Pimples on penis for three weeks
by Jdg6149, Mar 27, 2013
Hello doctor. Thank you for considering my question.

I will start by giving some background. I am in a monogamous relationship and have not had any sexual encounters outside that relationship except for one thing about a year in the past that I would be remotely concerned about. I had an erotic massage that did involve some genital to genital contact but no penetrative sex. I was concerned about this encounter and later got tested for gon/clamid and was negative. I moved on with life after this mistake.

Now I am under much stress lately and three weeks ago I got a bunch of small pimples on one side of the shaft of my penis and a couple on the head. They were just small raised bumps and looked very much like small pimples. I went online to research it and of course was scared to death that I might actually have herpes. I went and got the igg blood test (I believe it was herpselect) and was negative for both types 1 & 2. I am still trying to figure out what this is. The pimples seemed to start to fade away but now appear more red in appearance. I'm going to break down and go to my dermatologist to get an answer but I really need the advice of an STD expert to know if I can truly put the herpes questions to rest and not drive myself crazy before I get in to see the doctor.

Based on the background and test results and my limited discription of the pimples what are the chances this is herpes? How reliable are the test results? I know I need to see the doctor soon but I at least wanted to try and get a good nights sleep not worrying about herpes.

Thanks for your help with this. Let me know if you need any more information from me.
Welcome to the forum.  Thanks for your question.

There are no STDs likely to cause the sort of problem you describe.  Herpes of course comes to mind for pimple-like lesions and red bumps, as it has for you.  However, with the negative blood test, it would have to be an initial infection, which usually would have been more severe, including progression to painful open sores, inflamed lymph nodes in the groin, and perhaps fever.  And you haven't apparently been at risk for recent acquisition of a new HSV infection.  It is conceivable your partner has a longstanding, asymptomatic genital HSV infection that has only now been transmitted -- but that also seems unlikely.

The majority of genital skin rashes are not due to STDs; most are simply genital involvement of garden variety dermatological conditions that can occur in other locations.  If you are uncircumcised and most of the lesions are under the foreskin, a yeast infection might be possible.

In short, I agree with the advice you had on the herpes community forum, and with your inclination to see a dermatologist.  You're not going to be able to figure this out by just thinking about it, searching on line, or asking any further questions on this or any other forum.  And as Grace said on the herpes forum, definitely avoid using any special soaps, creams, or any other treatment until seen by the dermatologist.

If you would like, let me know the outcome after you have been professionally evaluated -- perhaps I'll have more comments at that time.  But until then I would advise against speculating and also against worrying.  The large majority of genital rashes turn out to be minor, easily treated conditions.

Best regards--  HHH, MD
Member Comments (9)
by Jdg6149, Mar 29, 2013
Hello again doctor. I do have an update for you and quite a few questions. I hope I can think of them all now but I may have a couple follow ups. Thank you again for the help here.

I went to the dermatologist today and he said the bumps I have are molluscum contagiosum. He explained the basics about it and scraped the bumps with a small tool to excise them. He then told me to do the same if any more showed up. He said it can be sexually transmitted but also from towels or equipment in gyms. I do occasionally go to the gym. Of course I have quite a few questions about this and I've learned that most of what I find online is not all that accurate. So I truly hope you can help me with this.

First of all I will tell you that I am married and I truly have not had any recent sexual contact with anyone other than my wife. I am also very confident that my wife is trustworthy and has not been unfaithful. In fact I've already talked with her about this and we are trying to figure out how I got this. I should also add that she is pregnant and we are both very concerned if this could in anyway be a risk to the baby.

I have several questions. First, what are the chances this is from the massage I had almost a year ago? What is the incubation period of this virus? I'm very concerned about spreading this to my wife. My dermatologist said I should use a condom until the bumps are gone. Is this reasonable?
Also, I'm really going crazy trying to figure out how I got this. I know this seems like I'm grasping at straws but around the time I first got the bumps I noticed I had several subcutaneous bumps on my right thumb and the bumps on my penis started right where my thumb would be when I use the bathroom. Is that even plausible?

I have been to the gym as recently as a few weeks ago. I did a class where I did push-ups on the floor and touched many other pieces of equipment. Is it possible to get it on my hands then spread it to my genitals when I go to the bathroom?

Also, how long does an infection like this typically last? I'm still very confused as to how I could get this in that area without sexual contact.

Thanks for listening and considering my questions. I'm sorry they aren't more organized. I'm a little freaked out by this.
by Jdg6149, Mar 29, 2013
I should add that I was confused by the diagnosis. A couple days before I saw the dermatologist I tried an anti fungal cream I've used for jock itch before and it seemed to be responding slightly. Also the pictures I see online of MC don't seem to quite match what I have. In any case I suppose it's wrong for me to doubt a dermatologist with 30 years of experience.
Interesting.  I thought of molluscum contagious initially, but it's very uncommon at your age; genital infections usually are seen in teens and adults up to 25 or so.  I'm sure your dermatologist's diagnosis is correct; this isn't something any dermatologist would be likely to misdiagnose.

Genital area infections are usually sexually acquired, and that seems especially likely for penile infections.  Most genital area MC involves the pubic area, which can more easily be infected by nonsexual contact.  Do either you or your wife have regular contact with young children?  MC is most common as a facial infection in children, usually under age 5, who typically get it by contact with other kids' saliva; and adults in their environment can then be infected, perhaps when saliva-contaminate fingers scratch the genital area.

I'm a bit skeptical about the dermatologist's explanation of contaminated towels etc.  That's a time-honored explanation for otherwise difficult to explain STDs and other genital infections.  But it might explain a few infections in situations like yours.

I agree your wife should be examined, not only because she has been exposed to you, but it's possible you were infected from her.

Your dermatologist can better tell you what to expect in terms of duration, recurrent lesions, etc.  Some more lesions may pop up and need to be removed or otherwise be treated, but probably not for more than a few weeks, if that.

In any case, this isn't anything serious.  Because MC can be sexually acquired, as an STD specialist I need to raise the question of whether your wife might have had recent extramarital sex.  But that seems unlikely, and based on your sexual history, we can assume one of the other explanations.  Anyway, it's a minor condition, a rather trivial inconvenience, not an important health threat.
by Jdg6149, Mar 29, 2013
Yes doctor. We have a 2 year old boy and he is in day care one day a week as well as nursery care at other social functions. We all live together and most weeks I do care for him all day for 2 days a week. The dermatologist did ask if I had small children. I suppose that is a plausible explination. Based on the incubation periods I've read about it would almost certainly have to be a non-sexual accusation of MC. I did have those bumps on my thumb last month. But honestly I don't know.

As far as my wife is concerned. She has not had any symptoms at all and I'm very sure she has been faithful. I'm sure you hear that all the time in the STD world but it is not a realistic concern on my part.

While waiting for your response, I did have a chance to have a follow up conversation with my dermatologist over the phone. He said it is not something to be concerned about and it presents no risk to the pregnancy. He also was pretty clear that while this can be transmitted sexually it is not always the case.

I have seen that there is a bit of a debate between the dermatologists and STD specialists on this point of MC transmission in adults always being sexual in nature. Which leaves me a bit confused too I guess. I do know that the one mistake I made almost a year ago was the only thing for me and I completely trust my wife. I may never figure out exactly how this happened.

What are your thoughts? I truly respect and look forward to your opinion.
by Jdg6149, Mar 29, 2013
Sorry for the additional post but you've sparked my memory about a fact. About 6 weeks ago my 2 year old had the RSV virus and we all caught it. Needless to say there was a lot of our little boys phlegm being wiped up by us and it seems to get everywhere. If he had been exposed to MC somewhere that may have made more likely to transmit. Anyway, I suppose it would be almost impossible to figure out.
"What are your thoughts? I truly respect and look forward to your opinion."

You already have my opinion.  I'm sure virtually all STD specialists and virtually all dermatologists recognize that MC is transmitted in adults by both sexual and nonsexual mechanisms.  There has been no formal research in transmission in adults, leaving lots of room for differing opinions based on clinical experience, i.e. the patients we see over the years.  Working in an STD clinic, almost all my cases seem to be sexually acquired.  Dermatologists see more people in whom sexual transmission seems less likely.  It's neither a big deal nor a big debate.  (I'll bet your dermatologist would agree with this statement, if you care to run it past him.)

I missed your information about hand lesions. I can't speculate whether they were MC or not; but if so, perhaps you infected your penis, maybe through masturbation.  In any case, I would bet your infection is traceable to your son.  But I also agree "it would be almost impossible to figure out", and my suggestion is that you not even try.  It simply doesn't matter at this point.

None of this has any relationship to the recent RSV in the family.
by Jdg6149, Mar 30, 2013
Point well taken. I will try to stop obsessing about how it happened.  Of course I was concerned it was related to my massage 10 months ago but based on what I've read that seems most unlikely or impossible. In the spirit of moving forward I did have a few questions.

1. My wife is pregnant. Is there any possible health risk to the baby from MC?

2. My wife has not shown any symptoms yet. How long before we are sure she is out of the woods with this?

3. Is it possible for us to trade this virus back and forth between us?

4. My dermatologist recommends using a condom for a while. Even a couple months after my symptoms are gone. Does this sound reasonable to you? Or has this virus made me take a vow of chastity for a while? :-)

5. I saw on other posts that you think people will develop an immunity to this virus after exposure. This seems to be at odds with what I've read on the CDC site and a few others. What is your reasoning for this? My understanding is that the virus doesn't enter the blood stream so how does the body build antibodies for it?

Thank you for your time and help. I fear I've allowed this to create too much anxiety for me but reliable information helps. Our main concern as a couple is any threat to the baby.

There is no known problem with MC in pregnancy or known risk to the baby.  There are no firm data no how long it may take for lesions to appear.  Usually within a few weeks, however.  Despite what you interpreted on a CDC website, the evidence in fact is that immunity develops over time and that recurrent infections are rare.  Than includes "ping pong" infections back and forth between partners.  I can't say it never happens, but it seems to be uncommon.  Condoms "for a while" can't hurt, but it's probably like closing the barn door after the horse has gone:  assuming you and your wife have been sexually active since your penile lesions first appeared, she has already been heavily exposed and I doubt condoms at this point will make much difference.  But as I said, it can't hurt.  (Interesting that your dermatologist thought sexual transmission isn't a common explanation -- but is concerned about it in this circumstance.)

That will need to end this thread.  Take care and best wishes for a successful pregnancy and for your growing family.