[Question #1019] One more question, kindly,

51 months ago
Dear experts,

I have been asking few questions already, last one been #983. and unanimously being answered of no/negligible risk of hsv2 for that encounter by Ms.Warren and Dr.Handsfield. the hsv2 test at 9 days after exposure came negative.

its been a couple of weeks that I noticed two very tiny bumps on my penis shaft.   I showed it to a doctor and he said they are "white heads" or "oil glands". He said they are very common and he himself also gets them often. Not a sign of herpes at all. He said try to eat garlic.

They were hardly visible without stretching the skin. They seem like small ovals filled with fat and are somehow under skin rather than on the surface, unless stretched and they kinda bubble out. From since, maybe two weeks has passed, and I can see that the one is a bit bigger than before, still no/minor visible mark until I stretch the skin. while when I search ( by stretching the skin) I can find three or four others smaller ones other parts of my penis.

They are not like a group of blisters and except two of them that are close, the rest are completely scattered. They are not red or painful too. Other than my heightened sensitivity to the area, they themselves are not painful. e.g. when touched or pressed.

 Should that incident had not happen I would have probably ignored them.

I have few question:
1- Are you guys still supporting the idea that they are not herpes blisters ?  considering those happening right after this indecent.
2- For the last month, so many of my lifestyle has changed due to anxiety of dealing with this, could that be a result of sudden appearance of these ?
3- Last time doctor said he can not swab test these, I am out of country but once back, should I insist for swab test?

Thanks a lot










51 months ago
want to add to this, these bumps/pimples are 1mm by 2mm.. the smaller one are even smaller, but they have a oval shape. from my search in internet they do look like more sebaceous or fordyce  glands than of herpes pictures, but what do i know ?... I am male in my late 20s, isnt it rare to get those now ? Thanks again.
Edward W. Hook M.D.
Edward W. Hook M.D.
51 months ago

Good day. Today I happened to pick up your most recent questions and will be addressing them.  To prepare to provide an appropriate answer, I reviewed your early interactions with Terri and Dr. Handsfield and I agree with all that they have said before. I certainly agree that your receipt of masturbation in the course of a massage is a no risk event.  It also seems as though you are being awfully hard on yourself and as a result are examining yourself far more often and extensively than is warranted or is good for you- when anyone examines themselves (or others for that matter), they are almost certain to notice things that would have otherwise been unnoticed and that are normal, rather manifestations of an illness of any sort.  I suspect that this is what you are doing.  In answer to your specific questions:

1- Are you guys still supporting the idea that they are not herpes blisters ?  considering those happening right after this indecent.

What you describe in no way sound like herpes lesions.  They could well be cysts, Fordyce spots or some other benign process.


2- For the last month, so many of my lifestyle has changed due to anxiety of dealing with this, could that be a result of sudden appearance of these ?

It is more likely that your continuing self examination, guilt and anxiety are causing you to notice things that are normal and/or have been present for some time than that your concerns caused them.


3- Last time doctor said he can not swab test these, I am out of country but once back, should I insist for swab test?

Many health care providers have the misconception that herpes culture or PCR can only be performed when lesions, and particularly ulcers or blisters, are present.  This is incorrect. PCR or cultures can be performed on lesions even when blisters or open sores are not present.  Thus  a swab test could be performed on your lesion.  From your exposure history and descriptions however I see no medical reason for testing.

I hope my comments are helpful.  EWH

---
51 months ago
Thank you very much Dr. Hook, i appreciate you going through my previous posts.

Regards
Edward W. Hook M.D.
Edward W. Hook M.D.
51 months ago
Glad to help.  I hope my comments will help you to move forward.  EWH---
51 months ago
May I kindly ask which one of my symptoms more strongly dis-associate these from herpes lesions ? 
The fact that there is no redness on top and around it, or the fact that it stayed more or less the same way for the past two to three weeks (little growth) or the fact that is not painful !?

The doctor who had seen them told me prepare to have them for some time before the get absorbed or suddenly poped out. May i kindly ask if you have any comment on that ?
51 months ago
Dear Dr.Hook,
My last question somehow happened as you were writing your response and I balieve that made it to be not shown. Can you please share your thoughts with me on that ?

I am so worried all over again. Why on earth i should have these when they exactly match with the timing of this incedent? I am sure i would not missed these if I was not this alert too, they are definitly noticeable now. Two of them are growing in size. They are not like typical water filled blisters as i see in the internet though.

Thanks



Edward W. Hook M.D.
Edward W. Hook M.D.
51 months ago

You are correct, I did not see your follow-up.

Medicine and medical advice is often not based on a single finding or observation but on consideration of multiple pieces of information.  My response, like that of my colleagues before me is based upon the fact that receipt of masturbation is NOT a risk factor for acquiring STIs, including herpes as well as that the lesions you describe do not sound at all like herpes lesions.  As I mentioned to you before, it is quite possible that these lesions were present and unnoticed until you began to examine yourself so closely, despite you belief that this is not the case.  The fact that they were noticed coincidentally with receipt of masturbation does not change this.  As to what they might be, while I have not seen them, your doctor has offered logical alternate suggestions including benign sebaceous cysts or glands.  If you wish to verify these or seek alternate diagnoses, I suggest that you have them examined by a dermatologist.  EWH

---
51 months ago
Thanks Dr.Hook,

As I mentioned before my worry is more about the existence of Saliva as lubricant.

while I agree that I may have missed them previously, as there are some similar very very small things there when I search thoroughly. the fact that they grew in size to be totally noticeable over the course of these past 2~3 weeks is something that I am quite sure of. and as well the itching feeling that comes and goes.

the only external factors could be
1: the fact that I examined the area by stretching it(although I tried to be as clean as possible by washing my hands prior and after, maybe sometimes not prior). 
2:the fact that I lost weight (10pounds) in two weeks due to anxiety.

Other than these two I guess the only explanations of this coincidence are just pure draw of bad luck; or, that damn immature incident that I dreadfully regret.

I respect your knowledge and assessment Dr.Hook, as well as other esteemed experts here, and it is extremely helpful by reassuring me that the probability is very very low, but the consequence could be quite catastrophic for me.

Thanks a lot.










Edward W. Hook M.D.
Edward W. Hook M.D.
51 months ago

Receipt of masturbation is safe sex no matter what is used as lubricant (including saliva) and, for mutual masturbation, no matter whether partners get each others genital secretions on one another.  STIs are NOT transmitted in saliva.  Dr. Handsfield and Ms. Warren have either directly or indirectly mentioned the same thing.  Please appreciate that there are no cases in which saliva has been reported as a vehicle for STI transmission- not "very, very" few - none.

Skin lesions may change form the unintended trauma that occurs with repeated manipulations and self examination, even when the process is as gentle as possible.  This may effecting the lesions you have noted. 

My advice remains the same as above - "If you wish to verify these or seek alternate diagnoses, I suggest that you have them examined by a dermatologist"

My third reply to your questions, this thread will be closed later today.  EWH

---