On December 1st I began having penile symptoms also consistent with a yeast infection- white scabbing, redness, a “hot” sensation and scaley testis. 

After 2 weeks of OTC (Lotrimin and generic anti-fungals) many symptoms improved, but not entirely. Scabbing did heal, but redness somewhat remained. Also- sites where the scabs were didn’t look the same.

After a dr. visit I was given a 1 week rx of fluconalzole and ketokonazole ointment, regimen finished today.

Concerns: sites where the scabbing was (scabs are gone) while still mildly red, look scarred. One on the top of the shaft the skin where healed looks like a scab you might see on a knee- shiny and the skin grain runs horizontal. 2 scab locations on bottom of shaft are healed but skin now looks like small patches of pimples without whiteheads though, with each tiny bump the size of a fine tip pen at most, or like minuscule scales. Hard to describe but very tiny- the skin grain isn’t linear but looks patchy here. The internet is an awful place and I can say it doesn’t look like anything I’ve seen like papules or folicultis- these bumps are smaller, and not distinguishable to touch. These locations also run red to the touch rather quickly and only where the scabs healed.

We’ve also been diagnosed with HPV in the past, but this doesn’t look consistent with warts either.

Active yeast still, something else or possible scarring in those locations? My wife and I want to resume sex but I’m worried I still have some type of active infection, Advice appreciated.

Apologies if the category was incorrect also.

Thank you,

I'll provide the guidance I can, but I can't help as much as you might expect, for two related reasons. First, our expertise in in STDs, not other kinds of genital health or genital infections, and neither yeast infections in women or nor the sort of fungal infection you might have are sexually transmitted. Second and perhaps most imporant to your understanding, the kinds of fungal infections you and your wife have are very different from one another. It is unlikely you and your wife have the same problem or are sharing any particular infection. Genital area infections like yours generally are caused by fungi called dermatophytes, and the infections are called tinea; and although the yeasts that cause vaginal infections in women are fungi, they are very different from the organisms that cause the kind of genital symptoms you describe.

And as for our expertise, although I have a lot of experience with genital yeast in women, I'm definitely no expert in tinea, i.e. the sort of problem you describe. If I had a patient in our clinic with your sort of problem, we would refer him to a dermatologist -- and that's what I suggest for you. And while folliculitis certainly can cause similar symptoms, it also is not sexuall transmitted or acquired and in any case not likely to respond to either fluconazole or ketocontazole ointment. You don't say whether the doctor you saw is dermatologist, but that's the expertise I would advise. 

I agree it makes sense for you and your wife to avoid intimate contact until both your problems are sorted out and resolved. But that's not because you likely are sharing an infection -- but simply because the physical components of sex (moisture, friction, etc) migth exacerbate either or both problem. Best to wait until treatment is settled and things have resolved.

I hope these comments are a little bit helpful. Let me know if anything isn't clear.

HHH, MD

And also that the healing I have undergone is coincidental and natural versus being aided by the treatments I’ve been utilizing?

You are also correct- I saw a general practitioner in an urgent care facility. Unfortunately my personal doctor is very hard to connect with and many times I can only make visits to urgent care facilities due to his limited availability.

Is there any chance a visit back to the same facility would yield a rx specific to what I have after it failing to remedy my symptoms entirely? I can forsee trying to visit a dermatologist being a lengthy affair in the area I live in unfortunately. It sounds like the correct action but the logistics where I live will make it some time before that can happen. I’m sure your insight there is limited.

Thanks again,

I'm inclined to doubt the expertise of your urgent care doc or clinic in these issues, as you obviously do as well. As suggested above, a dermatologist -- perhaps one at an academic medical center -- would make sense if the problem continues.