Sexually Transmitted Diseases/Razor Bumps, STD or Paranoia ?

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Hey what's up doctor Mark ? My name is Joe, I am 21 years of age and to be honest I am pretty sexually active . I can count on one hand how many times I've have had sex without a condom which probably doesn't help because I know it only takes once . I just wanted to know what you thought the possibilities were and what I could possibly have gotten based on the details that I'm giving you. Sooooo here goes... Like I assume anyone does, I shave pretty regularly because I don't like pubic hair. If I forget to shave, I will do so before I have sex most of the time. I shave with the same clippers that you cut hair with but they've become sharp somehow and I have nicked myself a couple times. Given those details, I have about 5 or 6 red bumps in my pubic area which lay under my pubic hair and about 4 more tiny ones going up each side of my penis until about the half way point . I've had them since the very end of October , today is now the 27th of January . I've did an insane amount of research due to a serious case of paranoia and i just want to know what the possibilities are . The bumps have not really spread within the 4 months, I've only grew maybe one or two more that are very tiny and almost unnoticeable . They have not blistered or opened up so I don't think it's Herpes and by what the images show on "chancres and ulcers", I have reason to believe it's neither Syphilis nor Warts of any sort. Sometimes the bumps get slightly irritated and turn red but only if I bother them , they're usually a pretty neutral color . They don't look too troublesome , I actually showed a couple people around me that I trust and they said that they almost look like shaving bumps . That's fine and dandy but I'm almost certain shaving/razor bumps do not last 4 months and sometimes locate at the halfway point of the penis. I know you can't cure me or treat me over the web doc but I could really use something to get me a little bit closer to a solution. Oh and one more thing, it does burn when I pee but I was previously checked for that and my doctor said i was squeaky clean . She said the pain in urination is due to my unhealthy eating habits and my extremely high level of acid intake. Just wanted to share that just in case that had anything to do with anything . Ok thank you doctor for your time and expertise , it is oh so greatly appreciated .

Answer
Hello Joe,
Gee, those photos are so dark, it is very tough to see much of anything!  Before I address your question, I would recommend that you NEVER use the term or believe the concept of being "clean" squeeky or otherwise, as a metaphor for free from sexually transmitted diseases. [Here's a funny youtube short about "DDF" spoken by two gay robots:  https://www.youtube.com/watch?v=MZ541LDcUYQ]

I would recommend that you use the electric clipper with the shortest hair guide in place to avoid inadvertent nicks from the moving blades. You will cut the hair to about 1/8-1/16" off the skin, which is really unnoticeable, but will decrease the injury to the skin, and prevent hair bumps. Have you tried using plain vinegar on the skin to observe for possible whitening from HPV? This is known as "acetoleukoplakia", a whitish bump or plaque on the skin, and is frequently associated with HPV and warts.  Sometimes, sebaceous glands develop into cysts. Sometimes, repeated injuries to the skin may cause epithelial cysts or scars, but better lit photos would help to figure out exactly what you may have!

Last, the burning with urination may be due to chlamydia, gonorrhea, mycoplasma, ureaplasma, and possibly trichomonas.  Eating certain foods may change the pH (acid-base balance) of your urine, but the level of hydration/dehydration of your pee may also play a role. If dark yellow, it is very concentrated; pale yellow, very dilute. Add a cruciferous vegetable (such as cabbage, asparagus, etc.) and it may affect the odor; add beer or alcohol, and it too will affect the odor.  However the nerve endings at the tip of the penis need to be irritated first, in order to respond to the change in urine pH or concentration. Such irritation may be from inadequate lubrication during sex, or the tip of the penis everting out (like a pouting lip) and rubbing against underwear during work or recreation.

Hope this helps!
Good luck!
--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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