, Dentist
Laser treatment is becoming widely recognised and can be applied to prevent caries from developing and to reduce the progression of caries. The mechanism of laser should be understood before a dentist could apply in his daily practice.The Enamel surface of tooth is made of crystals called ‘Hydroxyapetite’ and it is permeable in nature therefore, allowing diffusion of ions. During laser treatment, moderate heat(CO2 laser produces temp > 1000 degree celcius) is produced which changes the composition of Enamel from ‘hydroxyapetite’ to ‘carbonated apetite’ in which there is loss of water in the crystals, as a result the pores of Enamel shrink down to form ‘Microspace system’. The Microspace system provides a means for trapping Calcium, phosphate and fluoride ions which release during demineralization and acts as site for re-precipitation. The trapped minerals phases inside the Enamel and impedes lesion formation and progression causing enhanced resistance against demineralization. As the microspaces are smaller in size, it decreases the permeability of the Enamel thereby reducing the diffusion of ions in and out thereby reducing the demineralization process. Thus a seal is achieved and so is resistance to caries.The Dentin also gets acid resistance as there is increased mineral content due to burning of organic matter from tissue so there is increased Calcium and Phosphate found in recrystallized Dentin.LASERS IN ENDODONTICSEndodontic procedure carried out by conventional methods may not be successful in spite of utmost care. Despite the mechanical removal, irrigation and disinfection of canals, the bacteria can still persist which cannot be reached by conventional techniques. As the technology has advanced, now lasers are used in endodontic procedures to improve the prognosis of the treatment of tooth. Laser light penetrates upto >1000 micrometre into the dentin and provides a distinct advantage since the bacteria can immigrate upto 1000 micrometre into tubules. When in contact with laser, cell membrane gets destroyed due to the impact of direct heat and this damage is enough to stop the growth of the bacteria depending on the wavelength and frequency of laser irradiation used by the dentist. It is a very effective tool for disinfecting the root canal after mechanical root canal treatment as it has sufficient penetration depth.It is effective in curved canals also and the energy is transported by thin flexible fibres which have diameter of only 200 micrometer. Laser eradicates the microbial flora of root canal and also has same effect on surrounding dentin without affecting the surrounding tissue and has good disinfection mechanism without causing pain and improving the prognosis of the endodontic treatment.LASERS IN ORAL AND MAXILLOFACIAL SURGERYLasers have played an integral part in the evolution of practice of oral and maxillo-facial surgery as the procedures can be executed efficiently with less complication. There are many advantages such as :-Maintenance of sterile condition.Precise and accurateDecreased post-operative swellingImproved tissue scarring and healingMore accessibleLess instruments neededLess painLess cost, staff and timeLaser in Implant (Peri-implantitis)Laser makes it possible to remove diseased tissue around a dental implant without causing any significant harm to the healthy tissue. It is gentle, reducing inflammation and discomfort while encouraging new bone growth to reinforce and save your implant. Cosmetic facial Laser surgeryLaser is used to treat facial lesions and skin wrinkles by removing the surface layer of skin allowing the underlying skin to re-epithilialize in a uniform manner. E.g. tissue tags, epidermal nevi, lentigines, superficial pigmentation, skin wrinkles, scar revision, melisma etc.‘Laser’ in routine dentistryPericoronitisFrenectomy and AnkyloglossiaLaser assisted Biopsy

Laser Hair Removal - Frequently Asked Questions

Dr. Nithya Raghunath, Dermatologist
In the past, the usual remedies for unwanted hair were plucking, shaving, waxing, or chemical depilatories. Some are painful, some are messy, and all are only temporary. Laser hair removal is an FDA-approved process of permanently reducing or eliminating unwanted hair on almost any part of the body except near the eyes. The process takes anywhere from several minutes to several hours, depending on the area of the body involved.What is laser hair removal?Laser hair removal uses a low-energy laser, which passes through the patient's skin, being absorbed by the pigment in the hair follicle. Each pulse of the laser targets and inactivates a large number of hair follicles. Approximately 3-6 treatments are necessary, although some people do require more treatments.Inadequately trained technicians can cause permanent scarring, hyperpigmentation and disfigurement. Always make sure the person who is performing any laser treatment has the required training and experience as well as the correct laser for your skin type and color. Popular areas of treatment include the brows, lip, chin, chest, shoulders, neck, back, legs, thighs, arms, underarms and ears.Is the hair removal permanent?During each treatment session, a certain percentage of the hair follicles are damaged such that hair will not grow from them again. With each treatment session, additional hair follicles are damaged until hair is completely absent in most cases.Is the treatment painful?There is some discomfort during laser hair removal, but the pain is generally less than waxing or electrolysis. Depending on how aggressive the treatment session is, the skin may be slightly to significantly pink following treatment. A certified dermatologist offers a potent numbing medication, which significantly dulls the pain. In most cases, no anesthesia is necessary.For maximal results, it is best to avoid bright sunlight for approximately 10 days prior to treatment. The area to be treated should be shaved immediately prior to the treatment. The aftercare is minimal. Sun exposure should be avoided for a few days after treatment.What are the risks and side effects of laser hair removal?The possibility exists that some side effects or complications can occur given various variables, including:NormalItching, during treatmentRedness for up to 3 daysSwelling (around the mouth) up to 3 daysPain, tingling, or feeling of numbnessRareCrusting/scab formation (on ingrown hairs)BruisingPurpura (purple coloring of the skin) on tanned areasInfectionTemporary pigment change (hypo-pigmentation or hyper-pigmentation)Side effects occur infrequently and, as a rule, generally are temporary. If any of the above last for more than 3 days, make sure to contact your doctor. The doctor needs to know in order to adjust settings on your following treatment.What are the stages of hair growth and how does it affect me?There are three phases of the hair growth cycle:Anagen (active) is the growing phase or when the hair fiber is produced. During anagen, the hair contains a great quantity of melanin, the pigment which gives your hair its color. This is the phase during which laser hair removal treatment is most effective.Catagen (club hair) is the period of controlled regression of the hair follicle. This phase is when the lower part of the hair stops growing, but does not shed, and the follicle is reabsorbed. It will be difficult for permanence to be achieved when the hair is in the catagen growth cycle.Telogen (tired) is the last of the hair growth cycle. In this resting phase, the old hair falls out in preparation for the development of a new anagen hair. Permanence cannot be achieved when the hair are in the telogen growth cycle.

Laser Hair Removal Overview

Dr. Bhavesh Shah, Dermatologist
Laser hair removal has come a long way since the first laser for hair removal received FDA clearance in the mid 1990s. Older generation lasers were slow, very painful and worked only on individuals with very dark hair and very light skin. Now there are varieties of laser hair removal specially designed for different skin tones, hair types, etc. It usually takes a series of treatments for permanent hair removal, but there’s a treatment out there for just about everyone. Types of Lasers used for hair removalNo single laser is ideal for every individual. Depending on your skin and hair colour, some lasers will be more effective than others. Diode LaserLonger wavelength allows deep penetration into the skin and safety for darker skin typesNot effective for lighter and finer hair Smaller spot size, which results in longer treatment timeThe longer treatment time necessary for diode laser hair removal  Nd:YAG laserCan be used on all skin types, including tanned skin Large spot sizes and fast repetition rates allow large areas to be treated quickly Provides less effective treatment for fine and light hairs than some other hair removal lasers Ruby LaserFirst laser introduced for hair removal Laser beam is well absorbed by melanin pigment in hair, making it good for removing finer, lighter hair Should be used for hair removal on patients with fair skin, as it may burn those with dark or tan skin Slow repetition rate and relatively small spot size, which may mean a longer, more expensive treatment with greater discomfort Alexandrite LaserThe fastest hair removal laser Large spot size (up to 18mm) and high repetition rate Can rapidly treat large body areas - an entire back can be treated in less than 30 minutes Suitable for patients with fair to olive complexions Intense pulsed light (IPL)Used for hair removal, but primary use is to treat skin pigmentation problems Unlike lasers, IPL devices emit the full spectrum of light wavelengths Works best on patients with fair skin and dark hair 

Laser Hair Removal: Overview

Dr. Venu Kumari, Dermatologist
Are you tired of shaving, plucking, or waxing? Do you get razor bumps or acne-like breakouts when you get rid of unwanted hair? If so, you may want to consider laser hair removal. Dermatologists use lasers to remove unwanted facial and body hair safely and effectively. Thanks to advances in technology, most people can safely have laser hair removal. Removing the unwanted hair often requires a few office visits. Most patients need between 2 to 6 treatments. Afterwards, most patients are free of the unwanted hair for several months. When the hair regrows, most patients see noticeably less hair than before. The hair also tends to be finer and lighter in color. Laser hair removal can be repeated when the hair regrows. What dermatologists treat: The lasers designed for hair removal can be used on most parts of the body. Many lasers effectively treat large areas. Laser hair removal can treat the: Back Bikini area Chest Face, especially the upper lip and chin Neck ShouldersInsurance coverage: Insurance does not cover laser hair removal. To help you decide whether this treatment is right for you, you should review the following facts. Warning:Laser hair removal can be dangerous in inexperienced hands. Burns, permanent changes to your skin color, and scars can occur. You can greatly reduce the risk of possible side effects by having your treatment performed by a medical doctor who is extremely skilled in using lasers and has in-depth knowledge of the skin.  The AAD recommends that you choose a certified dermatologist to perform laser treatments.What must you do after getting laser hair removal? To avoid possible side effects, all patients need to protect their skin from the sun. After laser hair removal, you should: Avoid direct sunlight from hitting your treated skin. Not use a tanning bed, sun lamp, or any other indoor tanning equipment. Follow your dermatologist’s after-care instructions.You will see some redness and swelling after treatment. This often looks like a mild sunburn. Applying a cool compress can help reduce your discomfort. Is there downtime? No, laser hair removal generally does not require any real downtime. Immediately after having laser hair removal, your treated skin will be red and swollen. Despite this, most people return to their everyday activities. When will I see the results after having laser hair removal? You will likely see the results immediately after treatment. The results vary from patient to patient. The color and thickness of your hair, area treated, type of laser used, and color of your skin all affects the results. You can expect a 10% to 25% reduction in hair after the first treatment. To remove the hair, most patients need 2 to 6 laser treatments. After finishing the treatments, most patients do not see any hair on the treated skin for several months or even years. When the hair regrows, there tends to be less of it. The hairs also tend to be finer and lighter in color. How long will the results of laser hair removal last? Most patients remain hair free for months or even years. When some of the hair regrows, it will likely be less noticeable. To keep the area free of hair, a patient may need maintenance laser treatments. What are the possible side effects? The most common side effects are minor and last 1 to 3 days. These side effects include: Discomfort Swelling Redness    

Simplifying Laser Treatment for Unwanted Hair

Dr. Shreeshail Kumbar, Dermatologist
What are unwanted hair ?Unwanted  hair in women is basically having terminal hair in areas where normally women have finer hair, It’s called Hirsutism.For men unwanted hair may be excess hair on trunk, beard covering most part of cheeks, or may be full body.Hirsutism can be caused by either an increased level of Androgens, (the male hormones) or an over sensitivity of  hair follicles to androgens. Genetics plays a major role in unwanted hair .How do lasers help in targeting unwanted hair?Nd YAG and Diode laser are proven lasers for Indian skin and hair type. Laser basically targets chromophores (colored cells).For hair targeting lasers MELANIN is the chromophore. So they destroy only specific cells without damaging other cells without chromophores.Why we need multiple sessions for optimal results?Laser targets only growing hairs, and all hairs are not in growing phase at any given time.So, when you take laser, with each session thickness, density, and rate of growth comes down.Will the hairs go completely and permanently?Results in laser depends on body part and hormonal issue the person is having. For example, under arm hair is good in density and thickness, so laser can target them very effectively. Secondly, under arm hair is a universal phenomenon, there is no hormonal abnormality.When we talk about unwanted facial hair, results vary a lot depending on duration of hair thickening, density,thickness, hormonal imbalance, medications etc.So in Hirsutism, is it worth taking laser as its not going to remove hairs completely?In a lady with Hirsutism there is a continuous process going on at hair follicle level, where finer hairs are gettingthicker gradually. That’s the exact reason why people are not very happy with laser treatment for hirsutism. One need to understand this to be happy with laser treatment.The fact is, laser is destroying existing thicker hairs which are in growing phase. However, results depend on how fast or slow finer hairs are getting thicker. This is totally individualized depending on hormonal status.On a long run it helps in controlling hair density, thickness and reducing thickness permanently.If one works on other factors like weight reduction, exercises diet etc , laser can really benefit and help in improving quality of life. Is it possible to get hirsutism with normal levels of blood hormones?Yes, Hirsutism with normal blood hormones is seen in many individuals. The reason is end organ hypersensitivity, they have sensitive follicle which react to even normal hormone levels. Hirsutism in itself is a very vast subject, difficult to cover everything in this topic.What are the side effects of Laser?Most of the side effects of laser are temporary like redness and mild swelling. However, there can be heat reaction in some individuals especially with darker skin.Laser in contraindicated in Pregnancy and lactation Take home message.Laser hair reduction is a good modality of treatment for unwanted hair.Results depend on multiple factors like body part, hair thickness, skin color, hormonal profile ,etc.Dermatologist with laser experience  can advise you better as results are totally individualized .

Know More About Laser Hair Reduction Before Heading to Parlour

Dr. Bhavesh Shah, Dermatologist
Know what to expect if you decide to go for laser hair reduction!For obvious reasons, unwanted facial hair is a source of great embarrassment for women. Not only does it affect self-esteem, but it also requires repeated visits to beauty parlours to get rid of it.Facial skin is delicate and repeated bleaching or waxing may damage it or cause pigmentation. This is why lasers come to the rescue. They eliminate unwanted hair without harming the skin.Although women with unwanted facial hair use it more, it is also popular among metrosexual men who want to get rid of facial or body hair as per current grooming standards. Before opting for a laser treatment, though, familiarize yourself with how it all works.The type of lasers usedOf the many types of lasers, the Nd:YAG, IPL and diode lasers are used for laser hair reduction [LHR].The wavelength of Diode laser is such that it is almost entirely absorbed by the melanin [pigment] of the hair, leaving the skin unharmed. Hence, it is the most preferred for this procedure.How it is doneFirst, the area to be treated is shaved. This reduces the chances of heat contact with the skin and facilitates smooth movement of the laser probe. Don’t worry, shaving does not increase the thickness of the hair.A thick layer of cooling gel is then applied on the area and sequential laser shots are given. Many people report experiencing a warm/stinging sensation during this stage. Some sensitive areas are made numb using anaesthetic creams prior to the procedure.At the end, ice is applied on the area to ease discomfort. Lastly, a high SPF sunscreen is applied on the area and you can go home.Immediately after the treatment, you might find redness and swelling around the hair follicle. These symptoms usually disappear in a couple of hours.After-careProtection against sunlight is an absolute post-care measure, not only on the day of the session but throughout the therapy. Do not indulge in beauty or cosmetic treatments or cosmetic therapy like chemical peels for at least a week before and after a session.Sitting scheduleHair growth occurs in a cyclical manner. There is a growing phase or anagen, resting phase or telogen and a shedding phase or catagen. Only anagen hair is most affected by laser.What that means is that though the laser targets the entire treatment area, it affects only around 30 per cent hair. The anagen hair needs to be targeted in the next cycle by repeating the session after 4 – 6 weeks.That’s why LHR cannot be done in a single session; one might notice nothing more than a reduction in the density of hair after the first session. On an average, 6 – 8 sessions of LHR are needed for optimum results.At the end of the prescribed number of sessions, around 80 per cent hair is permanently removed leaving the rest as fine and thin hair. This hair can be managed by follow-up [maintenance] sessions every three months or so.For best results, rule out any hormonal imbalance. In case there is an imbalance, combining LHR with medication gives better results.Thicker the betterContrary to popular belief, lasers work best on thick and coarse hair. Thick hair is better able to absorb a laser than colourless and fine hair. Fine light-coloured hair may not completely disappear, but becomes finer than what it is.What may go wrongIf the redness and burning sensation experienced immediately after the treatment persist, contact your doctor; it could be skin burn. Burn occurs mainly due to technical errors or due to extreme sensitivity of the skin.Hence, get the procedure done from a  medical professional [Dermatologist]. It’s better to ask for a patch test before the first session to see how your skin responds to laser.Further, if lower intensity energy is used than required, it may stimulate hair growth. This is known as paradoxical hair growth and happens rarely. The new hair tends to be fine and light coloured. It is treated by graded increase in the energy used for treatment.A word of cautionDo not undergo the laser session if you have an infection of the skin or severe acne at the site to be treated.Skip the treatment if you are sensitive to the sun, are pregnant or suffer from auto-immune medical conditions.Ensure that the dermatologist does a detailed skin examination before your first laser session.Do not wax before a procedure as laser cannot be done on hairless skin. Your doctor needs to see some hair growth before starting the procedure to decide the energy settings of the machine according to the hair type.

Generously Generic: Know Your Medicines

Dr. Tanoy Bose, Internal Medicine
One fine winter evening when I was consulting a 45 year old obese fair lady who actually forgot to bring her past health records, I enquired about the medicines she is taking on daily basis. She recollected a few brands which I noted down. On asking whether she is on Aspirin or Thyroxine, she denied of such drug but quickly recollected that she takes Eltroxin 50mcg and Ecosprin AV75mg daily. Well, she did not know that the active ingredient of Eltroxin is Levo Thyroxine and that of Ecosprin AV is Aspirin & Ator vastatin combined. The former is given to replace thyroid hormone deficiency to those who are hypothyroid and the latter is usually given to those who are suffering or are at the risk of developing coronary artery disease. If I am not that very wrong, more than 95% of patients do not remember medicines by their generic names. So what difference does it make? Well, it’s the money that matters. For those who are ill-informed, the market prices of most of the drugs of regular as well as special use are tagged with exceptionally high price just for the sake of an industry.The statistics from McKinsey & Co. states that the growth rates of Indian Pharmaceutical Industry is compounding at 12 to 14% per annum since last 5 years and have projected the value of the industry is going to be around $20 to $24 Billion by 2015. This growth would be driven primarily by rising incomes, and be supported by five other factors: enhanced medical infrastructure; rise in the prevalence and treatment of chronic diseases; greater health insurance coverage; launches of patented products; and new market creation in existing white spaces. If we zero down to the basic issue of generics versus branded drugs it is the pocket pinch that matters. I don’t think if quality is assured, people will love to shell out more for a branded drug rather than buying a generic product.What are generics?All drugs are products of research. They are born in a research laboratory and end up in a pharmacy shop. Whatever be the results of the research product in the laboratory, their usage in general public for any particular indication is highly regulated by the US FDA. Financially the companies have to bear a huge burden to research and develop a drug, undergo clinical trials for them in phasic manner and further make them available for general prescription. Further, after the drug is launched and approved by USFDA the company holds a patent for the drug for say tenure of 10 to 12 years. Hence, during this period the cost of drug is very high as the company needs to recover the cost of R&D. However, after lapse of license,the drug molecule is available for other companies to copy and rebrand and bring them into market again. The cost of the drug falls drastically now as the companies now selling the copied drug did not have to spend on the R&D. The only investment for these companies is the price of the molecule and the technology of packaging and marketing. These drugs which are sold under different brand names after the post licensing period of a particular molecule are called generic drugs. However, the qualities of these generic drugs are also under FDA regulation. According to FDA, to substitute a generic for a brand name drug must follow these criteria:It must contain the same active ingredient, the same dosage strength and the same dosage form (e.g. tablets, syrup etc) and have the same route of administration and further it must deliver the same of active ingredient to the blood stream.Hence cheaper does not mean poor quality. The difference from patented drugs is the generics may vary in shape,size, color or taste. They have different inactive ingredients. However, there are authorized generics that need to maintain similarity in these parameters too. Almost 50% of all drugs prescribed in India are generics. Thus generic drugs may cost almost 20 to 80% cheaper than the patented drug.Is the quality guaranteed in a generic formulation?Researchers have compared patented drugs with generic formulation from different companies in a random manner and 36 of 38 studies virtually found no differences in the drug quality control. But, FDA has barred the publication of drug equivalence studies. Hence it is difficult for the prescribing doctor to know whether there had been any difference between the drugs in the equivalence study or not. It’s worth mentioning thatIndia tops the world in exporting generic medicines worth of Rs.50,000 Crores and currently Indian Pharmaceutical industry is one of the world’s largest & most developed.What is the price paid for not using generics? It’s worth mentioning that India tops the world in exporting generic medicines worth of Rs.50,000 crores and currently Indian Pharmaceutical industry is one of the world’s largest & most developed.In spite of being the largest exporter of generics in the world the story behind the screen is very dull. Just have a look at few of the statistics.WHO says that 3.2% of Indians will fall below poverty line because of inflated medical bills.Approximately one third of the rural population do not seek medical treatment due to financial constraints.And about 47% of rural and 31% of urban hospitalizations are financed by loan and sale of assets.About 70% of Indians are spending their out of pocket income on medicines and healthcare services in comparison to 35% in other Asian countries and are still suffering from infectious & communicable diseases due to lack of quality and affordable treatmentWhere do I get the generics?Generic medicines are best bought from the government sponsored generic drug shopped opened under the banner of “JANAUSHADHI”in most of the Indian states. Janaushadhi stores are functioning under the banner of Bureau of Pharma PSUs of India (BPPI) under the aegis of Department of Pharmaceuticals, Government of India. States like Punjab, Delhi, Haryana,Andhra Pradesh, Odisha, Uttarakhand, Chandigarh, Jammu & Kashmir, Himachal Pradesh and Jharkhand have already implemented Janaushadhi stores providing quality generic medicines at a cheap and affordable price. Few states like West Bengal has initiated Fair Price Medicine shops in a Public Private Partnership models to provide generic medicines at a whopping discount of up to 62.7%. They are opened adjacent to or in collaboration with different government healthcare establishment the largest being at the SSKM Hospital, Kolkata.Can we have examples of price comparison?I have made an attempt to compare the prices of the generics available on the website of Janaushadhi to that of branded generics available in the market. In fact I have approached a regular chemist shop and asked for these prices. Also I have reduced the quote by 11%as that particular chemist shop was giving a discount of 11% on any drug bought from the chemist. Now let’s compare the cheapest discounted branded drugs with the Janaushadhi generics. Generics and Branded Generics : The price difference This comparison is bound to raise eye brows. I am sure it’s unthinkable for most of us that we had been buying medicines at such high price and we are at the verge of realization after sucha long period of illiteracy. Do we get all sorts of medicines at these generic drug stores?Well, wish the answer could have been yes. Unfortunately all medicines are not available at the generic drug stores.While scrolling down the list provided by Janaushadhi website I found drugs for treatment of Rheumatoid Diseases are missing. Drugs for treating neurogenic pain, Parkinsonism, schizophrenia, newer drugs for diabetes management,inhalers and insulins are missing. I am sure they will soon be incorporated or might have been incorporated by now. Even without these drugs the net price of the monthly medications fall drastically if purchased from the generic drugstore.Any words of Caution?Well, there has to be some words of caution. The country is lagging in maintenance of quality control and most of the quality control is outsourced. Further, the government not necessarily declares the data of quality check to the general public. Hence, many doctors keep on highlighting the quality of the generic medicines.My recommendation is, whenever you have the opportunity to buy the drugs from a government sponsored stores, consider the quality is guaranteed by the government. Hence, you can very well go and purchase the medicine and use it personally.Adverse Reactions: Unless the drug is too spurious, it is unlikely that somebody will suffer from any adverse reaction. Spurious drugs are usually sold in peripheral aspects of a city or major town mostly is districts and village areas. Hence, one should be very careful about purchasing generic drugs from these areas.What I practice and recommend?When I am sitting in my clinic at Kolkata, I write the composition of the drug e.g. Paracetamol.[ Drug that reduces fever ], Amlodipine [Drug that controls blood pressure] ,Pantoprazole [ An Antacid ] instead of the brand names. This helps the patients in two ways. Either they can go to the Fair Price shop and buy the cheapest ones and save a lot, or they can go to any chemist and ask the chemist to provide the brand which is cheapest for that particular composition. I do practice in districts of West Bengal where there are brands which I have never heard off. In these areas I always write the brand of the drug and tend to keep the price low. In this way the spurious drug sellers can be fended away and I can ensure that quality drug is served and chances of health hazard is minimum.