Red bumps on Penis Head

[worriednortherner]

Hi Doctors,

Thank you for taking my question.  Over the past couple of years, I have had some sexual encounters with strippers where I have had condom protected vaginal sex and received protected oral sex.  I have also received unprotected oral sex on a few occasions from strippers as well.  There have been a few times where I worried because the condom slid up my penis shaft almost half way or the woman used her mouth to roll on the condom. I do not believe a condom ever broke or did not cover the head of my penis.  I have also had unprotected sex with a female friend of mine several times during the past 3 years, who says she's clean.  I tested negative for gonorrhea, chlamydia, and hiv a couple months ago.

Last night I noticed 2 small slightly raised red bumps on the head of my penis.  They don't itch or hurt.  I immediately became scared because they involved the penis.  They don't appear open or liquid filled.  Today, they seem the same or slightly better, but still red and raised when looking at them.  I have no idea how long they've been there. I just happened to notice them last night.  The last time I had unprotected oral sex from a stripper or protected vaginal sex with a stripper was probably 3 months ago.  The last time I had unprotected sex with my female friend was about 6 weeks ago.

1. Do these bumps sound like HPV, herpes, or syphilis?
2. Can you get HPV/warts from receiving unprotected oral sex from a female?
3.  How do I know if these bumps are warts from HPV?
4. If they're warts, is there a time line in which it will take them to go away on their own so if they go away faster, it will mean they're not warts or an std?
5. I took 1 pill of azithromycin for 3 straight days (box said 500 mg) for respiratory infection about 10 days ago. will this cure any std?
6. Would a Dermatologist be the right doc to see?
7. Should I do a vinegar test i read about online?

Thanks a lot

[H. Hunter Handsfield, M.D.]

"Shiny" is typical for lichen planus, which might be even more likely if the color is slighly purple or lavender.  Also look in your mouth:  are there white/lavender stripes or a lacy pattern inside your cheeks?

[worriednortherner]

Hi Dr. Handsfield,

Thanks for the quick response. I'll try to see a Dermatologist or primary doctor.  I'm actually circumcised.  The two red bumps definitely have a red tone to them and have somewhat of a shiny appearance where I can feel bump in the skin as I graze my finger over them.  The last time I actually received unprotected oral from a stripper was back in January and protected vaginal from a stripper probably 3 or more months ago. If my friend goes to have a pap smear would she be able to tell me if she has HPV or warts?

Thanks again, and I'll post what my doctor says.

[H. Hunter Handsfield, M.D.]

Welcome to the forum. I'll try to help.

You don't provide enough description for me to predict a cause of your penile red bumps,  except that I'm pretty it's no STD.  Why?  First, non-STD problems explain the large majority of penile rashes and bumps, except those with blisters or open sores (herpes) or warts (which are not generally red in color).  If you are uncircumcised, then nonspecific or yeast balanitis (the term for inflammation of the head of the penis) may be possible.  Lichen planus is a common penile rash, and sometimes psoriasis appears on the penis.  And most of the hundreds of other causes of dermatitis also can show up on the penis or elsewhere in the genital area.

To your specific questions:

1) I doubt it's any of these.

2) Oral sex may transmit HPV/warts, but probably rarely.

3,6) How do you know what's going on?  By visiting a doctor or clinic in person.   A dermatologist would be ideal, but most general physicians or STD clinics would also be able to make an accurate diagnosis very quickly.

4) How quick they clear up, if they do, really isnt' a good clue either for or against HPV/warts, or other causes either.

5) Azithromycin would cure most bacterial STDs (gonorrhea, chlamydia, syphilis) but would have no effect on warts/HPV or herpes.  However, azithromycin and other antibiotics can trigger yeast infections -- see above if you are uncircumcised.

7) The "vinegar test" is totally unreliable.  It's not exactly quackery, but close to it, and we never do it in my clinic.  Some HPV infections don't turn white, and not all white things are caused by HPV.  Don't do it.

I'll be interested in the final diagnosis.  Please return with a follow-up comment after you have been professionall evaluated.  in the meantime, I'm pretty sure you have neither herpes, HPV, nor any other STD.

Regards--  HHH, MD