[Question #12452] [Question #12391] Follow up:

Avatar photo
7 months ago
I retested at 25 days past possible exposure because i noticed a red bump at the lower part of my penis shaft 23 days after possible exposure. I do shave and the bump is more than likely an ingrown hair but the location and look of the red mark made me want to make sure. I tested using 2 over the counter “First To Know” Rapid tests, both were negative.
My question is how reliable are the over the counter rapid tests for syphilis?
Is it easy to identify a syphilis chancre in the beginning of development from an ingrown hair? 
How long does a chancre take to develop from first sign to an ulcer? 
Avatar photo
Edward W. Hook M.D.
7 months ago
Welcome back to the Forum although I'm surprised you felt the need.  The answers to your questions regarding the possibility of syphilis were contained in his prior reply when he said" By far the most important is your use of doxy-PEP in the correct dose of 200 mg:  that alone makes it impossible you have syphilis from this event. Therefore, the accuracy of syphilis testing at 13 days (or any other time) doesn't matter; you didn't need testing at all, except for its reassurance value."  In addition, the fact that your only exposure was receipt of oral sex which almost never leads to syphilis acquistion and, when it does, occurs among men with other men as sex partners.  Finally, if this were syphilis, it is more likely than not that your rapid test would have been positive (they occasionally are falsely negative when used within a day or two of lesion appearance)

FYI, the average time to development of a syphilitic chancre (which is a bump that becomes an open ulceration within a day) is 21 days.  

OTOH, development of folliculitis' as shaving sites is a regular occurrence.   

Considering all of the information mentioned above, I remain confident that the lesion you have noticed is not syphilis.  I hope I can convince you of that.  EWH




---
Avatar photo
7 months ago
It is most likely folliculitis as you suggest. I noticed the bump around 23 days post possible exposure so it triggered some anxiety. It hasn’t gotten any worse and definitely isn’t an “open ulceration.” It’s difficult to find good information on syphilis so I appreciate the help. I did use the rapid tests 2 days after noticing the bump but if they can be considered reliable i will try to stop worrying. 
Avatar photo
Edward W. Hook M.D.
7 months ago
I would certainly encourage you to stop worrying at this time.  EWH---
Avatar photo
7 months ago
Thanks Doctor, happy new year
Avatar photo
Edward W. Hook M.D.
7 months ago
I hope my comments have been helpful  Closing the thread now.  Happy New Year to you as well.   EWH---