What is Medical Dermatology?

Medical dermatology is a branch of dermatology that focuses on the diagnosis, treatment, and management of various skin conditions, including but not limited to, acne, eczema, psoriasis, rosacea, skin cancer, and infectious diseases of the skin. Medical dermatologists are trained to identify and manage a wide range of skin disorders using various diagnostic techniques such as skin biopsies and laboratory tests. They also provide treatment options such as prescription medications, topical creams, light therapy, and other procedures to help improve and manage skin conditions. Medical dermatology plays a critical role in helping patients maintain healthy skin and prevent future complications.

Do you accept Medical Insurance?

Please note different insurances are accepted at different clinics but please call to verify*:

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Newport Beach (Orange County) - Accept PPO and traditional Medicare (NO HMO)

Address: 180 Newport Center Drive, Suite 225, Newport Beach, CA 92660

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Government Insurances:

Traditional Medicare (Medicare+Supplement and Medi-Medi)

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Commercial PPO:

Aetna PPO

Blue Cross PPO

Blue Shield PPO

Cigna PPO

Health Net PPO (*select plans call to verify)

United Health Care PPO

GEHA PPO

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Arcadia (Los Angeles) - Accept HMO, PPO and Medicare

Address: 612 W Duarte Road, Suite 501, Arcadia, 91007

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Government Insurances:

Traditional Medicare (Medicare+Supplement and Medi-Medi)

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Commercial PPO:

Aetna PPO

Blue Cross PPO

Blue Shield PPO

Cigna PPO

Health Net PPO (*select plans call to verify)

United Health Care PPO

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HMOs:

Allied Pacific IPA (Medicare Advantage, Commercial, Medi-cal HMO)

AMDC (Medicare Advantage HMO)

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Monterey Park (Los Angeles) - Accept HMO, PPO, and Medicare

Address: 616 N. Garfield Ave., STE 203, Monterey Park, CA, 91754-1153

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Government Insurances:

Traditional Medicare (Medicare+Supplement and Medi-Medi)

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Commercial PPO:

Aetna PPO

Blue Cross PPO

Blue Shield PPO

Cigna PPO

Health Net PPO (*select plans call to verify)

United Health Care PPO

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HMOs:

Allied Pacific IPA (Medicare Advantage, Commercial, Medi-cal HMO)

AMDC (Medicare Advantage HMO)

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Dermatology and medical hair loss consultations are covered by insurance. General male and female pattern hair loss consultation, True Hair Therapy ™, PRF, botox, fillers, chemical peels, benign skin lesion removals, microneedling, and other elective procedures are considered cosmetic in nature and thus are not covered by medical insurances.

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All co-pays, deductibles, and co-insurances are collected at the time of service. Please note that as a patient, you are ultimately responsible for verifying your insurance is in-network with True Dermatology, and obtaining the exact cost of your services at our medical clinic. We encourage you to actively engage with our billing department or your health insurance provider to gain a clear understanding of the fees associated with your treatment or procedure. While we strive to provide estimates and guidance regarding potential costs, these should not be considered definitive figures. Actual costs can vary based on the specifics of the service provided, individual insurance plans, and other factors. We strongly recommend that you inquire about any financial concerns prior to receiving services to ensure clarity and avoid any unexpected expenses. Your proactive involvement in understanding and confirming the costs of your healthcare is an essential part of the treatment process at our clinic.

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Do you treat skin cancers? Basal Cell Carcinoma and Squamous Cell Carcinoma

Yes, we provide skin cancer treatments including excisions and non-surgical options. Mohs Micrographic Surgery will be performed at our surgical center in Monterey Park, Los Angeles. We also partner with local Mohs surgeons in the Orange County if the drive is too far. While we take great pleasure in treating your skin cancer, we rather not do it. As a dermatologist, I would rather help you prevent skin cancer in the first place. By treating your precancerous actinic keratosis and also reversing sun damaged skin I hope to prevent as many skin cancers for you as possible.

Actinic keratosis

You may be wondering what are the rough scaly areas on your face, arms and legs that keeps reappearing even if you pick it off. If you have spent your entire life in sunny California, it is more than likely that these scaly papules that feel like small speckles of sand paper on your face and arm are actinic keratosis, which are pre-cancerous skin lesions that have a small risk of turning into skin cancer if left untreated. If you had a lot of sun exposure, have a weak immune system, or are over the age of 50-years-old, you may be at high risk of developing or already having actinic keratosis. Some actinic keratosis can turn into squamous cell carcinoma skin cancers, which kills more than 15,000 Americans every year.

How Can I Treat My Actinic Keratosis?

Common treatment options include:

1. Cryosurgery (freezing)
2. Curettage (scraping)
3. Medium depth chemical peeling (TCA) with our without Jessner's Peel

Topical immuno-modulating creams (Efudex or 5-Fluorouracil, imiquimod)

Vitamin-A derivative Tretinoin cream (which is also anti-aging and used for treating Acne)

Facial field therapy: combination of Efudex or 5-Fluorouracil, imiquimod, and Tretinoin in a treatment regimen determined by your provider.

Cysts

Cysts are benign skin lesions often appearing as a nodule with a pore that contains soft "cheesy" material that tends to have a repulsive smell.  Sometimes these cysts may become inflamed or infected causing discomfort.

Why Did My Cyst Come Back After I Squeezed It?

Because the cyst is caused by a formation of a walled off sac within the skin with a pore opening to the skin. When you push or squeeze the cyst you may express a malodorous material from the pore of the cyst and be tempted to squeeze as much out as you can to get rid of the cyst. However, squeezing the cyst will only cause scar tissue and inflammation that will make the cyst harder to remove. Please avoid irritating the cyst.

Small cysts may rapidly grow into larger ones and can be much more easily treated with far less discomfort if caught early. It is also important to make sure your cyst is indeed a cyst rather than a non-benign growth such as skin cancer. The first step is to set up a consultation with your Dermatologist at True Dermatology to discuss the best treatment for you.

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Acne

What is Acne?

Acne is one of the most common skin conditions in the United States that affects 85-100% of people at some point of their lives. While this disease primarily affects teenagers, acne can persist far into adulthood particularly in women of child bearing age.  

Overproduction of a normal oil on the skin, increases under the influence of male hormones (androgens). This, coupled with insufficient shedding of exfoliating dead skin cells, plugs hair follicles.

The plugged follicle can become inflamed and have increased growth of normal skin bacteria, Cutibacterium acnes

Medications such including lithium, cortisone, hormones, iodides, some seizure medications, or progesterone containing contraceptives, chemotherapies, as well as dairy products (especially skim milk) can also cause acne lesions.

While the statistics are interesting, we are more interested in working with you to create a personalized treatment regimen for you to better control your acne. No one’s acne is the same. Each personalized plan is catered based on your severity, gender, hormonal influences, diet, family history, age of onset and much more. The goal of your acne treatments will be to not only resolve existing pimples but also prevent new ones from forming while addressing scarring and unwanted pigmentation at the same time. The faster we get your acne under control the less total scar and permanent skin damage you will have and less acne scarring that needs to be treated.

​How can I treat my Acne?

​All cases may benefit from: Salicylic Acid peels, and Holistic Dermatology

Common treatment options by severity includes:

Mild to Moderate cases

• Topical Treatments (Treat existing acne)

• benzoyl peroxide 5% lotion, clindamycin 1% lotion, benzaclin 1%/5%, azelaic acid and topical retinoids including adapelene, tretinoin, or tazarotene (anti-aging, anti-scarring)

• Oral options for Females (Regulate and stabilize hormones to prevent new acne breakout)

• oral contraceptives (yaz, ortho-tri-cyclen), spironolactone

• Blue Light Treatment (Shut down active acne inflammation)

• Blue Light Treatment or Photodynamic Therapy (PDT) is the most popular alternative that we recommend to the majority of our acne patients. BLU-U light treatments are FDA approved treatments for moderate acne.

• Salicylic Acid peels (Reduce acne blemishes)

• Salicylic acid (beta-hydroxy acid) peels result in superficial chemoexfoliation of the top layer of the skin. This peel not only treats active acne but also fastens healing and reduction of blemishes left behind from previous acne.

• Holistic Dermatology Corner (Treat and prevent acne inside out)

• choose a diet that is anti-inflammatory with low glycemic index (ie: Avoid Dairy & Sugar and processed foods; Organic grains & Meats preferably)
• Think about consuming vitamins orally: Niacinamide and probiotics
• Avoid drinking dairy milk; instead, use almond, coconut, or oak milk. Only consume dairy-free/pea protein shakes.
• Any oil-containing face products should be avoided! Utilize only water-based products (including makeup and sunscreens)​

Severe/Scarring cases

• Accutane (Isotretinoin)

• Accutane is a vitamin A Derivative and is considered the most effective treatment of choice for anyone with scarring acne. Requires monthly follow-ups with urine pregnancy tests for females.​

• Salicylic Acid (beta-hydroxy acid) peels

• High concentration of medical grade superficial salicylic acid peels (not the over the counter versions) are effective treatments for treating active acne as well as residual redness or brown spots left over from acne.

• Steroid Injections

• Injections of cortisone, also known as cortisol (a substance that occurs naturally in our bodies), are used to treat deep cystic acne on the body or face. A cortisone steroid injection is administered directly into the pimple to provide pain relief, aid in the breakdown of surrounding tissue to provide comfort, and cause the pimple to contract. Even though cortisone doesn't often treat acne, it is an excellent and speedy solution if your pimple is painful and swollen. Be careful since a divot in the place where the steroid was injected can result from using too much of it.

• Acne Extraction/Acne Surgery​

• ​Patients with milia or blocked or congested cystic acne undergo extractions (trapped pockets of an oil gland). Insurance may occasionally cover extractions, but this is not always the case. Our providers occasionally need to employ extraction equipment to aid in clearing the deeper packed areas.

Brown spots

What Are These Brown Spots on My Face?

Brown spots are benign skin growths that come in many variations ranging from flat brown liver spots (lentigo) to raised rough plaques over the chest and back (seborrheic keratosis). You may find them starting out as light brown oval spots that may evolve into thicker rough spots. Seborrheic Keratosis (SK's) may range from a few spots to several dozens, often depending on one's genetics. Brown spots often increase as we age. Some may be irritated or even painful especially with clothing friction.

Other brown spots include larger brown patches around the cheeks and side of the face in areas commonly exposed to the sun called (melasma). These persistent brown pigmented patches are difficult to treat and extremely sensitive to the sun and hormonal fluctuations particularly during pregnancy.

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Are My Brown Spots Dangerous?  

First, you need to go see your dermatologist to make sure what you have is indeed a benign brown spot rather than a rapidly growing melanoma. According to the American Cancer Society, melanomas are responsible for almost 8000 Americans deaths per year. To the untrained eye, pigmented or dark seborrheic keratosis may be easily mistaken for nodular melanoma while liver spots (lentigo) may be mistaken for Lentigo Maligna, which is a life-threatening skin cancer.

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How Can I Treat My Seborrheic Keratosis?

Common treatment options for inflamed seborrheic keratosis include:

Liquid nitrogen cryotherapy/cryosurgery

Curettage after numbing with local anesthesia (lidocaine, similar to the one used at dentist offices)

Physical destruction of the unwanted irritating brown spots with cauterization

Over the products do not work for seborrheic keratosis.

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How Can I Treat My Lentigo?

Common treatment options include: strict sun protection, topical creams (retinoids and whitening agents), liquid nitrogen cryotherapy/cryosurgery, chemical peels, lasers, intense pulsed light, and microdermabrasion. These treatments are not medically necessary treatments and will be considered cosmetics. Over the products do not work for lentigo or liver spots.

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How Can I Treat My Melasma?

Common treatment options include: strict sun protection, topical creams (retinoids and whitening agents), liquid nitrogen cryotherapy/cryosurgery, chemical peels, lasers, intense pulsed light, and microdermabrasion. These treatments are not medically necessary treatments and will be considered cosmetics.

Other than sunscreen, all other the products do not work for treating melasma. Over the counter hydroquinone 2% is generally too weak by itself to have any significant clinical effect on treating melasma.

Moles and Nevi

Are These Moles?

Moles or “Nevi” come in all shapes, sizes, colors, and locations throughout our lives. Some arise during childhood while others arise during adolescence or adulthood and even during pregnancy. Some moles you had your entire life while others have hair growing from them. Moles may occur not only on the skin but also under the nail on the scalp and even on the eye.

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Are Changing Moles Bad?  

While some moles may change appearance when irritated or may grow proportionally during childhood, it is important to make sure that all of your moles are examined by a dermatologist. Some moles will likely never ever turn “bad” while others will require close monitoring or even sampling with a biopsy. Among the three most common types of skin cancers, Melanoma is the most serious type and has the potential to rapidly spread throughout the body. It is estimated that there are 100,000 new melanomas diagnosed every year in America with almost 8,000 associated deaths.

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Are New Moles Normal?

While it is common for children and adolescents to develop new moles, the occurrence of new moles in adults is far less common after the age of 50. Thus, it is important that a biopsy is considered for any new, changing, or atypical appearing mole.

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In fact, the majority of melanoma cases diagnosed do not come from moles that you have had your entire life. Even atypical moles rarely ever turn into melanomas. Majority of melanoma arise as completely new moles. Patients who had a history of severe sunburns, tanning bed use, family history of melanoma, or even have natural red to strawberry blonde hair are at particularly high risk of melanoma compared to the general population. Thus it is recommended by dermatologists for you to have all new moles examined to determine first whether it is a mole or not and whether it needs to be sampled or “biopsied”.

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What is the difference between Good versus Bad moles?

A general rule of thumb known as the “ABC’s of melanoma” is to see your dermatologist if any of your moles meets one of the following criteria:

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• A – Asymmetry: one-half of the lesion does not mirror the other half.
• B – Border: the borders are irregular or indistinct.
• C – Color: the color is variegated and the pigmentation is not uniform, or there are varying shades and/or hues.
• D – Diameter: the lesion is > 6 mm in diameter.
• E – Evolving: changes in appearance or new symptoms in a lesion over time.

Please refer to skincancer.org for pictures of Melanoma

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What is The Dark Line on My Finger Nails?  

While there is a list of conditions that can cause nail changes, it is not uncommon to develop a band of pigment on the nail. Given its sensitive location on the nail and difficulty sampling, it is very important for your dermatologist to determine whether the dark line on your nail is caused by increased pigment production (melanocyte activation), a benign mole on the nail, and to make sure that the dark line on your nail is not an acral lentiginous melanoma, a life threatening skin cancer. Abnormal nail color and pigmentation more commonly affects individuals with skin of color including Asians, Hispanics, Middle easterners, and African Americans. In fact, the famous late Bob Marley died from acral lentiginous melanoma at the young age of 36 years old.

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​Can I Get My Moles Removed?

Consultation with your dermatologist who will use a dermatoscope to look at the patterns on your mole to determine whether a biopsy or sample of the mole needs to be taken. Moles can either be removed using a shave or punch biopsy. Shave biopsy involves numbing the skin with injected lidocaine similar to the anesthetic used by your dentist and a small blade is used to shave your mole flat. A punch biopsy will involve using a 4mm or smaller cookie cutter like blade to "hole punch" out your mole and a stitch will be placed on the biopsy area and you will come back to the office in 1-2 weeks for the stitches to be removed and to discuss the biopsy results.

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• Removal of suspicious moles are covered under insurance and are considered a medical procedure. All moles removed will be sent for pathological tissue examination by dermatopathology laboratory.
• Removal of Clinically Benign Moles are not covered by insurance, and are considered a cosmetic procedure. All moles removed will be sent for pathological tissue examination by dermatopathology laboratory. It should be noted that from a cosmetic standpoint, scars from moles removed may actually be less cosmetically appealing than leaving it as is. The type of mole will determine the cosmetic outcome

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