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 Hyperhidrosis
Hyperhidrosis (excessive sweating) is a common disease affecting about 5% of the United States population. A new product to treat this, glycopyrronium wipes (brand name Qbrexza) has been FDA approved in 2018. I will likely prescribe it once it is available in pharmacies. The company reports it to be available starting October 2018; however, in my experience this may practically mean early 2019.
The clinical trials involved about 700 patients. About 60% of treated patients had significant improvement versus 30% of the placebo group. Overall it was well tolerated. Only 4% of patients discontinued the mediation. The most common side effects were dry mouth and dilated pupils (mydriasis). Other side effects included urinary retention/hesitancy, blurred vision. There were 2 patients with serious side effects. One had “moderate unilateral mydriasis [considered treatment-related]” which I assume resolved after stopping the wipes, but information on the final outcome was not provided in the study publication. The other patient had “dehydration [considered treatment-unrelated].” A caveat is that the clinical trial was only 4 weeks in duration.
Current treatment for hyperhidrosis is currently so-so. In medical dermatology, treatment usually begins with over-the-counter antiperspirants then prescription antiperspirants then oral pills (e.g. glycopyrrolate). In my experience, oral glycopyrrolate has almost always been successful in its purpose of decreasing sweating. However, there are numerous potential side effects. About one quarter of patients have to discontinue the medication due to side effects. This is obviously higher than the reported rate for the wipes. It is what is called an anticholinergic medication so its side effects include: dry mouth, blurred vision (mydriasis), dry eyes, constipation, urinary retention, dizziness when standing quickly, confusion, slowed mental processes, and abnormal heart rhythms.
Charles Chiang, MD, FAAD
Board Certified Dermatologist
- Glaser DA, et al. Topical Glycopyrronium Tosylate for the Treatment of Primary Axillary Hyperhidrosis: Results from the ATMOS-1 and ATMOS-2 Phase 3 Randomized Controlled Trials. J Am Acad Dermatol 2018
Moodie T. Anticholinergic medication
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