When all this started a few decades ago, graph paper and pen. Then I switched to CC2 somewhere along the way. Now I use Adobe PS heavily as of a few years ago, seen Chris West's maps and was marveled by the amount of personality he could give them. I do eagerly wait to see what ProFantasy comes up with the next version for CC, I have seen the screen shots and they were pretty nice.
As for NPCs, I created NPC Designer for a reason..
Char Gens: None, have yet to find one I like..
As for NPCs, I created NPC Designer for a reason..

Char Gens: None, have yet to find one I like..