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) 251-1500. We look forward to serving you!
"What's New in..."
A monthly column by Dr. Chiang
What's New in Seborrheic dermatitis & Psoriasis
Having completed a fellowship in hair, I see more patients with hair issues than most dermatologists. Dermatologists like myself are best at treating hair diseases involving inflammation, especially alopecia areata along with other non-scarring and scarring conditiPatients understandably do not like having dandruff on their own scalp or that of their children. The two most common conditions causing this are seborrheic dermatitis and psoriasis. While steroid medication is usually considered first line, some patients prefer to avoid steorids, esp parents coming in with affected infants and children.
A prescription nonsteroidal spray (Loyon™) has been receiving increasing attention for helping both conditions by containing moisturizing dicaprylyl carbonate & dimethicones. These are gentle keratolytics (remove scale). It does not contain steroids or salicylic acid. The first published study in 2017 enrolled 20 infants & children (aged 3 to 36 months) with seborrheic dermatitis and 80% improved to very mild or mild scaling intensity after 8 days. The prescription was applied to the affected scalp and washed away with baby shampoo after at least 3 hours. This was repeated daily as necessary, up to 3 applications. "It does not achieve its effect by pharmacological or immunological means, but by a physical mode of action with the absence of systemic effects." Three side effects related to the prescription were noted, two of itching and one of sweat accumulation, with all resolving within 5 days of stopping treatment. There were no safety concerns. It was "well tolerated, safe and effective in facilitating the removal of scaling in infants and children with cradle cap."
The second published study was of 40 adult patients with psoriasis treated daily for 7 days with Loyon™. These patients also applied the spray for at least 3 hours but, likely due to the fact psoriasis is usually thicker than seborrheic dermatitis, were encouraged to leave it on overnight before shampooing. There was improvement in at least one severity grade in 73.1% of patients, with an average improvement of 37% in their scaling after 7 days of treatment. This was a decent (but not great) result given that psoriasis typically has much thicker scaling than seborrheic dermatitis and the medication has no known systemic side effects. The results do indicate that patients would usually need steroid medication as well if they wish more improvement. Loyon™ was summarized as a "safe, well-tolerated, practicable, and efficient keratolytic."
Drawbacks are that it is only FDA approved as a "device", not a "medication." Device approval is far less rigorous than medication approval. The manufacturer obtained FDA 510(k) clearance March 2017 as their study showed "comparable safety and efficacy to a similar device that is already on the market." In addition, insurance coverage is always a concern for newer branded prescriptions. There is no generic currently.
If you have scalp scaling (dandruff), consider making an appointment for dermatology consultation at (626) 251-1500 to discuss your options.
Charles Chiang, MD, FAAD
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