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Sexually Transmitted Diseases/STD scare, any identification possible?

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Groin 1
Groin 1  

Groin 2
Groin 2  
Hello Mr. Behar,

I'm a healthy 26 year old, sexually active caucasian male. I haven't had a cold in years and every check up/physical have come back with a clean bill of health.

I last had sexual intercourse with a woman on August 9, 2014. She was my 4th partner. The last time I had unprotected sex would have been May of 2013. As of this evening I noticed a couple bumps in my groin region after doing some manscaping in the shower. I've experienced ingrown hairs before and whether I like it or not, I typically pick them off/pop it, wash up and never hear from them again. Hence, my first instinct was to pick at this one. It reacted similarly to an ingrown hair, but then I found a few more bumps and truthfully, I panicked. I've never even had a cold sore (I understand HSV-1 can lie dormant my entire life).

I'm scheduling an appointment for Monday to have a blood test, but I'm absolutely panicking thinking this may be a primary outbreak of HSV-2. The next 3 days are going to be brutal for my overactive mind and getting an opinion in the meantime may help.

You'll find attached pictures of what I'm experiencing. The red one is the one I picked at before I realized "Hey, this might be something else." I'm not experiencing any pain urinating, no tingling, no itching, and no other breakouts. I understand as well that these may very early onset and the other symptoms may come later. Upon further inspection it may be just about one of a few STIs and this is just me self-diagnosing. They have not grown, spread, or multiplied in the past few days.

Thank you for your advice and guidance."

Answer
Hello Eller,
These are NOT herpes. These bumps reflect folliculitis from an irritated hair follicle becoming infected with skin germs such as Staph or Strep. Apply moist heat followed by an over-the-counter antibiotic cream or ointment and they should go away in a few days. DON'T manscape with a straight edge razer; instead use a buzz clipper with a very short hair guard, so that it is very very short but not all the way to the skin.  Pubic hair is usually very curly and when growing back, these hairs tend to grow back into the skin causing hair bumps. Using a straight edged razor causes microscopic scratches that allow the normal skin germs to infect irritated hair follicles and oil glands.

Herpes is a nuisance recurring viral infection that resides in the nerve roots along the spinal cord; when they reactivate, the virus affects the peripheral skin nerves where the virus first entered the skin-- the lips, nose, genitals, finger, etc.  The first exposure and infection encounters your immune system without any type of immunologic defense. Therefore that first time encounter with the virus causes a more severe reaction as the "primary outbreak."  You would notice it! It is numb, tingly, itchy (because it is a peripheral nerve infection at the skin), followed in a day or so with red, fluid filled blisters that are tender, followed by blister breakdown and eventual healing over the course of 1-3 weeks. Recurrent episodes are brought on by stressful events, and the actual blistering event eventually shortens, based on the strength of your immune reaction.  

Check out: medlineplus.gov for more authoritative information about herpes; and google.com/images for graphic photos.

Good luck, stop worrying!  Do NOT waste your time and money with a blood test which most doctors do not order correctly to identify what you have.

--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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