Sexually Transmitted Diseases/Penis Coronal red

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Question
15 days ago right side redness
15 days ago right side  

2 days on left side
2 days on left side  
Hi Mark,

Thanks for your precious time to help us here.

I had Balanitis when i am 24 and have recovered for quite a while after treatment. Recently i had protected sex with some women and my penis coronal(right side) show the following syndrome: redness,swelling, wrinkle/rough surface if penis not fill with blood. Initially it's on the right side of Coronal, and just 3 days ago, after i have rubbed my penis with women's leg, the left side show similar syndrome with bigger area, it seems skin on penis and coronal got bigger damage.

I have started to use the 1% w/w Clotrimazole Canesten Cream, have seen white stuff (it looks more like skin peeling rather than white substance from Balantis, i can show you when you reply me in second post)

please let me know your detailed expert thoughts.

Thanks so much!

Answer
Hi Jack,
The skin of your penis looks normal.  Balanitis is an inflammation of the foreskin and sometimes glans (head) of the penis. It can be caused by yeast or other causes.  Although uncommon, it may occur multiple times and therefore may require multiple treatments.  NOTE, that clotrimazole in your canesten cream may be ineffective, as there are lots of strains of yeast that are now resistant to this antifungal medication.  I usually suggest an over-the-counter product called terbinefine (Lamasil AF) in the athletes foot section of the drugstore.  

However the photo does not look like you have balanitis!  The "15 days ago photo" definitely shows an irritation but presumably now, has healed.  

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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