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

TRANSMISSION

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: How do you get HPV?
A:
HPV is transmitted by skin-to-skin contact. HPV is most commonly transmitted by sexual contact. This does not exclusively mean intercourse. A person can get the infection from rubbing during foreplay. The infection is more likely to occur in areas where there was a lot of friction which can result in small breaks in the skin. The virus can then invade the skin through these small fissures and establish a dwelling place for itself in the skin.

Q: What ways other than sexual contact can result in the further spread of an HPV infection on myself?
A:
Genital warts are very contagious. A person who already has warts can spread the infection to previously uninfected areas on themselves in multiple ways, including in areas where they wear tight clothing, from abrasion during exercise or sports, drying themselves with a towel vigorously after taking a shower and even by cleaning themselves very thoroughly but perhaps too hard after a bowel movement.

Q: What precautions can I take in order to avoid spreading the infection?
A:
A person who has an infection in the genital area needs to be mindful of the fact that they need to thoroughly wash their hands before touching themselves in the genital area.

Q: Can you infect somebody with HPV even if you can’t see any growths in the genital area?
A:
A person may not have easily recognizable growths on their skin but can still have HPV and be highly contagious. A person who is infected is a carrier who can potentially transmit the infection to a current or future partner.

Q: What is asymptomatic transmission?
A:
Asymptomatic transmission is when a person without any apparent signs or symptoms can still spread the infection to another person with whom they come into contact. Asymptomatic transmission is a very important way that the HPV virus is spread.

Q: Why is asymptomatic transmission so common?
A:
Asymptomatic transmission occurs frequently because of the large number of people who have small inconspicuous growths or no growths at all although they are carriers of the infection and are nonetheless shedding the virus. People who are asymptomatically shedding the virus frequently do not even know that they have an HPV infection are less likely to recognize the need to practice safe sex and use condoms.

Q: Is there a greater chance of my getting infected from a person with lots of large genital warts or by asymptomatic transmission from a person who is a carrier?
A:
There is a greater chance of you getting the infection from a person with multiple large genital warts because more virus is being shed by these warts. People who are asymptomatic shedders of the virus shed fewer viral particles but are also less likely to use condoms. The use of condoms would decrease the chance of a person who is asymptomatically shedding the virus from infecting their partner(s).

Q: What are the chances that a person who does not use condoms will get an HPV infection from somebody who has an HPV infection?
A:
Approximately 40%.

Q: What is the incubation period for an HPV infection?
A:
The general range of the incubation period is from 1-9 months. The average incubation period for an HPV infection occurs within 3-6 months after contact.

Q: If I do not develop genital warts during that time, does that mean that I will not get an HPV infection?
A:
If you do not develop the infection within 3-6 months of contact, there is a reasonably good chance that you will not develop the infection but the chance of developing an infection is still present. You should be mindful to use condoms until you know that you are clear of an infection for a 6 month period of time. There still remains the chance that you acquired a low grade infection and are a carrier who can infect others.

Q: If I don’t get an HPV infection within 6 months does that mean that I am immune to the virus?
A:
Nobody is naturally completely immune to the virus. You may have a good natural resistance to the virus where your body is able to suppress the growth of the virus even though you may have been infected, but at another time in your life when you are tired, worn down, stressed out , or have a chronic disease or other condition which is decreases your resistance the virus can then awaken from it’s latent state and cause an active infection.

Q: What areas in the man are most likely to be most contagious with HPV?
A:
The anatomic sites in men which have the highest concentrations of HPV DNA are the head of the penis (glans), the foreskin and the shaft of the penis. The foreskin has the highest concentration of HPV DNA when it is present, which is only in the uncircumcised man. The scrotum and inguinal area may also contain HPV DNA, but the occurrence of infection in these areas is less common than the other sites.

Q: How commonly does HPV occur in the urine, semen and urethra?
A:
The occurrence of HPV in the urine, semen and urethra is low.

Q: Can HPV infection go away on their own without being treated?
A:
HPV infection are frequently transient and can resolve on their own without being treated.

Q: Can HPV be transmitted from the mother to the child during pregnancy?
A:
HPV infections transmitted from the mother to child during pregnancy are rare. The main time when the child will be infected is during the birth process while the child passes through an infected birth (vaginal) canal. Delivery by Cesarean section should theoretically decrease the frequency of this type of transmission, but this is not an absolute and infection has nonetheless been documented in babies delivered by C-section.

Q: Is HPV transmitted more easily from a man to a woman or from a woman to a man?
A:
HPV infection is more easily transmitted from a man to a woman. The larger surface area on the vulva and vaginal area makes this region more susceptible to infection.

Q: Can you get an HPV infection from oral sex?
A:
HPV infections can be transmitted by oral sex and the increased incidence of oropharyngeal cancers has been attributed to the increased incidence of oral genital sex.

Q: What is the best way to avoid this?
A:
Minimize oral sex when growths are present in your partner’ s genital area. If you have any cuts, breaks or fissures on your lips, tongue or in your mouth, minimize any type of contact to the genital area in order to avoid giving the HPV virus the opportunity to get into a break in the skin in the mouth area where it can more easily establish an infection.

Q: What are the chances of a person getting an HPV infection during their lifetime?
A:
50%-80% of sexually active adults in the United States will have been exposed to an HPV infection by the time they are 50 years old.

Q: How frequently do HPV infections ever go away on their own?
A:
Most HPV infections clear up on their own but many do not. A person who is in contact with a person who has an HPV infection that may eventually resolve can still get infected while the other infection is in an active stage.

Q: Does that mean that the chances are that most of the time I won’t get infected?
A:
You can still get infected from somebody who still has an active infection when you come into contact with them, although their infection may eventually clear up on it’s own. This should not be especially comforting to you if you nonetheless caught the infection during the time when it was active.

Q: How do I prevent that from happening?
A:
You need to use a condom.

Q: Any particular type of condom?
A:
Latex condoms give the best protection.

Q: If I see a growth in my genital area can I just wait and see whether it goes away on it’s own and not rush to treat it?
A:
You can take this tact of “watchful waiting” but you need to use condoms during this time and preferably see your physician to discuss your options about getting it removed.

Q: What is the downside of waiting to see if it goes away on it’s own?
A:
The infection can potentially spread to and infect additional areas on you, especially in areas where there was friction i.e. from working out, tight clothing, rubbing. You also have a higher chance of spreading it to a partner during this time, even if you use protection.

Q: Should I wait to see if the growths go away?
A:
You can wait to see if the growths go away. Many people feel uncomfortable with the idea of leaving it to chance to see whether contagious growths go away on their own. You also need to be mindful of the fact that the visible growths can go away but you may still be contagious and a carrier who can still infect your partner(s).

Q: What if the genital warts don’t go away on their own?
A:
This would indicate that you may have less of a resistance to the infection. Genital warts occur more frequently in men compared to women. Men have a less robust immune response, manufacture fewer antibodies against the HPV virus and develop less of a resistance to HPV infections than women.

Q: Do different people have a lower resistance to HPV infections than others?
A:
Men have a lower immune resistance to HPV infections than women. This is why genital warts occur more frequently in men than women. The frequency of HPV infections in women goes down as they get older but it stays the same for men.

Q: What does it mean if a person has a persistent HPV infection?
A:
Infections that persist and do not go away on their own are more likely to contain the high risk HPV strains. A person can also have persistent infection with low risk strains when they have less of a natural resistance to infection.

Q: What are the chances that an HPV infection will go away on its own?
A:
70% of abnormal Pap smears in women clear up on their own within one year after they were initially diagnosed. 90% of all abnormal Pap smears will clear up on their own within a two year period of time.

Q: Do most people who have an infection know that they have it?
A:
Most people who have an HPV infection are without symptoms and do not know that they have an infection.

Q: Is the HPV infection gone for good if a person was diagnosed with an HPV infection and it was then treated or went away on its own?
A:
Once you have an HPV infection it does not go away. The infection can become latent and it always has the potential to recur. The person who was infected with HPV becomes a carrier.

Q: What does it mean to be a carrier?
A:
A carrier has a low grade HPV infection which is not associated with any growths or symptoms indicating it’ s presence but the carrier is still contagious and may be asymptomatically shedding the virus which can then potentially infect their current or future partner(s).

Q: How common is asymptomatic shedding?
A:
Asymptomatic shedding is very common. 50%- 80% of sexually active adults in the United States have had an HPV infection by the time they are 50 years old. These individuals can potentially infect their current or future partners who have not yet been exposed to the infection. Asymptomatic shedding is one of the reasons that HPV infections are so common and are occurring in epidemic proportions.

Q: How is HPV spread?
A:
HPV is most frequently spread by sexual contact. HPV is not spread exclusively by sexual intercourse. HPV can be transmitted by rubbing during foreplay or oral sex. There are many cases where people who are virgins (both male and female) getting an HPV infections.

Q: Can HPV be spread by non-sexual ways?
A:
The main way that HPV is spread is through sexual contact, but there are nonetheless cases of HPV being spread when there has been no sexual contact. Non-sexual means of transmission are possible and most likely do occur but are not a common way of acquiring the infection.

Q: Can HPV infections in the genital area be spread from hand warts?
A:
Although hand warts can potentially under certain circumstances infect the genital area, this is not a common occurrence. A hypothetical situation might be where a person has hand warts (caused by types not associated with genital HPV strains) which then infect their own genitals by touching the area. The strains of HPV that most commonly associated with hand warts have zero potential to progress into HPV-related cancers.

Q: Do warts on the finger ever contain the high–risk genital HPV strains?
A:
There have been reported cases of finger warts that were biopsied and HPV DNA typing demonstrated the presence of high risk HPV 16/18 strains. This is an unusual and highly unrepresentative situation but it has been reported.

Q: What are some other examples of how HPV infections can be acquired that does not involve sexual contact?
A:
friend or colleague who recently touched their own genitals, the virus gets transmitted to the other person’ s hand, the hand subsequently touches their own genitals and an HPV infection is established through pre-existing breaks in the skin. This is a hypothetical but viable explanation of how certain infections have been spread.

Q: Can you get HPV through a blood transfusion?
A:
HPV is not spread by blood transfusions.

Q: Is there a blood test for HPV?
A:
There is no common commercially available blood test for HPV.

Q: Can HPV spread through inanimate objects?
A:
It would be highly unusual for a person to catch an HPV infection through an inanimate object. It is unlikely that a person would catch an HPV infection from a toilet seats, bathtub, shared underwear, bathing suits, clothing, etc The HPV virus on an inanimate object does not survive after a short period of time.

Q: How does the actual infection occur?
A:
The transmission of the virus most commonly occurs after there is friction, mechanical trauma and/or abrasion to the skin. Breaks in the skin occur during sexual contact or rubbing. The HPV virus is then able to gain entry into the skin and establish an infection at that site.

Q: What is the most common age for a person to get an HPV infection?
A:
The age group when people have the greatest chance of getting new HPV infections is when they are 15-25 years old.

Q: Why do so many infections occur at those ages?
A:
The age range between 15-25 years of age is a time of sexual experimentation. People are more likely to have a greater number of partners during this time.

Q: Is there a point in time when it is too early or too late to get an HPV infection?
A:
A person can get an HPV infections at any time throughout their lifetime.

Q: How common is HPV on college campuses?
A:
Studies performed at large university centers established that more than 50% of college-aged women acquire an HPV infection between their freshman and senior year of college.