Dr. Alan Kling MD. – Kling Dermatology Dr. Alan Kling M.D. - Dermatologist Upper East Side & Brooklyn – Best Dermatologist NYC
1000 Park Avenue New York, NY 10028
Manhattan , 1000 Park Avenue New York, NY 10028 10028 Manhattan
Dr. Alan Kling MD. – Kling Dermatology
Dr. Alan Kling M.D. - Dermatologist Upper East Side & Brooklyn – Best Dermatologist NYC I was referred to Dr. Kling’s office because of a recurrent problem I’ve had for awhile. I had already seen two other dermatologists and I kept having a problem and it seemed like this thing would keep going on forever. I asked my internist for a referral and he said that Dr. Kling was the absolute only guy I should go to for this problem. I was already I little fed up with doctors but I decided to go anyway for a consult. Boy, am I glad that I did! Dr. Kling explained what was going on and gave me reading material so I would understand what was going on. I followed his advice and I finally have this condition under control. I finally feel normal again. He really did a lot for me.. I was referred by my family doctor and think that Dr. Kling is an excellent physician. I initially came in with along list of questions about my condition and he read the list and answered all of my questions. The doctor I went to before couldn?t be bothered and he took one look at my list and essentially walked out of the office. I changed jobs and the location of my new job was not that convenient to Dr. Kling’s office but I would switch around my schedule to go to see him because he is very nice and very smart and very personable and that is not an easy combination to find. Dr. Kling put me on a medication that I have to take on a regular basis, and whenever I come into the office he checks in his laboratory to see if there are any samples. He once had his secretary track down the drug representative so that he could get free samples so that he could give them to me. How good is that? Dr. Kling has been treating me for psoriasis for a long time. Dr. Kling placed me on many different medications over time until he found a regimen that worked best for me. I was most impressed by the fact that whenever there was a new medication or treatment he would research it and explain it to me thoroughly beforehand, so I knew what to expect. He also once stayed late in order to remove a large cyst on my back that had started to drain. He rescheduled something else he had going on in order to get this done because he knew that I would not have been able to go into work the next day if it wasn’t first removed. He really went out of his way to help. I am aware that dermatology seems to appeal to the vanity in all of us. We go to a Doctor and expect miracles even if we’ve had problems for a lifetime. What I feel I have to say and what is probably the most important is that Dr Kling takes the right approach. He sits you down and truly formulates a treatment path that makes sense and actually works! I’d had a host of issues and one by one he explained the relationships between all of them. The myth and mystery were stripped away and even though my problems were of a personal nature I was always made to feel comfortable and in the best of hands. I no longer hesitate going for treatment, as Dr Kling has made me at ease and comfortable . It’s nice when you’ve found the “Right Guy”. Doctor Kling really listened to my concerns and talked to me thoroughly before recommending a course of action. He didn’t pressure me and took his time to make sure that all of my questions were answered once he recommended a treatment. He’s very friendly and seems to have a great deal of experience. I’ve seen a few dermatologists in NYC and Dr. Kling is definitely the best so far. Also, his staff is extremely helpful, knowledgeable, and patient (unlike any other office staff I’ve seen). The entire staff was very accommodating and friendly. Dr. King is professional, courteous, and genuinely cares about your well being. Some of the reviews made me hesitant to make my 1st appointment. As yet, my experience was just great and Dr. King engaged for more than thirty minutes explaining and clarifying my questions. I certainly recommend Dr. King to family and friends. I’ve been seeing Dr. Kling for about ten years. My complexion was bad with the stress I was having from work and the medications other doctors were giving me weren’t really working that well. Dr. Kling go me on a regimen that worked and everything is now (finally!) more or less under control. Those injections he gives me make the acne bumps go down in a day or two. They are great when you know an important business meeting is coming up or something social is going on. I was seeing Dr. Kling on a regular basis for several months before my wedding to make sure that I looked good for my big day and it turned out so well that I continued to see him on a regular basis ever since. He also helped me out with this contact allergy I had to the nickel in my wedding ring (can you believe it?), but that’s another story. . What does this man do to keep himself looking young? I have had every imaginable combination of chemical peels, Botox, filler, sclerotherapy and I’m really happy with the results but he says that he doesn’t do any of that stuff for himself. What does this man do to keep himself looking so young? He says that he uses sunscreen. I’ve gone to him for over twenty years and he looks the same age. Whatever he has, I want it!. I was referred by my family doctor and think that Dr. Kling is an excellent physician. I initially came in with along list of questions about my condition and he read the list and answered all of my questions. The doctor I went to before couldn’t be bothered and he took one look at my list and essentially walked out of the office. I changed jobs and the location of my new job was not that convenient to Dr. Kling’s office but I would switch around my schedule to go to see him because he is very nice and very smart and very personable and that is not an easy combination to find. Dr. Kling put me on a medication that I have to take on a regular basis, and whenever I come into the office he checks in his laboratory to see if there are any samples. He once had his secretary track down the drug representative so that he could get free samples so that he could give them to me. How good is that?. I teach at a private school close to Dr. Kling’s office. There are many other teachers there who go to his office and they all think that he does great work. There are also many students who have been referred to him through the years and they have also been very enthusiastic about him. I have seen Dr. Kling on and off for about ten years and he has helped me a lot with my condition. I was referred to Dr. Kling by my internist. I had previously been seeing another physician but the condition I had was not getting better. Dr. Kling was extremely meticulous and thorough. I saw him on a regular basis and eventually it got better. I am now going to graduate school out of town at a place which is several hours away from NYC, but I make the follow up visits back to NYC to see Dr. Kling. I am not switching doctors. It’s not so easy to find somebody who knows what they are doing.. I was originally referred to Dr. Kling by my best friend, who spoke very highly of him and strongly encouraged me to go. I have been going to see Dr. Kling on and off for about 20 years for lots of different stuff that just comes up. I’m amazed that he always gets the diagnosis right. Sometimes the stuff that I had was pretty straightforward. Other times, he would ask question after question and then zoom in on what it was. The most important thing is that I always got better. I have many friends and co-workers who have gone to him both at my old firm and the firm where I am now, and they all had really positive experiences with him. My wife and my daughters have also gone to him and he has also been very helpful with them. I first saw Dr. Kling years ago when I had a bad infection. He gave me a prescription and samples of the medication that he had in the office to make sure that it had a chance to work as soon as possible.. He spent a lot of time explaining my condition to me. I was really scared and I called him with a lot of questions. He was very patient. I still come to the office now for other things. He was very helpful. Both my wife and I have gone to Dr. Kling. I had a pretty perplexing skin condition and I was told by my family doctor that Dr. Kling was the person to see to figure it out. He spent a lot of time talking and explaining things to me. I had seen two other doctors before, and I realized that educating me about what I had was the most important step so that I was motivated to do what I had to do in order to get it under control. I’ve bumped into Dr. Kling at social things over the years and I am always glad to see him. I like talking to him..
Rating: 4 / 5 stars

EFFECTIVENESS OF THE VACCINE

hpv-kling2ALAN KLING, M.D

Dr. Alan Kling is recognized as one of the foremost specialists in the field of HPV infections. Throughout his years as an HPV specialist, Dr. Kling has contributed to research and lectured at various medical schools, including Columbia, Cornell, Mount Sinai, NYU, and Yale as well as having been a part of a number of national panels on HPV and HPV prevention. His extensive research has allowed him to keep up with the latest HPV treatment protocols and to educate others in the field as well. While HPV is an important field of dermatological study for many physicians, Dr. Kling has clearly separated himself from the pack, making him the top HPV treatment specialist in NYC today.

Dr. Kling's private practice offices are located at his Park Avenue practice on the Upper East Side and in Park Slope, Brooklyn.

Q: What kind of effectiveness has been observed in women who got the HPV vaccine in the long term?
A: Australia had provided free HPV vaccines to 12-18 year old girls in a school-based program. Researchers observed that the proportion of women under 28 years old with genital warts decreased by 25%.

Q: How was the frequency of the occurrence of HPV infection in heterosexual men affected when only girls were vaccinated?
A: Heterosexual men had a 5% decrease in genital warts.

Q: Why did heterosexual men who were not vaccinated experience a decrease in their chances of acquiring an HPV infection when only the girls were vaccinated?
A: This observed effect is the result of the “herd immunity. ” The efficacy of the HPV vaccination in females led to less of a reservoir of the HPV virus in women that was available to infect heterosexual men.

Q: Was this herd immunity effect seen in all heterosexual men?
A: The decreased incidence of genital warts was seen predominantly in younger heterosexual men. Younger men tend to have sex more frequently with women their own age or younger. If these women were already vaccinated and immune to HPV at the time that they sexual contact with an older male partner who already had an HPV infection, they will not get the infection and cannot subsequently infect a guy their own age with whom they have sexual contact.

Q: Was there any advantage to gay men when women were vaccinated?
A: Gay men did not gain any improved chances of a lower chance of getting genital warts when women alone are vaccinated.

Q: How do you also protect the gay population from HPV infection?
A: Widespread vaccination of all men will most likely result in a statistically decreased occurrence of HPV infection in both heterosexual and gay men and will provide protection against both genital warts and the numerous HPV-related cancers.

Q: Should all men be vaccinated?
A: There is an enormous advantage for all men (heterosexual and gay) to get vaccinated. Being immunized against HPV infections decreases the man’s chances of getting HPV infections that can cause genital warts as well as any one of numerous HPV-related cancers. Men will also be spared the medical, psychological, social and economic penalties of having an HPV infection.

Q: Why do we hear so much about HPV and vaccination in women but so little about HPV and vaccination for men?
A: Most of the pioneering work on HPV was done by physicians and scientists who were concerned about the association of HPV with cancer of the cervix. Women had a naturally occurring advocacy group in this regard. Physicians were searching for better ways to improve the early diagnosis and treatment of women with high risk HPV and with precancerous and cancerous lesions. Research in the field of HPV exploded and once a certain level of understanding of the HPV virus was achieved a vaccine was developed.

Q: What were the initial concerns about men with HPV?
A: The attention to men with HPV focused on men as being carriers of the HPV virus that could infect women. The interest in men was related to the importance of the male factor in causing cancer of the cervix. There was little discussion of the direct health issues men might have if they were infected with HPV until recent years.

Q: Why was the field not looking closely at the effect of HPV on men?
A: The HPV field is strongly oriented towards the prevention and treatment of disease in women. When HPV infections at other sites are always initially examined using the research models perfected through the study of cervical cancer. Historically, relatively little attention in the HPV literature has been devoted to the diagnosis, treatment and prevention of HPV infections in men.

Q: When was the HPV vaccine for men developed?
A: The HPV vaccine was demonstrated to be safe and effective in women. The vaccines were subsequently FDA approved for use in the United States for women. Gardasil (Merck) was approved as a vaccine for women in 2006 and Cervarix (GSK) was also approved as a vaccine against HPV. Merck subsequently submitted data demonstrating that their HPV vaccine (Gardasil) was also safe and effective in men and Gardasil was approved for men in 2009.

Q: Was the HPV vaccine for men developed in order to address concerns about the effects of HPV in men?
A: The main driving force of the medical and scientific community as well as the marketing strategy for the vaccine companies was to get men vaccinated in order to decrease the number of men in the population who can infect women. The data submitted to the FDA for approval of the HPV vaccine (Gardasil) for men demonstrated that the vaccine decreased the incidence of genital warts in men and also decreased the incidence of a precursor growth of anal cancer.

Q: Why are we now hearing more people encouraging men to be vaccinated?
A: The main concern of the gynecologic community, who are the natural advocacy group of women, is to increase the protection of women from HPV. In recent years it has been increasingly recognized that if men are also given the opportunity to be vaccinated there would be a decreased prevalence of HPV in both the female and male population.

Q: Why didn’t they advocate that men should also be vaccinated as soon as the vaccine was available?
A: The initial plan was to decrease the total amount of HPV in young women by having women exclusively vaccinated. Not enough women volunteered to receive the full three shots of the vaccine, which would not only protect them but also establish a significant herd immunity response in the population that would result in a significant decrease in the prevalence of HPV in the general population. Men therefore also needed to be targeted to be vaccinated, in order to decrease the amount of HPV in the general population so that fewer women would be exposed. There has subsequently been an increased recognition of the importance of addressing the numerous HPV-related infections, precancers and cancers which occur in men, and an appreciation of how the vaccine may also help to prevent these conditions.

Q: How percentage of women do physicians think need to be vaccinated in order to make a significant impact on the immunity of the entire population against HPV?
A: Although the HPV vaccine is recommended for girls up to 21 years of age (up to 26 years old under certain circumstances), only 35% of the female population in those age ranges in the United States had received all three vaccinations. 70+% of women need to be vaccinated in order to get a significant herd immunity effect in the entire population.

Q: Was vaccinating men a consideration early on?
A: The vaccine is very expensive. Health care economists and government policy scientists determined that the most cost effective way to protect women from getting an HPV infection would be to focus their efforts solely on getting as many females of the appropriate ages vaccinated. Vaccinating men was initially considered a non-cost effective approach to decreasing the incidence of cervical cancer in women so men were not initially targeted to get the vaccination.

Q: What consideration was given for the potential advantages to men of being vaccinated?
A: The protection of men against HPV infections including genital warts, and HPV-related cancer was not initially the main focus of discussion. The discussion was focused on how to achieve the greatest amount of protection for women.

Q: What is the long term advantage of HPV vaccination in reference to decreasing the chances of cancer?
A: The HPV vaccine has been demonstrated to effectively prevent the growth of cervical cancer precursors caused by high risk HPV DNA in women. Studies were designed to detect the appearance of cervical cancer precancers as an endpoint because it would be unethical to wait to allow a cervical cancer to develop. Protection against genital warts caused by low risk strains was also demonstrated. The decrease in the incidence of both precancerous growths and genital warts indicated that the vaccine is effectively boosting the immune system against both the high and low risk strains of HPV in the vaccine.

Q: What evidence is there that the HPV vaccine will also protect against HPV-related cancers?
A: The incubation period for the HPV virus to grow out into genital warts is 3-6 months. The fact that there is a significant decrease in genital warts indicates that the vaccine is working. Cervical cancer takes 20-30 years to develop from the time of the initial HPV infection. Other HPV-related cancers in differ anatomic locations (anus, rectum, oropharynx, penis) also take a long time to grow . The decreased incidence of precancerous lesions is taken as a proxy and encouraging suggestion that the long term incidence of other HPV-related cancers similarly caused by the high risk strains may also be decreased. The increased protection against the high risk strains of HPV should also decrease the chances of the development of other HPV-related cancers.

Q: Are studies currently being done on the effectiveness of the HPV vaccine in preventing the development of HPV-related cancers?
A: Long term studies of the effectiveness of the HPV vaccine against numerous HPV-related cancers are underway. The final data will not be available for many years because HPV-related cancers can take 20+ years to grow out. The preliminary data will be released intermittently as the results come in.

Q: What are the conclusions from the Australian study of young women who had received the HPV vaccine?
A: The marked the reduction in the occurrence of genital warts in women in the year following vaccination supports the efficacy of the vaccine. The reduction in genital warts among non-vaccinated heterosexual men but not among non -vaccinated gay men is consistent with reduced heterosexual transmission of HPV as a result of female vaccination due to herd immunity.

Q: What screening methods can be used in men to detect whether they have an HPV infection?
A: The relatively simple and straightforward screening methods available to women are not available to men. Men who see or feel a growth(s) in their genital area or who have been informed by their partner that they have an infection need to be evaluated by their physician in order to determine their status.

Q: Is there a blood or urine tests that serve as a screen for HPV infections?
A: There is no effective blood or urine test for HPV in either men or women.

Q: Do men have a greater chance of getting genital warts than women?
A: Men develop genital warts more frequently than woman.

Q: Why do men develop genital warts more frequently than woman?
A: Women are able to mount a more robust antibody level response to HPV infections than men, which gives them a higher resistance to infection.

Q: What is the difference between a man and a woman’s immunity to HPV?
A: Men do not develop antibodies as frequently as women, and when they do they have lower antibody levels.

Q: Why are men not able to produce antibodies as effectively as women?
A: The body has a much more difficult time forming antibodies against growths on the surface of the skin (i.e. penis) than on moist surfaces (i.e. vagina, cervix).

Q: Are the numbers of anal and rectal cancers increasing?
A: The incidence of anal and rectal cancers is increasing in heterosexual and gay men as well as in women. The rate of increase of anal and rectal cancers in gay men is especially high and this is worrisome.

Q: How does the number of cases of invasive cervical cancer in women compare to the cumulative number of HPV-related cancers which occur in men?
A: The screening methods against cervical cancer in the United States have driven down the incidence of invasive cervical cancers to a number that is lower than the cumulative number of HPV-related cancers which occur in men. The continued screening of women for cervical cancer continues to be of critical importance.