TREATMENT

hpv-kling2ALAN KLING, M.D

Dr. Kling is a recognized expert in the field of HPV treatment, Dr. Kling has lectured on HPV at Columbia, Cornell, Mount Sinai, NYU, Yale and many other medical centers, as well as at numerous national meetings. He is up-to-date on the latest advances in the diagnosis and treatment of HPV. Dr. Kling is the recognized go-to-person for HPV-related diagnoses in the metropolitan NYC area.
Dr. Kling’s private practice offices are located on the Upper East Side in Manhattan and in Park Slope, Brooklyn. The offices are comfortable, stylish, elegantly decorated and impeccably clean. You can feel reassured that your consultation and treatment will be performed by an accomplished, experienced, and well-respected board-certified physician.

Q: What are the different ways to treat an HPV infection?
A:
Methods for treating an HPV infection are broadly categorized as being either surgical or medical treatment.

Q: What are the surgical methods for treating HPV infections?
A:
Surgical methods include removal by freezing (liquid nitrogen), burning (electrodessication), cone biopsy, destruction by chemical surgery (podophyllin, TCA, BCA), excision, and laser therapy. Women can get the LEEP (loop electric excision procedure). Ablative infrared coagulation can be used to treat growths in the anal and rectal canal for both men and women.

Q: What are the medical methods for treatment HPV infections?
A:
Self-administered medications include imiquimod cream (Aldara® or Zyclara®), podofilox (Condylox), and Veregen.

Q: What are the different ways that HPV can be treated in women?
A:
In women, positive Pap smears can be followed up with colposcopically guided biopsies, freezing with liquid nitrogen (cryotherapy) or the LEEP procedure (loop electrical excision procedure). More aggressive HPV changes on the cervix have also been treated with cone biopsies. Genital warts are treated the same way as in men (see above).

Q: Should I get treated for genital warts that I have now although I am not now sexually active?
A:
Most people prefer to be treated and completely clear of warts ASAP/ First, there is certain yuck factor associated with having the infection. People also want to be ready to go if and when they have the opportunity to start a new relationship. A time when you are not sexually active is the perfect time to begin treatment.

Q: How long does treatment take?
A:
The treatment for HPV can require just one session or it may take multiple sessions if there are a large number of growths or if there are recurrences. There may be down time when you will be advised not to have sexual contact while you are healing. The follow up period after treatment is extremely important, because there is a long incubation period for the infection and you need to make sure that your physician can identify any early recurrences which may occur. There is never a good time to have down time, but when you are not currently in a relationship is an especially convenient time to get treated.

Q: Can I wait to see if the warts just go away?
A:
Watchful waiting is always an option, but you would need to proceed with this option with extreme caution. The infection that you have now may not go away and can actually spread and infect new areas and leave you with a larger number of lesions and a more extensive area that will require treatment than you have before. You must use a barrier protection method like condoms during this time in order to ensure that you are minimizing the chances of spreading the infection to a current and/or future partner(s).

Q: Don’t many cases of genital warts go away on their own?
A:
Although many genital warts will spontaneously resolve, they may not all go away and you will continue to be infected and present a risk of infecting anybody with whom you have sexual contact.

Q: What is the cause of recurrences of HPV?
A:
Different people have different levels of resistance or immunity to HPV infections. Many people have been observed to develop an increased number of recurrences of HPV during periods of emotional or physical stress.

Q: Do men or women get more frequent recurrences of genital warts?
A:
Men get more frequent recurrences of genital warts. Men have less of an immunity to HPV than women. The incidence of genital warts actually goes down as they grow older, indicating that women have developed an immunity to the virus. The incidence of genital warts in men remains constant as they grow older.

Q: Why do men have less of an immunity to HPV than women?
A:
Antibodies against HPV are more readily formed after exposure to mucous membranes, as occurs on the vagina, cervix, anal, rectal and in the oropharyngeal area. Antibodies do not form as readily in areas of skin like on the penis and pubic area.

Q: Is there a cure for HPV?
A:
There is no cure for HPV. Once a person has the infection they always have the chance of getting a recurrence, but with appropriate follow up visits and watchful surveillance the condition can be kept under control.

Q: What is the point of treatment?
A:
HPV can be successfully managed so that the chances of it returning, progressing or spreading it to a partner are minimized. HPV is a totally containable condition.

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