Yenepoya Medical College

Preamble

There has been an upward trend in patients seeking cosmetic treatments for concerns ranging from acne, pigmentation, wrinkles and aging. A significant number of patients attending dermatology OPD at YMCH present with these complaints. Hence, this fellowship in cosmetic dermatology aims at training dermatologists in various cosmetic procedures to enhance their skills and knowledge.

Goal:
To formally train dermatologists in the field of Cosmetic Dermatology so that the trained candidates can practice and deal with various types of cosmetic concerns.

Aim of the program

To make fellows competent in cosmetic dermatology to handle various cosmetic problems, learn new procedures and develop new skills.

Objectives/Outcomes

PO1 - To acquire knowledge as regards to various cosmetological problems and procedures
PO2 - To be aware of the recent trends in the field of cosmetic dermatology
PO3 - To attain basic skills and techniques of performing cosmetological procedures like Lasers, injectables, chemical peels.
PO4 - To develop techniques for counselling patients before and after the procedure.

Program specific Outcomes PSO -

PSO1	To make a diagnosis	Examine and assess the patient for cosmetic concerns regarding acne, pigmentation, aging and facial symmetry.
PSO2	To formulate a treatment plan	To identify the patient concerns, formulate the plan and execute the treatment such as conservative or procedural based.
PSO3	To counsel the patient	Explain the risks and benefits of cosmetic procedures vs conservative management and to take into account the patient's preferences and expectations.
PSO4	To Perform appropriate Procedures	To be able to assist /perform various cosmetic dermatology procedures
PSO5	To Manage or prevent Complications	To assess the probable complications of the procedure and to notify it

Eligibility for admission

Post MD (DVL)/DNB(DVL)/DDVL
b. Number of admissions:
2 per year

Syllabus / Course contents

Anatomy and Physiology
1. Classic anatomy
2. Topographical features and underlying bony and cartilaginous structures
3. Blood supply of the face
4. Sensory innervation of the head and neck
5. Motor innervation of the head and neck
6. Muscles of facial expression
7. Characteristics of the skin in different cosmetic unit
8. Relaxed skin tension lines, cosmetic units and junction lines
9. Physiology of the skin and soft tissues
10. Microscopic anatomy of the skin and subcutaneous tissues
11. Photo-aging and intrinsic aging

Basic Principles of Cosmetology

Introduction to Cosmetology
Documentation - Informed consent Form
Principles governing Cosmetological procedures
Subspecialities of Cosmetology (Protective, Decorative and Remedial or Active Cosmetology)
Dermatological disorders coming under the purview of cosmetology
Cosmeceuticals
Instruments, Equipments and Universal precautions
Adverse reactions to cosmetics
Professional ethics

- The ideals of medicine

- Personal integrity and accountability

- Ethical accountability in physician-patient relationships

- Boundary violations in physician-patient relationships

- Professional accountability, licensing and discipline

- The physician and public accountability
Moisturizers
Personal care and Cosmetic products
Household cosmetics
Nail aesthetics - Artificial nails
Medi Facials
Chemical peels

- Superficial

- Medium depth chemical peeling

- Conventional peels

- New and Combination peels

- Peels for dark skin

- Peels for acne skin

- Peels for pigmentation
Cosmetic care and counselling for normal and problematic skin
Cosmetic camouflage
Adverse reactions in cosmetology
Common cosmetic techniques in beauty parlours
Managing a difficult patient - Body Dysmorphic disorders

Approach to cosmetic problems in dermatology

1. Acne and acne scars

2. Hirsutism

3. Pigmentary disorders

4. Cosmetic problems of nails

5. Hyperhidrosis/Bromhidrosis/Chromhidrosis

6. Aging skin problems

Procedures in cosmetology

Surgery for acne scars

- Punch excision

- Punch floatation
Electrosurgery

- Hyfrecator

- Electrofulgration

- Electrodessication

- Electroepilation
Radiofrequency

- For removal of skin lesion

- For tissue tightening
Mole removal
Cryotherapy

- Cryocan

- Roller device

- Dipstick method
Platelet rich plasma

- For anti-aging

- For acne scars
Iontophoresis
Dermaroller

- For acne scars

- Stretch marks

- Skin Rejuvenation
Non ablative fractional CO₂ lasers

- Acne Scars

- Keloids

- Facial rejuvenation & tightening
Botulinum toxin injections

- Facial Wrinkling

- Hyperhidrosis

- Mesobotox
Microblading
Threads

- Anti ageing

- Acne Scars

- Alopecia
Laser Basics

- Laser Hair Removal

- Fractional Lasers

- Q Switched Lasers

- CO₂ Lasers
Soft-tissue Fillers

1. Ideals of beauty

a. Mathematics of symmetry

b. Principles of facial shape and harmony

2. Facial anatomy and mapping

a. Facial aesthetics and changes associated with aging

b. The use of mathematical principles and proportions to achieve excellent filler results

c. Avoiding, diagnosing and treating complications
Chemical Lipolysis

- Subcutaneous drug for nonablative local fat

Programme Structure

Duration of the course	13 months
Seminars/ Journal Clubs	1 hour per week
Practical and Clinics	6 hours per week
Contact hours	42 hours per week
InterDepartmental meetings (Anatomy, Endocrinology, Psychiatry, Plastic Surgery)	2 per year/ per department
Simulation-based	2 hours per month

Attendance requirements

After completing 13 months of course with 80% minimum attendance is required to appear for the University exam.

Academic Requirements

1. At least one presentation/poster in international/national/state conferences
2. Regular presentations in Local body dermatology meets.
3. Maintaining a LogBook of all Clinical work and Practice.

Scheme of Examination:

University Examination
The final Examination will include the Theory and Practical Examination of 200 marks each.

THEORY PAPER: - Paper 1 and 2 (200 Marks)

Paper – I Fundamentals of Cosmetology Anatomy & Physiology	100 Marks
Paper – II Skin diseases & Cosmetic Procedures Recent advances in Cosmetic dermatology	100 Marks
Total	200 Marks

Nature and Number of Questions: Each theory paper will consist of 10 long essays

Duration of Theory Papers: 3 hours for each question paper

PRACTICAL: -

OSCE (Objective Structured Clinical Examination)	30 Marks
Practicals - Long case X 1 - Short case X 1	30 Marks 20 Marks
Viva Voce	20 Marks
Total	100

Criteria for Eligibility to Appear University Exam

80% attendance
Maintaining log book duly signed by the course director and coordinator
Paper/poster presentation either in national or state conferences

Criteria for pass

Minimum 50% marks in Theory
Minimum 50% marks in Practical

Declaration of results

Declared by the Yenepoya (Deemed to be University)/ Yenepoya Medical College

Logbook/Portfolio

The log book should be maintained, which must be countersigned by the course director.

Reference books and Journals

Mysore V, editor. ACS(I) Textbook of Cutaneous & Aesthetic Surgery. 2nd ed. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd; 2017.
Vasudevan B, Chatterjee M, Shilpa K, editors. ACS(I) Procedural Dermatosurgery: A Step by Step Approach. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd; 2018.
Savant SS, editor. Textbook Of Dermatosurgery & Cosmetology: Principles and Practice. 3rd ed. Mumbai: Bhalani Publishing House; 2018.
Tay YK, Chan YC, editors. Textbook Of Laser And Light Dermatology In The Asian Skin. Singapore: World Scientific Publishing Company; 2011.
Baran R, Maibach H, editors. Textbook of Cosmetic Dermatology. 5th ed. Boca Raton: CRC Press; 2017.

List of recommended journals

Journal of Cutaneous and Aesthetic Surgery
Lasers in Surgery and Medicine
Clinical, Cosmetic and Investigational Dermatology
Lasers in Medical Science
Journal of Cosmetic Dermatology
Journal of Clinical and Aesthetic Dermatology
International Journal of Cosmetic Science
Journal of Cosmetic and Laser Therapy
International Journal of Trichology
Journal of Cosmetic Science
Surgical and Cosmetic Dermatology

Any other information:

Course Director:

Dr Manjunath Shenoy
Professor and HOD,
Department of Dermatology, Venereology and Leprosy
Yenepoya (Deemed to be) University,
Deralakatte, Mangalore - 575018

Course Co-ordinator:

Dr Vishal Amin
Professor,
Department of Dermatology, Venereology and Leprosy
Yenepoya (Deemed to be) University,
Deralakatte, Mangalore - 575018

Subject Experts (External)

1. Dr B S Chandrashekhar
Chief Dermatologist,
CUTIS Academy of Cutaneous Sciences & Founder of Epicorium
5/1, 4th Main, MRCR Layout,
Magadi Main Rd, Govindaraja Nagar Ward,
MC Layout, Vijayanagar, Bengaluru, Karnataka 560040

2. Dr K C Nischal
Nirmal Skin & Hair Clinic
17, 8th Cross Rd, Govindaraja Nagar Ward,
MC Layout, Vijayanagar, Bengaluru, Karnataka 560040

Annexures: Annexure I

a. Blueprint for Theory and Practical Examination

Theory Examination:

Paper – I

Topics	Number of Questions	Marks
Fundamentals of Cosmetology - Structure and function of skin - Visco elastic Properties of Skin including RSTL - Skin aging - Sunscreens, retinoids, moisturizers, de-pigmenting agents, antioxidants: Pharmacology and Uses. - Cosmeceuticals	1 1 1 2 1	10 10 10 10 10
Anatomy & Physiology - Biology of eccrine and apocrine glands, hair follicle, sebaceous gland and nail. - Muscles of facial expression - Blood supply, sensory and motor innervation of the head and neck	1 1 1	10 10 10

Paper-II-

Topics	Number of Questions	Marks
Skin diseases & Cosmetic Procedures - Acne and Scar management - Pigmentary disorders - Cosmetic problems of nails - Hirsutism - Dermatologic procedures – Chemical peeling, electrocautery, LASERS – Physics and application - Botulinum toxin, fillers, Tattooing and tattoo removal - Psychodermatology	1 1 1 1 2 1 1	10 10 10 10 10 10 10
Recent advances in Cosmetic dermatology	2	10

Blueprint for Practical Examination:

Topics	Number of questions	Marks
OSCE a. Hirsutism b. Acne and acne scars c. Facial pigmentation d. Brittle nails e. Cutaneous Vascular anomalies f. Congenital / acquired melanocytic nevus	1 1 1 1 1 1	5 5 5 5 5 5
Practicals - Long case Soft tissue loss in face - Short case Aging skin problems	1 1	30 20
Viva Voce - Instruments - Therapeutics		10 10

ANNEXURE - II: Question Paper Layout and Model Theory Question Paper

YENEPOYA (Deemed to be University)
FINAL ASSESSMENT EXAMINATION
Fellowship in Cosmetic Dermatology - Paper I
DERMATOLOGY, VENEREOLOGY AND LEPROSY

Exam Date:
Max Marks: 100
Time:

Your answers should be specific to the questions asked.
Draw neat labelled diagrams wherever necessary.

Short Essay
(Marks: 10 x 10)

Enumerate the muscles of facial expression - Anatomy, blood supply and function.
Briefly describe fat compartments of the face. Add a note on SMAS.
Mechanism of skin aging. Describe intrinsic and extrinsic types of facial aging.
Sunscreens - types and uses. Add a note on oral sunscreens.
Write a note on the visco elastic properties of the skin including Relaxed Skin Tension Lines.
Describe the problems of aging skin.
Cosmeceuticals - definition, indications and adverse effects.
What is cosmetic camouflage therapy - indications, adverse effects and limitations.
Describe contact sensitivity to traditional cosmetics.
Write a note on the art of handling complications in aesthetic practice.

YENEPOYA (Deemed to be University)

FINAL ASSESSMENT EXAMINATION

Fellowship in Cosmetic Dermatology - Paper II

DERMATOLOGY, VENEREOLOGY AND LEPROSY