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Nipple concern

Dear Dr's,

I'm a 39 yo male that was stupid and went to a massage parlor 4.5 weeks ago.  I had both protected oral and protected vaginal intercourse for a few minutes at most. I also had a massage and the CSW kissed me on my back a few times. Then later she kissed my nipples, mostly my right nipple. We then proceeded with brief protected oral and brief protected vaginal sex.

When we were done I noticed a raised area on her upper lip. I asked her if she had herpes and she said no. Since English was her 2nd language I repeatedly asked and she said it was nothing. She said something about getting it 2 days prior after she ate something. It was not a classical presentation of herpes, it was a swollen area about the size of a pencil eraser with a black center on her upper lip, left side.

About 3 days later my right nipple hurt a lot. It was irritated, dried, and chapped. It could be a coincidence since I went for a rigorous 4 mile run 2 days prior but I was still concerned. Since then I've noticed my nipples have both been dry and chapped a little bit. Could it have been a STD?  What are the possibilities of a STD of any kind being transferred from the lips to my nipples?  I haven't noticed any other abnormalities of any kind on or near my penis...I'm mostly worried about my nipple which I know seems odd. I swear my right nipple feels different and looks different but I think it's anxiety getting the best of me since I made a stupid mistake. Occasionally I swear it hurts a little and I wonder if there's a small growth on my right nipple...but it's hard to tell.  Please share with me the realty of any transmission so I can either address it or put this behind me and move forward.

I'm in a committed relationship and wish I never did this. I was tested in late May and was negative for everything. I may get tested again just for peace of mind, if I do when should I go?
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239123 tn?1267651214
Welcome to the forum.  Thanks for your question.

The only infection that potentially might be possible from this exposure is HSV-1 of the nipple, if your partner's possible lip lesion was herpes.  However, the chance of that is exceedingly low, especially since you apparently didn't develop painful blisters or open sores of the nipple within a few days after the event.  And anyway, even in that case, the infection would not be transmissible to your wife or anyone else, except by direct skin or mouth contact with your nipple during a recurrent outbreak.

Also, I agree with your self-assessment about your anxieties and the "different" appearance of your nipple and the discomfort described:  I doubt this is anything except anxiety altering your perceptions.

You could have a blood test for HSV, if my reassurance doesn't settle your nerves about this.  However, I don't recommend it.  Just scan this forum for numerous discussions of problems with the HSV blood tests in people at low risk for being infected.  I also see no need for testing for any other STDs.  If you decide to go ahead anyway, your HSV test should be done 3-4 months after the exposure.  But if I were you, I wouldn't do it and I would continue unprotected sex with my wife witout fear of infecting her with herpes or any STD.

Best wishes--  HHH, MD
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