Sexually Transmitted Diseases/red dots on top of penis

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QUESTION: age: 23 country: USA

so for about two months now I've noticed these red dots on the top of my penis. I have been sexually active with a few girls, and but have never noticed that any had any diseases. the dots don't flare up and they don't itch or hurt at all when i urinate.  If you inspect them really closely you can go over the skin and see that the texture of the skin is a little rougher over the red dots than the normal skin feels.  If you look closely, i guess you can say that the skin is a tiny bit white or scabby looking but its really hard to tell. I'm thinking this isn't herpes because I've had no blistering, doesn't hurt to urinate, and its been pretty much the same looking since 2 months ago.  But then again I read online that everyone has different symptoms for herpes.  I do have dry skin, and I have had some fungal bacteria infections before. Is this herpes?

ANSWER: Hello Joe,
No, this is NOT herpes. Your photo looks like you are UNCIRCUMCISED, and the underside of the foreskin and the glans (head) is moist.  It is characteristic for the top layer of skin cells in uncirc'd penises to become rubbed off due to friction associated with inadequate lubrication, and what is then visible are these flat red dots.  In other words, these are normal surface capillaries that become uncovered with friction from sex.  They're always there, but just aren't always visible.  Use a silicone based lube during sex, and don't let the friction become too intense and everything should be fine. It should heal up in a few weeks! For more information about herpes, check out this link: http://www.cdc.gov/std/Herpes/STDFact-Herpes.htm

Good luck!
--mark


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

QUESTION: Mark, thanks for your response.

I actually am circumcised since I was very little. The top looks moist because I recently put on Lubriderm the past couple of days to see if it would do anything, but it hasn't really been working. Does this change your opinion on anything?

Answer
Hi Again, Joe,
Whoops! Sorry for the wrong guess about your circ'd status.  I think that the problem may still be friction induced. Do you recall any especially vigorous sexual activity prior to each onset of these red dots? Or, do you recall any prior skin conditions anywhere-- on your wrists, fingers, ankles, or elsewhere? It could reflect a skin condition known as "lichen nitidus."  The bottom line is that it is NOT an STD.  However, more information is needed to determine exactly what it is.

Good luck!
--mark  

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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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