Sexually Transmitted Diseases/Penile infection

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Question
Head
Head  
Hi,
I had a blister on the head of my penis, which turned into a wound as per the attached shot. It is painless, and does not itch. Is that an std?
I am very worried.

Answer
Hello James,
Healing blisters on the penis can be due to several things, including syphilis, herpes, and insect bites. Herpes usually is somewhat itchy, tingly, or painful, but not so on the head of the penis (glans penis). Since you live in a tropical area, there may be lots of insects or spiders which sometimes bite you in the wrong places (all of them are the wrong places!).  

The only way to know, is to have a blood test for syphilis. The rapid syphilis test requires a drop of blood if it is available in your area, as well as the traditional RPR or VDRL which requires a tube of blood.   

The herpes testing is a bit more difficult, and requires a fresh blister or ulcer, not one that is healing for a direct swab.  The blood work that may be done is rather nonspecific, that can only tell you if you recently had, or ever had herpes, but not whether the current healing area is due to herpes. If the blister recurs, than it probably is herpes.

If all tests are negative, and the skin heals without further incident, than it probably was due to a bug bite!

The one piece of information missing, is history! Have you ever had any similar type of skin lesion like this before, anywhere on you skin? Are you sexually active? Last sex was more than 3 months ago or less? Does your partner(s) have any corresponding sores or bumps? Note that sometimes these may be in difficult to view areas like the inside of the mouth, anus, or vagina, and that they too may be non-tender, non-itchy, etc. Use any medications or herbal products for any reason, lately?

Good luck, and don't worry about it.
--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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