For years, India has been home to a number of skin conditions and diseases such as acne, psoriasis, dermatitis, vitiligo, fungal and bacterial infections, to name a few. Although mortality due to skin diseases is low, they contribute to significant disability and stigma. Most of the data on the epidemiology of skin diseases from India is in the form of small case series or surveys from hospitals or communities and it does not give us the true picture of disease burden in the country.

For instance, conditions like psoriasis pose a financial burden along with psychosocial consequences due to the stigma attached to them. Thus, these skin problems are often neglected and people refrain from going to the doctor or end up doing self-treatment.

In addition, the anti-infectives, cardiac and diabetes segments have been known to dominate the Indian pharmaceutical market, leaving very little space for the dermatology segment to grow and carve a niche for itself.

The good news, however, is that things are looking up for dermatology. According to a recent AWACS AIOCD report, the segment has increased to 30 per cent in May 2022 (in moving annual turnover). The report has revealed that the segment is valued at Rs 11,043 crore in May 2022, and it looks to be one of the fastest growing therapies going forward. This spike in dermatology drug sales is a result of the increase in demand for anti-acne, emollients, anti-fungal and skin brightening formulations, as people are resuming their normal activities. 

“The dermatology sector in India is set to boom as people are facing factors such as lifestyle changes, environmental changes, pollution, and also short term factors like heat, humidity and pollution as they resume their daily activities as pandemic-led concerns subside. We see this opportunity as promising and are happy to boost supplies of novel dermatological medicines to allay the increasing skin complaints. We also hope to capture a larger market share for being the pioneers in dermatology manufacturing, by having a vast array of products both through our R&D and in-licensed collaborations”, says Sanjeev Jain, Founder, Promoter and Director, Akums Drugs & Pharmaceuticals.

Backing this trend is an observation by Bengaluru-based healthcare platform MediBuddy that has witnessed a manifold rise in dermatology consultations. Data compiled reveals that in the last few months, the portal has seen an overall growth of about 84 per cent in the number of people seeking consultations for skin-related issues.

“About 69.47 per cent of issues were relating to acne, with the rest pertaining to problems like pigmentation, face tan, generic skin disease, ringworm, psoriasis, etc. The data on the platform also reveals that of the total people who sought consultations about 75.9 per cent of people were males. Men and women are both susceptible to dermatological issues and our data shows that men are also increasingly seeking professional help for dermatological issues rather than ignoring them”, says Satish Kannan, Co-Founder and Chief Executive Officer, MediBuddy.

Pharma ups the game

The increasing prevalence of skin conditions, both infectious and non-infectious, has boosted the pharma companies to manufacture medications thereby increasing their R&D activities. For example, Mumbai-based Sun Pharmaceutical is currently conducting phase-2 clinical trials for a potential oral treatment for atopic dermatitis and moderate to severe plaque psoriasis.

On the other hand, Mumbai-based Glenmark Pharmaceuticals has recently launched India’s first topical Minocycline 4% Gel for the treatment of moderate to severe acne, under the brand name MINYM. In a study conducted by Glenmark in 2020, on the prevalence of acne in India, it was observed that 45 per cent of the patients were males and 55 per cent were females; and almost 72 per cent of the patients were in the adolescent group whereas 27 per cent patients were in the adult group.

Pune-based Ahammune Biosciences has emerged as the first drug discovery company in the country to develop a targeted new treatment option for vitiligo. With the transition to the human clinical stage, the company has now developed a space for itself in this domain and is now being approached by stakeholders for possible collaborations.

Sharing more insights about the new dermatology drug under development, Dr Parul Ganju, Co-Founder and Executive Director, Ahammune Biosciences says, “Our first new chemical entity has been developed for the treatment of skin depigmenting disorder, vitiligo. With a first in class mechanism of action, this is one of the first targeted treatments to be developed for the disease which affects millions of patients throughout the world. This drug candidate is currently in Phase I clinical trials. All our data establishes that AB1001 is very safe in humans when tested in highest concentrations.”

Ahmedabad-based Uniza Healthcare is another player focusing on vitiligo treatment by launching a lotion Vitellus in collaboration with a Canadian company Lucas Meyer Cosmetics and Indian company Mumbai-based Amvigor Organics.  The product comprises of ingredients such as Greyverse that stimulates melanogenesis and pigmentation and decreases in oxidative stress; Melitane that helps in promoting re-pigmentation of skin by stimulating melanogenesis and decreasing inflammation. 

Cadila Pharma, based in Ahmedabad, is also investing in developing new products in dermatology. Its latest development comes in the form of Laglo Soft Lotion for treating dry skin conditions. It is proven to be effective in treating skin conditions such as xerosis, ichthyosis, atopic dermatitis, psoriasis and skin ageing.

According to Praveen Sikri, Chief Executive Officer, Ikris Pharma Network, "Like all segments, developing solutions for skin-related conditions has its own unique challenges for pharma players. While seeking to address the dermatological or pathological aspects of a condition, makers of skin products also have to be mindful of the cosmetic side of the treatment. So, sometimes a certain formulation may be effective in treatment of the underlying condition but may not be cosmetically or aesthetically advisable. Therefore, selection of the right raw material and the ingredients in order to prepare a certain formulation is very critical.” 

Another major pharma player in the dermatology segment is Vadodara-based Alembic Pharmaceuticals that has recently acquired 100 per cent stake in Aleor Dermaceuticals from its joint venture partner Orbicular Pharmaceutical Technologies (Orbicular) to strengthen its skin-related manufacturing and marketing footprint.

Using technology for assistance

Besides developing new medications for various skin conditions, pharmaceutical firms are also exploring the use of technology for better diagnosis and treatment. For instance, Glenmark Pharmaceuticals has launched a digital patient education tool 'Hello Skin' in collaboration with the Indian Association of Dermatologists, Venereologists and Leprologists, to help patients suffering from Dermatophytosis (Ring Worm or Tinea) in India, and to adhere to the recommended treatment duration.

Likewise, Janssen Pharmaceutical Companies of Johnson & Johnson has announced the launch of icare4u, a comprehensive digital programme to support the physical and mental health of people suffering from psoriasis and other skin conditions.

Further, a number of startups have entered the dermatology segment with new technologies to detect skin diseases. An artificial intelligence (AI) driven smartphone app- DermaAId has been launched by New Delhi-based startup Nurithm Labs to address the access and accuracy problems in clinical diagnosis of dermatological diseases, including skin cancer. DermaAId can identify more than 50 skin diseases with about 80 per cent accuracy.

Then, there is Bengaluru-based startup CureSkin that enables users to take photos and instantly get AI analysis for acne, dark spots, pigmentation, wrinkles, and others for free. The startup has so far raised funding worth $5.5 million.

Another breakthrough in these times of digital expansion is the Fibon app backed by real dermatologists, unlike the AI model used by similar competitors. The dire need for Fibon arose for two reasons: dermatologists not being easily accessible and the possibility of diagnosing the majority of skin disorders at a glance and symptoms of a patient. With the transition from 2022 to 2023 and things shifting their focus to digital mediums, a phone app is probably making all the difference in people’s lives.

“One of the limitations to the dermatology market's expansion is the shortage of dermatology specialists, but this problem can be resolved by online doctor consultations for patients all over the world. The dermatology market is anticipated to increase significantly in the coming years because of changing lifestyles, and easy access to dermatology products in less time and at a lower cost through e-commerce”, says Karan Chechi, Research Director, TechSci Research.

The digital tools being developed by the industry are indeed putting the spotlight on the awareness of various infectious and non-infectious skin diseases in the country, but there is also a need to give due importance to this segment in the national health policies. Although there is no direct estimate of the socio-economic burden of skin diseases in a country like India, it is high time that we stop ignoring them.

Sakura Koner