[Question #1169] Feeling anxiety after possible exposure

49 months ago
Doctors ,
10  weeks ago I received a handjob. I have read that there is virtually no risk. But because there is a slight chance of infection I feel compelled to get some answers.
Since one day after I have had a some times itchy , sometimes tingly scrotum and at the base of my penis.
I still feel this 10 weeks post exposure.
7 weeks post exposure I developed a 7 to 10 mm red bump at base of penis. I thought nothing of it at first. It has never opened into a sore. It does however if I squeeze it have some pus. It is now three weeks since it showed up. Doesn't seem to want to heal. ( I should probably stop messing with it ) I do shave and thought it was an ingrown hair. But I don't see a hair.

1.Does seven weeks post exposure rule out herpes / syphilis?
The bump doesn't look like any of the pics I have seen online.

2.How do herpes lesions act?
What are the typical time frames for infection,

3.Could it be syphilis?
How do syphilis lesions act?

4.Could,the itchy tingly feeling be anxiety?
Should I be tested?

Many Thanks



H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
49 months ago
Welcome to the forum. Thanks for your confidence in our services.

There's sort of an inherent conflict in your first two sentences:  I agree with "there is virtually no risk" with a handjob (but might delete "virtually") but not with "there is a slight chance of infection". Theoretically, maybe so. But in my 40 years in the STD business, I have never seen nor heard of a patient who acquired any STD by hand-genital contact.

Second, "a 7 to 10 mm red bump at base of penis" isn't a symptom of STD. Certainly I've never seen anyone with this symptom as their first manifestation of herpes, syphilis, or any other STD. Among other things, skin inflammation or bumps in hair bearing areas (pubic hair, etc) almost never are due to STD. Further, no STD creates skin lesions from which pus can be expressed from deep in the skin. These are typical symptoms of a garden variety pimple or folliulitis (hair follicle inflammation) and I'm sure they have nothing to do with the handjob you had 10 weeks earlier.

Those comments pretty well address your questions. But to be explicit:

1) I agree this doesn't sound like herpes or syphiis.

2) Herpes lesions are very superficial. Think of them as occurring "on" the skin. By contrast, pimples, folliculitis, and other non STD infections typically are deeper; think of them as stating "in" the skin. Your description is obviously the latter, not the former.

3) Syphilis doesn't cause pus. A superficial red bump quickly (a day or two) becomes an open sore, typically painless and beefy red. (Google syphilis for pictures of typical lesions.)

4) No STD causes "tingling". You'll see that mentioned in connection with herpes, but this only means there may be tingling before a recurrent herpes outbreak starts. It's not an issue for initial herpes infections.

Should you be be tested? Based on the exposure and your symptoms, for sure no need. But given your concerns, maybe yes (for syphilis). The negative result might ease your fears more than my verbal reassurance. Herpes is a more difficult question, because the tests aren't perfect; and you could have a past HSV infection you don't know about, or the test itself might give false results. In other words, a positive result would not mean your current pubic skin lesion is herpes.

I hope this has been helpful. Let me know if anything isn't clear. Best wishes and stay safe--

HHH, MD

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H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
49 months ago
More on question 2:  Primary syphilis lesions start 10-20 days after exposure. 7 weeks is far too late.

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49 months ago
Thank you for the very quick response!
What if...... Just kidding. 
Thanks again for your expertise.  I can rest my mind.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
49 months ago
You're welcome. Thanks for the thanks. Take care and stay safe.

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49 months ago
 Doctor  Handsfield,
Well I thought that would be my last follow up.

Would either herpes or syphilis lesions continue to grow? 4 weeks old now. My lesion has been flaking off skin and is a little tender.  It is larger in size like 15mm and  shiny pinkis red. The skin also has two little splits in  skin.  Splits being about 3 mm.  Still no large open sore. 
I have an appt with my primary care Doc but of course it will be a while.  
My only exposure was the HJ. I am really trying to move on but it's hard with the lesion. 
Could this be from fungus?  It's been a real hot sweaty summer here.  Doesn't look like jock itch either.  I know this is my last follow up.

Thanks for your thoughts!

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
49 months ago
It doesn't matter whether or not whether "herpes or syphilis lesions continue to grow". Generally, no; but even if they could, my replies above make it crystal clear that no STD from the hand job even is a possible explanation. And don't overreact just because it's your penis. On the bookcase at my left elbow is a book titlte Genital Dermatology Atlas. Of its 300 pages, exactly 15 deal with STDs. In other words, STDs are an uncommon cause of genital dermatology problems.

Follow through with your doctor's visit, but don't be worried in the meantime. Whatever you have is unrelated to the non-exposure event described above, and most genital skin conditions are harmless inconveniences.

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