Sexually Transmitted Diseases/Penile gland spots

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Question
Top of gland
Top of gland  

Side of gland
Side of gland  
Hi Doc,
  I am a 31 year old married male that rarely ever has sex any more, I went on holiday for 31 days and had sex with my wife once, 5/6 night ago we had sex on valentines night but recently my nightmare has returned, I have had this reoccurring problem for over a year, I have been living in China for nearly 5 years, each winter it's very cold so I always holiday to a warmer place usually near the equator three years ago I had unprotected sex with a coworker the night after coming back I think it could be an sti, a week or so after returning back the the cold environment I have an outbreak of cold sores and this will show up on my gland, the Chinese doctors say it's yeast related and give me cream to use but it never works or is.a very slow process, I have been married now for two years and it still happens even without sexual intercourse, I noticed this 2 days prior my penis would be a little itchy with small white/yellow heads after cleaning it would feel worse and turn into a red rash, the Chinese doctors did a test and it showed a picture of the yeast looking like short strips of spaghetti.

Answer
Hello Super Ted,
I agree that it looks very much like a yeast or fungal related problem.  The cream they give you may need to be changed to something more effective. I'm not sure what medications are available, but there are several different creams that may be tried.  In the U.S., an especially effective one does NOT require a prescription:  terbinefine cream (trade name Lamisil) can be found where athlete's foot medications are usually found.  

The red areas are just areas of skin that have worn away revealing underlying dilated blood vessels which look like red spots or erosions.

When washing penis, use just plain water without soap.  You are UNCIRCUMCISED, and the moist, unkeratinized skin is easy to traumatize from anything that causes friction down there (athletic activities, sex, masturbation, tight clothing). Use a silicone based lubricant, which should help.

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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