Sexually Transmitted Diseases/Is this Herpes or something

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QUESTION: Hi Doctor, I'm Mike from Stanton, California.
I have been having protected sex and unprotected oral sex with a girl ive been seeing for the past month. The last time we had sex was five days ago. Yesterday I felt some itching in my groin area that comes and goes. I put lotrimin ultra on it thinking it was jock itch, though it still occasionally itches. I also cut some of the pubic hairs off with scissors thinking that maybe it was itching because the hair was too long. I also noticed white bumps on my penis shaft, though im not sure how long they've been there. Do you know what they are?

ANSWER: Hi Mike,
The whitish bumps look like Fordyce spots, a normal variation in the skin, however I may not be seeing everything on the photo that you are seeing. They are essentially tiny areas of retained skin oils that look like bumps because the skin is relatively thinner there than elsewhere on your body. Nothing to worry about. If the rash persists, or anything begins to look worse, write back.

Good luck!
--mark


---------- FOLLOW-UP ----------

QUESTION: OK thank you very much Doctor, I really appreciate you taking the time.
What do you think the itching might be? And as far as the white spots shown in the picture, there was one that was a little red around the edges (you can kind of see it in picture 2.). So I popped it and it looked like puss from a pimple and now as of today it looks like the other white spots or fordyce spots. Could that have been a pimple or something?

Thanks again,
Mike

Answer
Hey Mike,
Popping pimples can drive potentially infected material deep into the skin to cause an abscess, just as well as draining externally. It is therefore not recommended! Apply moist heat to soften the skin and the underlying sebum (congealed oil) to help it dissipate. It may have been a small pimple.

Good luck!
--mark  

Sexually Transmitted Diseases

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Mark P. Behar

Expertise

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!

Experience

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.

Organizations
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)

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

Education/Credentials
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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