Red Spots On Penis - Herpes?

[londonlad100]

Dear Doctors,

This past weekend, I had unprotected sex with a new girl I've been seeing. It's the first time we've had sex.

We had lengthy and vigorous sex on both Saturday/Sunday, but on Tuesday night I noticed about 5-7 tiny red spots on the underside of my penis shaft for the first time. They are still visible today (Wednesday) and I'd say look about the same.

The spots are very, very minor bumps and look to be mostly identical to the many "normal" tiny bumps I've always had on the shaft, except for the red colour. They are all light/pale red rather than a deep, dark colour. They are not painful or itchy, they're smooth but just noticeable to touch and blanch for a few seconds when pressed. They are mostly spread apart, but there are a few (or maybe just a small "red area" rather than bumps) in the centre of the underside of the shaft, following the line/vein.

Initially I had considered they may simply be existing skin (those "normal" bumps) that's been irritated by the vigorous sex.

I need to accept this could be more serious and my thoughts have turned to potential STDs, the most obvious being Herpes.

Does this sound like typical Herpes? Are symptoms usually this quick to appear? If it were, how long would you expect these painless red dots to become painful blisters?

I'm a male, 33, not circumcised,  and haven't had unprotected sex since my last long-term girlfriend over a year ago. I know myself to be STD free prior to the weekend through previous tests. I realise the stupidity of unprotected sex regardless of the situation and am aware of my potential exposure to a variety of different STDs.

I plan on visiting an STD clinic this Friday, though I'm hoping the spots will have gone by then (I'll visit anyway).

Your advise would be greatly appreciated and will at least give me something to consider prior to my visit to the clinic.

Thank you in advance,

G

[H. Hunter Handsfield, M.D.]

No distant online expert can "compete" with direct exam by a knowledgeable professional.  Since the GUM clinician feels this isn't anything serious, that also is my opinion.  Indded it is time "to forget about this now".

Best wishes.  Stay safe.

[londonlad100]

Hello Doctor,

I've seen a nurse at the GUM clinic this morning.

Her assessment was pretty much what we've been discussing, that it's probably some sort of inflammation/irritation of the skin rather than an STD.

She said it didn't seem like Herpes at all, or any other STD she could think of.

Regarding the spots, they've mostly all decreased in redness to the point when they're not noticeable, though I can still locate them easily.

Some had gained tiny white dry 'heads' (almost like a hard white hair, but a bit thicker) coming directly out of their centres. These mostly brushed off when I rubbed them last night, and what come off/out seemed like a tiny dry white column of "something" a few millimetres long. My guess is dry skin? Maybe dried sweat if there is such as thing? Definitely solid as opposed to wet, and no pain when removing/brushing them.

The Nurse said it looks like dry skin and has given me Aqueous cream to use to fight the dryness. She mentioned Thrush in passing, but didn't seem concerned either way as the symptoms are going by themselves.

Based on the rate of them 'reducing' to normal I'd expect them to be completely gone in another day or so.

Unless you feel the 'white heads' which i'm able to brush off (admittedly, quite a vigaurous rub, they don't just fall off) or the Thrush is going to need further attention, I'm happy to forget about this now?

Thanks again,

G

[H. Hunter Handsfield, M.D.]

I doubt this has anything to do with the ultrasound gel.  I can't say whether the speed of improvement predicts any particular cause.  In any case, it is pointless to speculate when you're soon to be professionally examined.

[londonlad100]

Hello Doctor,

Whilst I've been unable to get to a clinic today, I have arranged a visit as early as possible tomorrow morning which hopefully will shed some light on things.

After a nights sleep, the red bumps are definitely becoming less red and in some cases cannot be seen any more, which i'm taking as a good sign.

However, would aggravation of the sebaceous or sweat glands normally take this long to go? 4/5 days "recovery" seems very long!

Another possible factor which I didn't mention initially was that on the Tuesday morning (I noticed them late Tuesday evening) I underwent an ultrasound for testicular cancer. The test went well with no problems found, but a huge amount of thick ultrasound gel was used. I hadn't considered a reaction to this gel because i'd assumed the hospital wouldn't use gel that could aggravate, and would expect a reaction to be more wide-spread (obviously the majority of the gel was in the scrotal area, where I've noticed no change).

Thanks again,

G

[londonlad100]

Thank you again Doctor,

That is encouraging information. I'll certainly see if it's possible to get to a clinic sooner and I'd be happy to update you once i've had it looked at.

Agreed, the conversation with my partner should have happened prior to anything else and I'll certainly be having it now, if a little late.

Thanks again,

G

[H. Hunter Handsfield, M.D.]

This information doesn't change my opinion or advice.  The progression from bump to blister would generally occur within a day or so.  An unchanging appearance over a couple of days, plus no pain/itching/irritation remain pretty good evidence against herpes.

I would encourage you to find a way to get to the GUM clinic sooner rather than later, if at all possible. Whenever you do it, let me know the outcome.  In the meantime, you might have a conversation with your partner about her STD/herpes history, symptoms, etc.  

[londonlad100]

Thank you for the fast reply Dr.Handsfield.

Unfortunately I'm unable to get to a clinic before then due to work commitments, but I agree that would be the best option. The clinics opening hours are also quite restricted (thats the free british NHS for you!). Based on what you've said, i'm hopeful it is just irritation.

Does the 1-2 day period from herpes bump to blister always hold, or can it be longer, or not at all? It's just it would be nice to know if the red bumps remain unchanged after a few days more then I could start to discount herpes?

The only think i'd like to point out, which i doubt changes your opinion, is that the bumps are definitely red rather than pink. Maybe calling them pale was wrong, they're more a standard red but certainly not dark. The colour was actually the only way I noticed them.

I'm not too sure what a yeast infection is (will look on this site) but that sounds totally viable.

Thank you again, I realise you're unable to give definitive answers but this service is genuinely comforting.

G

[H. Hunter Handsfield, M.D.]

Welcome to the forum.

It seems most likely that your initial self-diagnosis was correct -- that the reddened bumps are the normal ones (sebaceous or sweat glands, probably) that for some reason are a bit pinker and more prominent than before.  Herpes simply does not behave at all like these lesions; based on your description, it is not a possible cause.  Once herpes lesions start as red bumps, within 1-2 days they become blisters, then painful sores -- i.e. they keep getting worse for several days and generally don't clear up in under 2 weeks.  And no other STD causes such symptoms either.  If not just prominent skin glands, maybe a superficial yeast infection (which isn't an STD)?

My advice is that you get to the STD clinic before Friday; do it today if possible.  If indeed the bumps are improving, and especially if gone by Friday, the clinic will not be able to tell what the problem was.  They undoubtedly would also reassure you about herpes.  But why not do it today so you can have a definitive explanation for the bumps rather than retroactive guesswork?

Regards--  HHH, MD