Sexually Transmitted Diseases/Is this Blantis?


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 I am 27 years old and from Birmingham, AL. have had this problem a few times. I believe the cause to be body wash with fragrance and latex condoms.  I am not sure if this is blantis or something else. If so what would you recommend for treatment. It began yesterday with minor discomfort and a small bump as normal, I had intercourse last night and this evening it looks like this. I used clotrimazole cream this morning but see no improvements if not worse. Any help will be greatly appreciated. Thank you. John H

Hello John,
Balanitis is a swelling, itching, and inflammation of the foreskin and sometimes the glans (head) of the penis, frequently  caused by skin fungi or just rubbing. Sometimes a condition called angioedema without an otherwise an identified cause can cause a similar appearance. Diagnosis is important because the treatments are vastly different-- antifungal or steroid cream.  What concerns me is what appears to be a whitish lesion on the underside of your penis best shown on the far left (underside) of photo 1, on the foreskin adjacent to the glans/head.

Clotrimazole used to be an effective antifungal, but many skin fungi are now resistant to this medication.  Terbinefine (Lamisil) is more effective. HOWEVER, I don't think that's what it is.  It looks more like angioedema to me, and a prescribed steroid cream may be more effective.  

Note, that if swelling continues and interferes with your ability to urinate, or if the skin swells and causes pain or coloration changes, than you risk a more dangerous complication, including phimosis, paraphimosis, and circulatory compromise that can cause tissue death. Apply cool compresses without rubbing can help reduce the swelling.  If no improvement within a day, or certainly if it worsens, than this justifies a trip to an urgent care or hospital emergency room, if you can'f find a doctor or other health care provider.

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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