Sexually Transmitted Diseases/std or pearly penile papsules


QUESTION: I recently gotten unprotected oral sex last week on Friday. Since then i have been taking a shower everyday and scrubbing my genitals frequently. I am almost positive that the female was clean but i'm still a little paranoid. I am urinating fine yet i feel a little itch under the penis head, i don't know if this is due to me washing with soap so much that the area has gotten dry. I also have noticed little spots appearing on the head and i was wondering if they were Pearly penile papules or something else. I appreciate your help! Thank you!

ANSWER: Hello Michael,
Your penis looks fine. It may be a little dry from the excessive washing, but I don't see any pearly penile papules, HPV/warts, or anything else that looks abnormal.

Good luck!

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QUESTION: Thanks for all your help so far. The itching stayed for a couple days and now it has went away. I feel like my penis head hasn't looked the same since i had the unprotected oral sex. Ive been seeing wrinkles on it and red dots coming and going here are pics. Do you think this could be any sort of std or anything like blantisis or a fungal infection? I am having no symptoms other that the appearance and the itching that had went away. I am going to get tested just to make sure but this is causing anxiety in my life and i am grateful for your help. thank you.

Hello Again, Michael,
It absolutely does NOT look like an STD. Balanitis is an inflammation of the foreskin and glans, usually caused by a skin fungus. Skin fungi may cause other rashes other than balanitis!  The skin may take on different appearances, after oral sex. Recall that saliva is a digestive enzyme that may begin to remove some of the surface cells of the skin of the uncircumcised penis. The resulting appearance may be what you have. Nothing to worry about.

Good luck!

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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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