Sexually Transmitted Diseases/Balanitis?


Hi Mark,

First a big thank you for answering all these questions.
I read a lot but I'm not certain if what I have is what I think it is... Balanitis seems to come in many forms..

I had a massage in a salon with 'happy ending' and didn't really have intercourse except that the glans of my penis might have touched the vagina of the masseuse without penetration. that's 10-11 days ago.

2 days later I started to see red spots on my glans and now I believe I might have Balanitis or something..
It doesn't hurt or itch, perhaps a very very mild cold sensation... not sure if its my imagination.

As I still had some Diflucan 200 Mg I decided to take one as I read that in some candida infections this would fix things. (with 150Mg) I took that 2 days ago.

I'm wondering if I should get some creme with clotrimazole or something..
I really want to get rid of this as soon as possible.

Thanks ...


Hi Zendor,
I can't tell from the photo whether you are circumcised or not (without or with foreskin). You didn't mention whether you have any other skin conditions, use any creams, cosmetics, or oral medications.

Balanitis usually is caused by a skin infection with yeast, and Diflucan (fluconazole) or Micatin (miconazole) may work, but clotrimazole is an older antifungal and many types of yeast are now resistant to this cream. I would try terbinifine (Lamisil) cream first. It is generally NOT thought of as a sexually transmitted condition.

Good luck!

Sexually Transmitted Diseases

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Mark P. Behar


Almost any question or concern about gay men's health issues, sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), etc. 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 “pre-screen” 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 consequences 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!


Family Practice PA since 1981; Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answered 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.

Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.; American Academy of Physician Assistants; Wisconsin Academy of Physician Assistants; National Co-Chair (2012-16), National Association of Black and White Men Together: A Gay, Multiracial Organization for All People (NABWMT)

Journal of the American Academy of Physician Assistants (JAPA) Q Visions, Quarterly Newsletter of the NABWMT

Bachelor's of Arts, 1972 (University of Wisconsin, Milwaukee, WI) Graduate Credits Experimental Psychology, 1972-75 (Tulane University, New Orleans, LA) Physician Assistant, Bachelor's of Science, 1981 (George Washington University, Washington, DC); Masters in Physician Assistant Studies, 2000 (University of Nebraska Medical Center, Omaha, NE)

Awards and Honors
Colposcopy Recognition Award (CRA), the American Association of Colposcopy and Cervical Pathology; Distinguished Fellow, Clinical Preceptor, American Academy of Physician Assistants; Fellow, Wisconsin Academy of Physician Assistants

Past/Present Clients
Brady East STD Clinic, Milwaukee, WI Milwaukee Health Services, Inc. (Martin Luther King Heritage Health Center), Dept. of Family Medicine and Early Intervention Program for HIV Infected Persons

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