Penis Pain developed this wek

[AnotherPanickedGuy]

Thanks for taking a moment to read and give advice.

38, Male

Had brief unprotected sex (2-3 mins) 80 days (11.5 weeks) ago. Also received 2 unprotected oral from the same woman.

18 days after I developed a rash.  Immediately went and got blood and urine for HIV 1-2, HSV 1-2, Hep ABC, Gonorrhea, Chamydia, Syphillis.  All negative.  I know now I should have waited for this some of these, but I take heart and decide my rash is a heat rash from working out.

3.5 weeks after exposure I went to dermatologist about rash since it did not go away.  Molluscum Contagiosum.  I was assured it is harmless long term.  Have been treated with cantharidin, which has worked well, and have my last appt next week just to follow up  Molloscum is mostly gone and I'm good there.  The next appointment is just to get a formal "All Clear".

Developed a raised spot on glans 54 days after exposure.  The dermatologist saw it three days after I noticed it during scheduled molluscum treatment.  Said it is probably irritation from masturbation, or possibly just dry skin (I have eczema issues).  Moisturize and it should go away.

60 days after exposure, raised spot peels and cracks (I admit I did not moisturize).  So I panic and go to STD clinic.  They examine me, and cannot find worrying issue.  Assure me raised spot does not look like any classic STD symptom, which helps me calm down a bit.  They go ahead test again for Chlamydia, Gonorrhea, Syphilis, and HIV.  Tests all comes back negative.  Am told that at 60 days I can rule these out.

Rocking along after until last Tuesday.  Allowing myself to masturbate again, and I got a little aggressive a time or two.  I noticed skin tag on meatus.  It looks a little red and inflamed.  I can't remember if it's been there all my life or not.  I start looking at and examining it, pulling open to look for lesions.  Nothing, but I'm panicked so decide to watch it.  I've messed with it a few times since but tried to make a point of stopping.  I did masturbate more over the next 2 days, the last time being Thursday, but was careful not to move meatus.  

Thursday night I feel tingling sensation in my penis.  I panic again.  But finally decide all the poking and touching the meatus probably irritated things.  Meanwhile skin tag looks the same, no changes. Probably always been there and I am just noticing because of my hyper awareness and STD paranoia.

Saturday tingling persists, but begins to subside by evening.  Sunday morning it's pretty well unnoticeable, but this afternoon it's back with a vengeance, not just tingling but pain in tip and through, can even feel in groin.

I've had no blisters suggestive of HSV, HPV, Syphillis, Chanchroid (had dermatologist do thorough checks each time I visited).  I have no burning when I urinate.  I've experienced no discharge.  The inflammed meatus area seems much less so today.

My gut tells me that I probably irritated things, maybe infected myself even, by messing around with the meatus while having a panic attack thinking it was a genital wart or something.  Doing some more online research taught me more about STDs, particularly about Herpes exhibiting strange symptoms and doing so much later than normal in some people, and of course, trichomoniasis, which I had never heard of at all...

I should add that I have my 12 wk blood and urine coming up this week.  I will take it at 82 days (just shy of 12 weeks but I have plans to be traveling for a week after), and testing for HSV 1&2, HIV 1&2, HEP B&C, and Trich  (I decided to skip syphilis, gonorrhea, and chlamydia since I tested negative for those at 60 days).  If any come back positive I'll obviously be heading to the doctor.

I do know there can be psychosomatic symptoms when one is stressed out, and I have been extremely so.  I am worried about having infected someone as well, so I need to know.  I had sex right before the molluscum rash and need to let this person know as well but that fact has made things worse for me mentally.  I also know there are other non-STD causes for things like this, including UTI, NGC urethritis, prostatitis.

My question is, what else should I be considering.  Also, if everything comes back negative, what should my next step be.  I've read enough of the posts from Drs. Hook and Handsfield before to know that I can trust a test at 90 days, and I'm pretty confident I will take the results to heart.  But if the symptoms persist this week, I don't want to ignore something that might have another cause.

[Charlie_Foster]

The meatus is a very specific area of skin, sensitive not only to touch (part of the reason it gives pleasure during intercourse), but also sensitive to mechanical or chemical irritation. Normally, the skin of the meatus can protect itself (like other areas of skin), but if you dig deep with a detergent or another other biological or chemical irritant, you compromise the skin’s natural state. This can then provoke the atopic dermatitis (either allergic or irritant).

The problem with dermatitis, as anyone who suffers from it in other parts of the body will confirm, is that it can be bloody hard to treat, especially if the skin is repeatedly exposed to the original irritant or new irritants (including substances that wouldn’t have produced irritation under normal circumstances. E.g. like if you put salt on a wound). Also bear in mind that the meatus is regularly stretched by sexual activity and/or erection, rubs against your underwear and is repeatedly in contact with numerous chemical substances (e.g. your urine and semen, shampoo, soap, chlorine, etc). Once compromised by the original damage, you’ve got a recipe for potentially prolonged symptoms.

To be specific, my symptoms over a 10-month period included:-

- Visible skin trauma of the meatus (redness, wrinkling, cracking)
- Small numbers of tiny intermittent blisters
- Visible changes in the shape of the opening
- Stretch lines contrary to what was normal before
- A recurring feeling of having to urinate, sometimes so persistent and strong that the muscles behind the genitals ached from the reflex to avoid peeing (even when there was no pee).
- Burning / stinging sensation at tip of the penis, usually beginning around 5 minutes after urinating, lasting several hours and worsened when wearing abrasive clothing (e.g. jeans)
- More pronounced sensitivity / discomfort the day after an ejaculation, especially if seamen wasn’t carefully washed off afterwards.

During the months of discomfort and frustration that passed without any useful diagnosis, I tried experimented with various treatments before finding one that rapidly produced a full recovery. I mention each below to save you time and avoid using substances that make things worse:-

ABSOLUTELY UNHELPFUL  (i.e. worsened symptoms for AT LEAST few days):-
            
- Bepanthen ointment
- Anything containing zinc oxyde (found in most treatments for rashes in the genital area)
- Calamine lotion (also contains zinc oyyde)
- Most cosmetic moisturisers, even those labelled hypoallergenic
- Anything with harsh ingredients or chemical fragrances
- Cortisone cream

NEITHER HELPFUL NOR UNHELPFUL  (i.e. useless without making things better/worse):-
- Antifungal cream…after all, dermatitis is not a fungus.
- Camilosan

MILDLY HELPFUL (i.e. eased the symptoms without curing the problem):-

- Keeping the penis head cool and humid by wrapping it loosely with damp tissue. This also helps to protect it from any kind of friction during the day
- Gently applying pure olive oil after showering to keep the skin hydrated. Do this twice per day.
- Avoid all contact with soap / detergent (not so easy in the shower, but strongly advisable)


THE MOST EFFECTIVE TREATMENT

The moment you’ve been waiting for. The solution (for me and hopefully for others) is called "Mustella linement dermo-protector”. It’s a skin cream made by a company called Laboritoires Expanscience in Paris, is relatively cheap and available without a prescription in Europe. Normally it’s used to protect babies from nappy rash (but DON’T assume other products designed to do the same will work - most of them fell into the “absolutely unhelpful” category, e.g. the zinc oxyde products.) Mustella make many products, so please only try this one as I can't vouch for the others. It’s described as hypoallergenic and containing 99% natural ingredients. Olive oil is one of them, but this can’t be the secret of its success in treating meatus dermatitis, since it works BETTER than pure olive oil and seems to be absorbed more deeply into the skin, protecting it from contact with urine or accidental contact with detergent in the shower and restoring elasticity. It also has other oils including Europea Fruit Oil and Zea Mays Oil. I would love to know exactly what it is in this product that’s making the difference. All I know is that the inflammation and redness began to subside within 24 hours and within 2 weeks all the physical discomfort and visual symptoms have disappeared.

Even if this specific product doesn’t work as well for you as it did for me, I encourage you to carefully try different products, ideally with natural oils, to find one that moisturizes and repairs the skin without causing any irritation.

Final piece of advice for me, you and others: from now on, treat your penis with the extreme respect it deserves. :-)

[AnotherPanickedGuy]

Well, the tingling/pain in my penis are annoying at at times acute, but they are unchanged and do not include discharge, which is a good sign I suppose.  As the to raised spot on my glans, since it hasn't gone away I may have the dermatologist take another look as well to assess for fungal infection.

Thanks!

[Life360_Dave]

Symptoms of penis std,s are white/gray puss discharge and burning while urinating. Topical issue are most often fungal related.

[AnotherPanickedGuy]

Thanks for clarifying Dave.  

As far as Trich is concerned, I'm more worried about another partner I has sex with a couple of weeks after this.  We have unprotected sex regularly, or did until I developed symptoms of molluscum.  But the agreement was that we would do so only with each other because we are in the know on each other's status.  I am not in the habit of unprotected sex otherwise, and usually insist on condoms.  This was a stupid indiscretion fueled by alcohol.  I'm 90% confident I dodged the other STD bullets on this one, but I'm testing for peace of mind and to protect someone else.

The pain is less today again, but before it subsided it became sharply for a few hours last night.  If things come back negative on my scheduled blood and urine tests, is there any recommendation you might have if the pain persists (besides the obvious "go see a urologist")?

Again, thanks for the info.  

[Life360_Dave]

Sorry you post was so long i missed that part. Testing at 8 weeks is a good indicator and 3 months conclusive. Trich is really not an issue for men.

[AnotherPanickedGuy]

Hi Dave,

You feel that the IgG test I took at 18 days of exposure should be considered conclusive?

Just to be clear, I have not yet taken the test at 82 days, nor tested for Trich yet.  

I just want to be sure I understand you.

[Life360_Dave]

Your tests are conclusive that you dont have any std including herpes.