2ND OPINION

[shownuff]

Hello Doc,
I have been very sexually active (hetero) over the past few months. I have have several sexual partners and Always have had protected sex (intercourse). I have also been the recipient of uncovered oral sex on the penis and scrotum. To my own laziness I am very poor with daily hygiene (showers/washing) and often sweat profusely in the genitals. I shave down there to help with cleanliness and have stupidly applied hand sanitize and rubbing alcohol in those areas after sexual activity (burns like hell). Lately I have had really dry skin (chaffing) around my genitals (folds/sides of scrotum) and recently noticed white bumps on the very bottom of my scrotum only (no where else). Seen a doctor today, he recommended a hsv2 and syphilis test because he said they are virtually identical in appearance. I opted for the hsv2 test only (because of price) and it came back negative. He ruled out warts and gave me clotimazole too apply over a couple of weeks. My question is how similar are the appearance of syphilis and hsv2? Internet pictures are all over the map (over the top in my opinion), but mostly to my ignorant eyes they don't really seem to mirror that much. I'm of course still worried and went and took a package deal test (syph,clap,gon,hiv etc) from get tested now.com. I initially thought it was my poor hygiene and sanitizer that is leading to some sort of rash, but I'm of course still worried. Thanks in advance. Have also been worried about touching (even while cleaning) my genital area then chancing spreading something (if there) to my kid. Is that possible, to pass along an std from touching an infected area then someone else (of course not at the same time).

[shownuff]

Touche Doc.....

[Edward W Hook, MD]

While theoretically any STD might be acquired through oral sex, the major ones are NGU and gonorrhea.  

There are, of course, persons who claim to have gotten HIV while using condoms correctly and consistently (something that, of course, cannot be verified) but I am not sure that is something that has been proven.  Further, "has it ever" questions are sort of silly- people have been hit by falling meteorites but to worry about this would be silly.

Nothing more to say.  EWH

[shownuff]

Thanks doctor. Just so I am clear going forward, what are the std's one can be exposed to (male) from receiving oral sex/fellatio? And are there any medical KNOWN cases of someone contracting HIV while wearing condoms ALL the time?
Your answers are helpful...

[Edward W Hook, MD]

Welcome to the Forum.  I'll be pleased to comment.  I must admit, when I read that your doctor thought that the bumps you had noticed were either herpes or syphilis I was a bit surprised.  The scrotum is an unusual place for either of these infections and your description did not suggest those problems to me.  There are many  "bumps" present on the normal scrotum which can be mistaken as abnormal and the location is an area where folliculitis (infected hair follicles of the skin- this is more common among persons who shave and whose hygiene is not optimal) and  benign skin cysts regularly occur.  These are what I was thinking of.

I would also add that your practices- shaving the area and applying hand sanitizer which can dry and/or irritate skin, are practices which can lead to irritation, rashes and peeling skin.  I would advise you to stop this until the area clears up and suggest that you wash the area, gently once a day.

I anticipate that your STD tests will be negative although it ws probably a good idea to test given your multiple recent partners.

Finally, please do not worry about transmission of any STD on your hands from yourself to others.  While theoretically possible, it is very, very rare- so rare that neither of us on the Forum had EVER seen an instance of this in our combined over 70 years of STD focused practice.

Hope this helps.  EWH