Sexually Transmitted Diseases/Abrasion on Penis head, or...??


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Hello and thank you so much for doing this service!

I need some advice if you would please...

I am a guy in my 30's, fairly healthy. I am uncircumcized, so I do occasionally have issues with balanatis. I have used OTC fungal creams in the past under the docs advice.  

Over the course of the last year I've lost 90 pounds and changed my diet a great deal.

Anyway, I've been using 2% micronazole for about two or three days twice a day or so to clear up a recent issue. It's largely resolved (I have a few small spots elsewhere too), except I seem to have a spot that doesn't entirely want to go away. It doesn't hurt, it doesn't seem to weep or lose fluid, and it's not getting any deeper or anything like that (my first fear was syphilis!)

I also some unprotected oral with two women but that was at least 3 months ago.  I had a recent STD screen this summer for anything that could cause a problem with urinating (I have a sensitive bladder and or interstitial cystitis, which can be uncomfortable like an infection and I try to manage that with diet) and I came back without signs of any infections at that time. The doc was kind of disappointed that there wasn't an explanation and told me to consider the above information, given that I've had multiple screenings in my life for the "common" stuff like the clymadia and gonorreha (sorry, spelling bad).

Since that time, my sexual history is not complicated, I've had two instances of condom protected penetrative sex, one vaginal, one anal.
I do not do drugs of any kind.

I manage urinary discomfort by being more selective about what I eat and drink. not perfect, but it's under better control.

I have horrible health anxiety, my choices may not have been super smart.
Is this spot just going to take longer? do I need a different approach maybe? I understand syphilis is rare in the US. If this is the case it's definitely atypical.

Sorry to ramble... my anxiety's talking. I think the flash photo makes it look more red and "deep" then it actually is. It's actually ever so slightly raised, and my "handling" of things may have made a little more so trying to take the pucs

Thank you so much.... really

Hello Mark,
Common issue among uncirc'd guys, and this does NOT look like an STD or anything other than a mild annoying skin condition, probably from friction. Nothing to worry about.  It will eventually heal. Numerous other recent posts seen here address the same issue.

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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