Sexually Transmitted Diseases/White dots


QUESTION: I have these white dots mostly around my pubic area. They don't bother me but their just there. Should I be concerned or is it nothing to worry about?

ANSWER: Hello Todd,
Sorry, photo didn't come through.  White dots that don't wash away may be Fordyce spots, sebaceous glands, tiny warts caused by HPV, and a bunch of other things.  

If you have a chance to resend clear photo, that would be helpful!

Good luck!

---------- FOLLOW-UP ----------

QUESTION: Did it go through this time?

Hello Todd,
Thanks for the photo.  It is rather blurry, but better than nothing, so I can't be certain what it may be.  Hair bumps (although it's difficult to see retained ingrown hair in this image), small pimples with pus from irritated hair follicles and infection with skin bacteria, vitiligo, sebaceous glands all come to mind.  They do not appear to be related to HPV or Fordyce Spots, but there is some overall redness of the skin, which usually means irritation from something!  

Avoid use of a straight edge razor and use electric clippers with plastic hair guard to avoid injury to the skin, and then apply hot moist compresses for 10 minutes at a time 2-3 times a day, followed by a topical antibiotic cream or ointment. If no change or condition worsens within a week, than consider a doctor visit or write back with a clearer close up photo. Stretch the skin tight to flatten it, and take a front on photo and a sideways shot so any degree of elevation can be appreciated.

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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