Itch - penis head

[asp182]

Hello, Doctor.  My question regards the fact that, although I have not had any sort of sexual contact of any kind (either vaginal or even just oral sex) in the past 5-6 months (except for mouth kissing), lately (past few weeks off and on) I have been feeling an itching sensation on a localized spot on the head of my penis.  I feel it on the head/tip of the penis, underneath my foreskin.  That is the only location I feel this sensation.  It is not drastic but occassionally feels sharp -- and I don't recall ever feeling this itch on a very specific, localized area of my penis head ever before in my life.  A year ago I slept with a girl who has had many partners who said she was clean, and about 6 months ago I slept with a girl who has not had many partners but who told me that she had tested positive for one of the strains of HPV - she said not the kind that causes genital warts but the kind that could cause cervical cancer in women.  Could this occassional itching on this specific, localized area of my penis head be related to that?  Does this sound like an STD?  Also, since I've never really examined my penis head this closely before my worry started, I've noticed that the head (sometimes) is not as perfectly smooth and polished as I remember seeing it being before.  Like, I've noticed more tiny "crevices" than I remember recalling before, i.e., just not as perfectly smooth as I recall (this is when it is flaccid, not when it is erect).  Almost as if it looks dry, but it is not dry.  What should I do?  I have been tested for everything (except HPV - can they test for that?) -- and for the past year (after the promiscuous girl) & the past 6 months (after the unpromiscuous girl who had a strain of HPV), all of my tests have been negative.  Negative for HIV now 9 months after possible exposure, is this reliable now?  Negative for chlamydia, syphillis, gonorrhea, hepatitis.  Positive for HSV-1.  Any answers/suggestions?  Thank you, Doctor.

[H. Hunter Handsfield, M.D.]

No STD causes penile itching without visible sores; and no STD is likely to first pop up with such symtpoms 6 months after it was caught. HPV doesn't do this.  Penile skin always gets more prominent creases as men age; it is entirely normal.  You're looking too closely and noticing something that 99% of men wouldn't even realize or pay attention to.

If you have not done so, I suggest you see a dermatologist about the itching symptom.  If s/he says your penile skin is normal, then it is normal.  You can put STDs aside and follow the dermatologist's advice about treatment, if any.  In the meantime, don't worry about this.  It's nothing except a feeling, not a disease.

Good luck--  HHH, MD

[asp182]

Right, there have been no visible sores when I have felt that itching feeling on my penis head.  I did have one sore awhile back which was determined to be HSV-1, but since that first outbreak I have not had any more.  Could that very localized, occassional itchy spot be related to HSV-1, even though I'm not having an outbreak and haven't had one since the first time?

Thanks for letting me know about the normalcy of the skin on the head not being as polished/smooth as I recall before my worrying about/examining this.  However, is it abnormal to also sometimes notice that there are occasional "dots" on the head where the flesh is not quite the same color -- i.e., where the flesh on the head is not even/the exact same color throughout, but there are some darker "spots" where the flesh is a little differently hued (i.e., darker "spots")?  Is this genital warts/HPV?  I have not noticed any bumps or anything raised, however.

Is it possible that this is a fungal infection, maybe showing that I might have HIV and that my negative 6 and 9 month tests aren't accurate?

If this is/is not an STD or any other sort of disease, what are your final thoughts on the HPV issue -- i.e., the last girl I slept with having it.  Am I now a carrier for my future partners -- and if I have it, will it stay with me forever?  And is there any testing for this in men?  THANK YOU, Doctor!

[H. Hunter Handsfield, M.D.]

You describe normal penile skin in all respects, and you describe nothing that suggests HPV, a fungal infection, or anything.  But the way to know for sure is to see a provider, trust his or her opinion after direct examination, then put it aside.

Nobody carries HPV indefinitely.  And it is impossible to have HIV and negative tests 6 and 9 months after infection.

I won't have any further commments.  Please accept the reassurance (or see a provider, if you must) and move on.