STDs Expert Forum
STD Risk?
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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STD Risk?

Hi.

5 weeks ago I had an encounter with an escort.  She was very careful and used a condom during oral sex and actual intercourse.  There were times where a condom was not used during masturbation etc and I suspect there was some contact between us but certainly no penetration without a condom and any contact otherwise would have been brief.

I was tested 2 weeks later for gonorrhea and clamidya and both came back negative.

A few days ago (so 4 weeks and 4 days after the event) I developed a couple of red rashes on the shaft of my penis, one towards the base, the other further up (but neither on the tip).  It's a little itchy but nothing much more, maybe the skin is slightly drier - to be honest it may have been there longer, I'm not sure but I had been to the gym and was very hot so they looked brighter if that makes sense.

Should I be worried? I'm thinking specifically Syphilis as I get cold sores on my mouth and I was under the impression this protected me from anything similar in the general region.

I have used a little nappy rash cream on the marks so far but only for the last 24 hours or so.  I can't say they are getting worse or better.  

Advice very much appreciated.
300980_tn?1194933000
Welcome back to our Forums.  It will be my pleasure to comment on your questions.  The encounter you describe was safe sex and I congratulate you for it.  Contact with a partner's genital secretions in one manner, shape or form is a typical element of "safe sex".  Genital secretions get on each other’s' skin in most cases yet STD transmission is prevented in the vast, vast majority of cases. The main exceptions to this are the so-called "lesion" infections such as syphilis or herpes which are the STDs which can be transmitted through skin-to-skin contact during foreplay of if the condom does not prevent lesion contact because of location.  Your gonorrhea and chlamydial tests prove that these infections were not transmitted in the course of this encounter.  As for syphilis, given your description this seems most unlikely.  One factor which makes me say this is the fact that your rash occurred in two separate places, one of which was covered by the condom.  A syphilis lesion occurring at this time would be expected to occur at a single location.

If the rash persists you may wish to have a dermatologist take a look however the probability that this is an STD of any sort is very, very low.

I hope my comment is helpful.  EWH
14 Comments
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Avatar_n_tn
Hi.

Thanks for this, it certainly does help put my mind at rest somewhat.  Can I just clear something up?  If I apply your logic about the location of the rash (ie 2 places rather than one) then that certainly rules out anything from the actual sex and the condom would have certainly covered at least one of these areas.  Am I right to deduce from the rest of your reply that any other contact (ie passing fluids via masterbation (masturbation)) would be unlikely to cause anything I may be concerned about?  As I said earlier, I get cold sores on my mouth from time to time so I think that means Herpes is out of the question anyway?  So that leaves us with Syphilis and it seems to be pretty unlikely from what you've said.

To be honest, the rash is barely more than some dry skin and slight redness, had I not had this experience 4 weeks or so ago I would almost certainly have ignored it or put it down to rubbing against my shorts while jogging at the gym or something.

Thanks again for you time.
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300980_tn?1194933000
You are correct in your deduction. The transmission of STDs of any sort through hand to gential (genital) contact is virtually unheard of and not a meaningful reason for concern.  

You are correct that HSV should not be a concern- both because of the description you provide, the manner of the contact, and your cold sores (which would prevent you vfom getting genital herpes due to HSV-1 and reduce risk for HSV-2).

Your alternative explanation is quite reasonable.  EWH
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Avatar_n_tn
Hi.

Thanks again, I think it's fairly clear I have nothing to worry about, guilt is a powerful thing and I clearly don't have the mental strength to cope with this sort of encounter!

The rash has now almost completely disappeared, with only some dry skin left (no redness to speak of.  I was getting some other odd symptoms yesterday, occasionally itchy palm and mouth, but I'm putting these down to anxiety and going to try to move on.

I appreciate the tone and time taken to respond, it's great having this opportunity to discuss such concerns.
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300980_tn?1194933000
I'm pleased you found my comments helpful.  EWH
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Avatar_n_tn
Hi.

I do hope it's okay to ask one more question.  The rash I described above went away after a few days, so nothing to worry about there - I put it down to dry skin or irritation.

Yesterday I noticed a slight redness to the area around the opening of my urethra, it's not hugely different to normal and had I not been probably paying far more attention to this sort of thing than I should I wouldn't have been concerned.  Still, I can't help that I am concerned, hence the question (sorry).

I'm guessing (hoping) that given the length of time since my encounter detailed in my first post, and the minimal risk/ contact if any that was unprotected, this is something either not to worry about or at the very least, unconnected?

Once again I'm sorry for my concern, I almost feel ridiculous typing this out.  Any advice greatly appreciated.
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300980_tn?1194933000
I would not worry and would urge you to shift your focus of attention to somewhere other than your genitals.  EWH
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Avatar_n_tn
Point taken and you've made me smile which whilst above the call of duty it is very much appreciated.
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Avatar_n_tn
Hi.

Thanks for all your adive so far, I'm afraid I have one more question - if I need to ask it elsewhere please let me know.

The redness around the opening of my urethra I mentioned is still there and is quite swollen - not sore or painful although I have had some uncomfortable feelings from time to time and perhaps the odd itch.

I appreciate this isn't necessarily a STI so should I be getting checked out for anything else?  My wife had thrush about 5 weeks ago and I wasn't sure if it could be that although it seems like a long time ago.  

Thanks
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300980_tn?1194933000
Redness of the sort you describe could be a manifestation of a fungal infection so GENTLE application of an antifungal cream (available OTC) might be worth a try. The other advice is to do you best not to re-examine yourself often OR vigorously as this too can contribute to local irriation. EWH
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Avatar_n_tn
Okay thanks, I'll try the cream, fingers crossed that sorts things.  My symptoms aren't like those of any of the STi's I was worried about so this does rather end this saga hopefully.

Thanks again for your help.
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Avatar_n_tn
Please let me know if I need to repost this as a new question, I just thought it useful to keep the thread up to date for others as well who may have similar issues.

I tried the cream for a week and got no change, then I tried a Fluconazole 150mg tablet 5 days ago and again, no change, so I'm guessing that rules out a fungal infection.

This certainly isn't like a symptom of Herpes or Syphilis (as far as I understand) and I tested neg for gonorrhea and clamidya and my encounter was, as you say, very very low risk, so my concern over STD's is pretty low (although still a nagging worry).

I can't get to a doctor until next Monday due to work travel, and I'm still seeing the same thing, in fact it seems to change slightly everytime I check, sometimes more swollen on one side of the opening, sometimes less so etc.  I'm pretty sure this isn't how it looked beforehand as surely I would have noticed, so I'm at a loss as to what is wrong. There is no pain or discomfort to speak of, alhtough I have had some random pangs of pain in places around my groin and bladder I suspect these are just normal and I wouldn't have noticed if the anxiety wasn't there.  

The stress and worry is starting to take it's toll so any words of advice, or pointing me in the direction of the right forum, or indeed telling me to stop worrying if this is normal would be greatly appreciated.
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300980_tn?1194933000
This will be my final comment.  You may post any results or follow-up reports you have but further questions will be deleted.

There is no evidence that this is an STD.  With the efforts at treatment you have probably ruled out a fungal infection.

I suspect there is nothing wrong here but you disagree.  Time to go see a dermatologist. If he/she says nothing is the matter, I urge you to believe them.  If they think there is a problem I would be interested in hearing  this.  EWH
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Avatar_n_tn
Ok thanks, I'll chill out and then see someone next week when I return home. I will of course update this thread with any findings.

Thank you for your patience.
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