Sexually Transmitted Diseases/Red area under tip of penis


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QUESTION: About 1 week ago I had protected vaginal sex. About 4 days later, the area in question began to become red and irritated. Haven't noticed any blisters but I am not sure if this is herpes or an irritation from the condom. I know the penis was touched by her hand and my hand for a few seconds.

I'm not sure what the risk is from a one time occurrence. I know Herpes can be transmitted from skin to skin.

What do you think this is?

ANSWER: Hello Jack,
The rash looks like a bit of what we call "angioedema"-- some non-specific swelling, and itching and irritation that has unknown specific cause. One of your hands may have had contact to a cosmetic or an irritant that is contributing to the rash, but it is unusual that it is only in that one place, only on one side.  Does the skin look like it is just somewhat swollen, or are those discrete fluid filled blisters?  

I don't think it is herpes, because an acute herpetic infection would not be restricted to JUST THAT VERY SPECIFIC AREA as it is shown.

Avoid scratching the area, and use an anti-inflammatory cream such as triamcinolone (by prescription).  Sometimes cold applications will help reduce the acute irritation.  

Stretch the skin out so that the rash can be better viewed, and it may be easier to see details of the rash.

Good luck!

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QUESTION: I took a picture trying to stretch out the skin so you can better view it.  I don't see any blisters. The redness seems to be down a bit but still tender to touch. Do you still have same diagnosis from the new image? Thank you so much for such a detailed answer!

Hi Again, Jack,
Sometimes, it is easier to say what it is NOT than what it is! It does NOT appear to be herpes or any other STD.  It does look like a mild skin irritation, that would respond to a topical steroid cream like I suggested last time.  

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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