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 Maganís 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!
"Whatís New in..."
A monthly column by Dr. Chiang
What's New in Rosacea
Past columns have discussed new medications becoming available for rosacea. However, first-line treatment is always avoidance of triggers. While sunlight is considered by most as the most important trigger (ie, sunscreen, sun-protective clothing, and sun avoidance as practical), alcohol is clearly a trigger as well. Unfortunately, some of my adult patients tell me it is just not practical to completely abstain from alcohol due to social reasons. Sometimes I am asked what alcohol is the ďbest.Ē A recent study of 4945 rosacea patients finally gives a good answer to that question. These patients submitted surveys every 4 years for 14 years of their amount and type of alcohol intake. My summary of the data would be that overall, white wine seemed to place patients at highest risk for rosacea then hard liquor then regular beer then red wine then light beer. In addition, the risk was dose dependent, e.g. drinking at least 5 four-ounce glasses of white wine per week led to about a 50% higher risk of rosacea compared to someone who never drank while drinking 1-3 glasses per month led to a 14% higher risk of rosacea. Unfortunately for my patients, that means even infrequent social drinking still increases their risk for rosacea.
Limitations of the study were not evaluating the mechanism for alcohol to increase the risk for rosacea. Also, while it makes sense that alcohol that increases the risk of rosacea would also flare rosacea once someone has it, a much smaller 353 rosacea patient study by the National Rosacea Society reported red wine being worse than white wine in flaring rosacea. That being said, I favor the data for 4945 patients over 353 patients.
For those who ask why this matters, rosacea has been associated with an increased risk of gastrointestinal issues. A study in Taiwan showed itís associated with almost double the risk for a condition called inflammatory bowel disease. A study in Denmark showed that those with rosacea had a higher risk of death for those who developed gastrointestinal disease, esp. liver disease. However, it is unclear whether it is the rosacea itself or the increased incidence of alcohol intake in those with rosacea that causes this.
Overall my summary is that if social drinking is an important part of my patientís life then light beer is the best and ideally less is better. For my patients who tell me light beer isnít acceptable, red wine would be my next recommendation. Of course, drink responsibly.
If you have rosacea or other skin issues, please make an appointment for dermatology consultation at (626) 331-6411 to discuss your options. Treatment is available although is most efficacious for the acne portion of rosacea. Treatment for the redness portion is more difficult and may involve high copay creams and/or cosmetic laser (ie, Magan Medical Clinicís Medical Aesthetics Laser Center).
Charles Chiang, MD, FAAD
- Li S, et al. Alcohol intake and risk of rosacea in US women. J Am Acad Dermatol 2017
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