Sexually Transmitted Diseases/Ulcer in the penis head


Hello and good day, Dr. I am 26 years old, male, from Malaysia. I had a single ulcer that hurts,small almost unable to see the crust,and it healed within a week. After two weeks, another ulcer appear. Same condition and it heal, probably even faster than the 1st. After that, I experienced redness at the tip of my penis. So, I got it checked by a urologist and he says everything seems normal. I forgot to mention to him about the ulcer cuz they healed and there are no marks so show him. I have not had sex (both oral or penetration). So, I don't think that I have STD but the redness at the tip of my penis stays. Sometimes it is better. Sometimes it itch and a bit of irritation. I believed that it is probably balanitis. I have a foreskin. My question is, are the ulcers caused by balanitis? Is it something I should be worried about? What should I do with the balanitis? I hope to receive a reply from you soon. Thank you.

Hello Wai,
Genital ulcers of any kind-- if they truly are ulcers-- need further testing to rule out viral or bacterial causes, some of which may be due to sexually transmitted infections; some may not. After everything heals, it is very difficult to accurately diagnose such a problem, until a fresh sore or blister reappears. Balanitis is merely an inflammation of the underside of the foreskin and glans, usually caused by skin fungi. If fungi are the culprit, than antifungal creams usually can effectively treat the condition.

Good luck! Hope this is helpful.

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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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