Detailed treatment narratives showing how we diagnose, treat, and track progress for common conditions.
Note: All case studies are anonymized. Details have been modified to protect patient identity while preserving clinical accuracy.
Patient: 23-year-old female, Gomti Nagar
Presenting concern: Active acne with post-inflammatory hyperpigmentation. Had been self-treating with over-the-counter products (benzoyl peroxide, salicylic acid face washes) for 18 months with no improvement. Previous visit to a general physician resulted in a short course of antibiotics with temporary improvement followed by relapse.
Assessment: Grade III inflammatory acne with comedonal component. Contributing factors identified: hormonal (irregular periods), environmental (hard water in her area), and product-related (using comedogenic moisturizer).
Treatment plan:
Outcome: Significant clearing by month 3. Treatment course completed in 6 months. Post-inflammatory marks addressed with a series of mild chemical peels.
Key takeaway: The previous doctor had prescribed antibiotics without addressing the hormonal and environmental factors. Proper grading and a complete assessment changed the treatment trajectory.
Patient: 35-year-old male, Mahanagar
Presenting concern: Recurring ringworm patches that returned every monsoon for 3 consecutive years despite antifungal courses. Patient had completed 4 separate rounds of oral antifungals prescribed by different doctors.
Assessment: Tinea corporis with steroid-modified presentation (patient had been applying a steroid-antifungal combination cream available over the counter). Skin scraping confirmed active fungal infection.
Treatment plan:
Outcome: Complete clearance within 6 weeks. No recurrence through the following monsoon season because the environmental triggers were addressed.
Key takeaway: The fungal infection wasn't "resistant" — it was being masked by steroid cream and undertreated with too-short courses. Environmental factors specific to Lucknow's monsoon were never addressed by previous doctors.
Patient: 40-year-old female, Indira Nagar
Presenting concern: Bilateral melasma of 4 years. Had been prescribed hydroquinone by another clinic and used it continuously for 2 years. Initially improved, then plateaued and worsened.
Assessment: Mixed-type melasma (epidermal + dermal). Long-term unsupervised hydroquinone use had caused ochronosis (darkening from the medication itself). Patient was not using sunscreen consistently and was exposed to significant UV during daily commute.
Treatment plan:
Outcome: Noticeable improvement by week 8. Ongoing maintenance to manage the dermal component, which was explained as permanent but manageable from the start.
Key takeaway: Long-term hydroquinone without supervision caused more harm than good. Melasma needs ongoing management — not a "cure" promise.
Patient: 28-year-old male, Aliganj
Presenting concern: Progressive hair thinning over 2 years. Had tried ayurvedic oils, biotin supplements, and minoxidil — all self-prescribed based on online research. No improvement.
Assessment: Grade III androgenetic alopecia (male pattern). Blood work revealed low vitamin D and ferritin (common findings in Lucknow patients with indoor lifestyles). Trichoscopy confirmed miniaturization pattern.
Treatment plan:
Outcome: Noticeable reduction in hair fall by month 2. Visible density improvement by month 4. Patient now on maintenance protocol.
Key takeaway: Self-prescribed treatments failed because the underlying cause (hormonal + nutritional) was never diagnosed. A trichoscopy and blood work took 20 minutes but changed the entire treatment approach.