Magan Medical Clinic, Dermatology
We provide quality dermatology care with compassion. Our specialty is medical dermatology, including:
Note: Cosmetic treatments are not performed in Dermatology but instead by Magan’s Medical Aesthetics Laser Center.
If you have psoriasis or hair questions, Dr. Chiang possesses special expertise. He completed fellowships in both fields at University of California, San Francisco where he saw a wide spectrum of patients (including the most severe), performed clinical trials, and published research.
We take pleasure in serving our community including Covina, West Covina, San Dimas, Rancho Cucamonga, Baldwin Park, Azusa, Glendora, Upland, El Monte, Duarte, Monrovia, Arcadia, La Puente, and Diamond Bar.
Same day appointments often available. No referral is necessary if you have PPO insurance. We accept a wide range of insurance plans (unfortunately, we do not accept Medi-Cal as primary insurance, only as secondary insurance).
For appointments, please call (626) 331-6411. We look forward to serving you!
"What’s New in..."
A monthly column by Dr. Chiang
What's New in Warts (condyloma)
I am seeing an increasing number of warts, including genital warts. This seems to be borne out in studies showing an increasing prevalence of the causative HPV virus in the United States. A CDC government was recently published of 2013-2014 data which showed any genital HPV was present in 42.5% of adults aged 18-59 (45.2% in men, 39.9% in women) vs 2003-2004 data showing any genital HPV being present in 26.8% of females aged 14-59. Note that while the age ranges were slightly different, it would only be part of the reason for the large percentage increase. The same data showed 2013-2014 HPV at high risk for progression to cancer present in 22.7% of adults (25.1% of men, 20.4% of women) vs. 2003-2004 high risk HPV in 15.2% of females aged 14-59.
The government stated that the actual number may be even higher than in the study, as the government did not include several high risk groups (those using illegal injection drugs, homeless, or incarcerated) in their study.
This is of concern because genital warts are an infection caused by the HPV virus. Beyond social stigma and its infectious risk, they also have potential to become cancer in both women and men. The good thing is that parents can discuss vaccination with the Gardasil 4 or 9 vaccine (Gardasil 9 protects against more strains of the virus than Gardasil 4) with their primary care doctor. The FDA indication is for both men and women ages 9 through 26 for the prevention of genital and anal cancer. While it is preferred to be vaccinated prior to sexual activity, there is likely some benefit to being vaccinated even after being sexually active as, per the CDC, “few sexually active young women are infected with all HPV types prevented by the vaccines, so most young women could still get protection by getting vaccinated.”
Note that many insurance companies do not cover this vaccination even if FDA indicated. This is especially true if the patient is already sexually active as theoretically the vaccine is not as effective. Many patients have to pay the full cost out of pocket. It is an expensive vaccination, several hundred dollars for each of 3 vaccinations. To my knowledge, insurance companies are not mandated to cover this vaccination, which is unfortunate.
If you have warts or other skin issues, please make an appointment for dermatology consultation at (626) 331-6411 to discuss your options. There are a few caveats for genital warts. Dermatology can treat external genital warts. However, most treatments (ie, freezing) leave scars. Warts inside the vagina should be treated by Ob/Gyn. Dermatology does not have the ability to provide vaccinations. Please see your primary care doctor for vaccination requests and questions.
Charles Chiang, MD, FAAD
- McQuillan G, et al. Prevalence of HPV in Adults Aged 18–69: United States, 2011–2014. NCHS Data Brief 2017 https://www.cdc.gov/nchs/data/databriefs/db280.pdf Last accessed 7/16/17
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