Hello,

At the end of August, I went for a massage. The masseuse, fully clothed, gave me a handjob. I'm married and this is the first time I've said yes to a handjob.

23 days later, I felt discomfort on the side of my scrotum. When I looked, I saw a large lump with a trickle of pus coming out. I squeezed to see and a little pus came out. After a week, I saw the beginnings of a hair that I removed with tweezers. Afterwards, it loosened up and the sensitivity disappeared. 

Being a hypochondriac, I was afraid of STDs, like syphilis. I told a doctor about it and he wasn't worried. He gave me doxy for 14 days to reassure me.

Since the 2nd day of treatment, I've had lots of side effects. I'm reluctant to continue taking them but I'm very anxious. I'm afraid of having sex with my wife.

There are contrary opinions on several medical forums about the risk of STD with a handjob. Even Quebec public health says there's a low risk. I don't know what to believe.

Since you are 2 experienced doctors, I'd like your opinion.

Thank you!

Let's start with the encounter you describe.  STIs, including syphilis are not transmitted through hand to genital contact.  The CDC and WHO each characterize receipt of masturbation as safe, no risk sex.  

Second, the lesion on your scrotum does not sound at all like syphilis.  When syphilis causes lesions it causes painless shallow ulcerations, not pus-filled bumps.  What you describe is a perfect description of folliculitis ("hair bumps") in which a hair follicle (the pore that hairs come out of the skin from) get blocked to cause a pus-filled pimple.  

Third, you have been examined by a trained clinician who does not feel that what you describe is suggestive of syphilis.  

Bottom line, what you have experiences is almost certainly not syphilis.  If  I had seen you in my clinic, I suspect I would not have provided antibiotics.  If you are having trouble tolerating the doxycycline, that's all the more reason to not take the doxycycline.  If you need reassurance that this is not syphilis, a syphilis blood test will be negative- if this were syphilis, the blood test would be positive.

I hope this information and perspective is helpful.  EWH

Hi Dr Hook!

Thank you for your reply. 

If I understand correctly, there is no risk of STD for me. There is so much contradictory information on the net, even on official government sites, that it's confusing. Just at the Canadian level, where I come from, there are provinces that indicate that there is a negligible risk (in short, no risk) and others, like Quebec, that indicate a low risk.

Yes, I spoke to a doctor, but it was a virtual consultation (chat) with photos. In Quebec, it takes a long time to get an appointment with your family doctor, so I used a virtual consultation app to get a quick appointment. 

The doctor I spoke to didn't prescribe a test because he didn't think it was necessary based on my risk. He gave me some doxy, I think more to calm me down than anything else because I was panicking. The reason I asked was that you and Dr Handsfields are both reputable specialists and I wanted your professional opinion.

The lump I had never ulcerated. It was sensitive to the touch of my thigh for almost a week, until the hair came out and it healed.

In your opinion, can I resume sexual relations with my wife without risk? 

Also, in your professional opinion, is it safe to stop taking doxycycline?

Thank you for your advice!

Certainly I see no reason related to this event for you not to be able to resume unprotected sexual contact with your regular partner.

Similarly, I suspect you can stop taking the doxycycline without a problem. 

Finally, let me confirm your experience with the Internet. For health related matters, the Internet is a poor source of information. Much of what is there is out of date, taken, out of context, or simply incorrect. Once again, I hope the information I provided has been helpful. Take care. EWH. 

Hi, Dr. Hook,

Thank you for the clarification. I believe, after our exchanges, that my brain, as well as the information taken on Internet made my imagination leave all the directions and that I panicked on a folliculitis which I was afraid was a syphilis.

Yes, I had spoken to a doctor via a virtual platform, who prescribed doxycycline, but he's a GP. I don't know how good his knowledge of STDs is, especially given the divergent opinions of the various public health authorities in Canada. You, on the other hand, are an eminent specialist on the subject, so I have complete confidence in your judgment and analysis of my case.

So, I'm going to trust your judgment and try to resume a normal life and put this event behind me. 

Based on what you've told me, I'm going to resume a sexual life with my wife without fear of giving her STD. I refused all contact because I was afraid of infecting her. According to your messages, since I have not been at risk, I cannot have STD from the handjob I received. So, no risk for my wife.

Thanks again for your kind words!

This will complete this thread.  Take care.  EWH