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About Mark Behar
Expertise
Almost any question or concern about sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), gay men's health issues.
There is no such thing as “d/d free” or “clean” (free of infection), so why do so many of us deceive ourselves into thinking that some people are indeed totally free from a potentially infectious disease, like HIV, herpes, hepatitis, syphilis, chlamydia, warts, gonorrhea, etc., just because they say so? Clinical laboratory tests are not perfect, and having a “negative” or “nonreactive” test does not mean that a person is free from infection. Perhaps at the moment the test was taken, the person was uninfected; or, perhaps, the test wasn’t sensitive enough to detect presence of the infection. There is really no way that anyone can determine that they are truly “disease free,” and there are over a hundred of infectious conditions that can be spread without your knowing anything.
Rather than trying to “prescreen” or “serosort” a potential sex-mate with deceptive questions that are impossible to know by today’s technologies, a wiser option may be to consider everyone infected with something, and either use appropriate protective measures (“safer sex”), or accept the responsibility and conseqences of possibly “catching” something from someone who’s hotter than expected (pun intended!).
There is much research that supports the contention that an HIV positive person reliably taking HIV medications, and having an undetectable viral load, presents a lower risk for transmission of HIV than people who may think or say they are HIV negative, but are not. Food for thought!
Experience
Family Practice PA since 1981;
Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answer STD questions submitted to their web site.
Professionally lectured at national and regional Physician Assistant and Nurse Practitioner conferences, and at national gay & lesbian health conferences on topics including HIV/AIDS, herpes, hepatitis, STDs, human papilloma virus (the cause of venereal warts), abnormal Pap smears, gay and lesbian health issues, among others.
Organizations
Distinguished Fellow, American Academy of Physician Assistants; Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.;
Wisconsin Academy of Physician Assistants;
Florida Academy of Physician Assistants;
American Society of Colposcopy and Cervical Pathology (ASCCP)
Publications
Journal of the American Academy of Physician Assistants (JAPA)
Education/Credentials
Physician Assistant Certified, since 1982;
Masters in Physician Assistant Studies;
Colposcopy Recognition Award, American Society of Colposcopy and Cervical Pathology (ASCCP);
Awards and Honors
Colposcopy Recognition Award (CRA), from the American Association of Colposcopy and Cervical Pathology
Past/Present Clients
Brady East STD Clinic, Milwaukee, WI
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You are here: Experts > Teens > Health for Teens > Sexually Transmitted Diseases > possible balanitis
Expert: Mark Behar
Date: 10/10/2008
Subject: possible balanitis
Question
QUESTION: Well, I developed this small rash like area on the left side of my penis. It is in the ring of folded skin at the base of the head. I am circumsized. I had it looked at briefly at an urgent treatment center when I was sick. The doctor said it was balinitis. She suggested that I use good hygiene, lotrimin, and wear boxers. I bought lotrimin ultra and it hasn't done a thing. It's chem name is butenafine hydrochloride.
So, I've had this for almost a year now. I was sexually active but not for the past many months. It doesn't even itch very much except sometimes after masturbation. I've put that cream on it, and it only seems to get worse. It clears up some when I cease using the lotrimin.
I have recently met a female and would like to deal with this before we become sexually active. Would an over the counter treatment for yeast infections work? Back when I was married, a doctor suggested that route when I had similar symptoms. It was a long time ago, I can barely remember.
ANSWER: Hi Matt,
Lotrimin is either butenafine, clotrimazole, or miconazole, some of the older topical antifungal creams. Actually they are all pretty ineffective. Over the counter lamisil or tinactin are better. But I'm not convinced that you have a skin infection caused by a skin fungus. I would suggest seeing a specialist who would be able to diagnose you properly. The most common form of skin infection of the head of the penis-- balanitis, is caused by skin fungi, such as yeast.
Good luck!
--mark
---------- FOLLOW-UP ----------
QUESTION: Well, I bought some cortisone 10 and some gold bond powder. I will try that at least for now.
The "rash" has looked the same the whole time and it rarely itches. I have noticed a smell from it that reminds me of unclean vagina, but that has only happened twice. It's not even all that red. Sometimes, after masturbation, the area is a little puffy.
Okay, the bottom line: should I be worried that it's an std? What kind of specialist should I go see?
Answer
Hi Again, Matt,
It does NOT sound like an STD. Cortisone 10 may not be strong enough, although this may be the strongest over-the-counter product available without a prescription. I have never been impressed with Gold Bond powder; not sure that will offer you any benefit at all.
The smell you notice-- that reminds you of an "unclean" vagina-- not sure what that is!! The "earthy," "mushroomy," smell may be due to a skin fungus (yeast). A "fishy," "putrid," "rotting," smell may be due to anaerobic germs that sometimes causes the syndrome in women called "bacterial vaginosis," but this is not usually "spread" to guys. However, if a guy has a foreskin, some anaerobic germs may cause a similar condition, especially when a drop or two of urine is left under the foreskin (ammonia, other nitrogenous byproducts) to mix with normal skin germs.
Good luck!
--mark
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