[Question #13608] Red brown spot after cunnilingus

2 months ago

Hi Doctors -

On 11/18 and 11/25, I performed cunnilingus on 2 different sex workers. Today I noticed a small red brownish spot on my tongue (head of a pin sized and round for the most part). No pain, and in a location I’ve noticed other spots on my tongue in the past. Usually, those spots are white but this is a red brown color.

Any thoughts? No other symptoms or dots anywhere else in my mouth.

Worried about syphillis and herpes.

Thanks

2 months ago

I should add… The small bump appears to be raised, Almost like a thread sticking up with a white head (if that makes any sense).

2 months ago

I should revise my description of the spot being more brown to black verses red in color.

Edward W. Hook M.D.

2 months ago

Welcome back to the Forum. In past interactions we have explained the low risk for STIs associated with cunnilingus. That information remains accurate. The lesion you describe sounds nothing like wither herpes or syphilis. Lesions for both of the STIs you mention are flesh colored, herpes lesions are typically multiple and syphilis lesions are larger and quickly ulcerate. Further, oral STIs rarely involve the tongue itself. Lesions which have blood associated with them tend to be black or dark brown in appearance.

Nothing you describe raises any concerns about STIs or suggests a need for testing. Testing however is always a personal choice and should you chose to test, I am confident that the tests will prove that you are not infected. EWH

---

2 months ago

Hi Doc - Thanks for your reply! Your answer was helpful confirming a lot of what I’ve learned from this site.

I have a general follow up question… Based on a lot of the threads I’ve read here, it’s seems that if one uses condoms the right way for intercourse and penetrative anal, most forms of oral sex have low risk. Not zero, but remote possibility of infection, especially during first exposure with a new infected partner. We should also understand that most CSWs employ practices to keep themselves safe , thus ensuring that they won’t be infected, which in turn keeps their clients safe.

So, it sounds like provided your stick to safer sex (oral/cunnilingus, handjobs, petting,’etc) and wear a condom the right way… a high percentage of the time one will not have issue.

However, I would think that if you a frequently see CSWs, like I have a tendency to do (at some periods I go 2x per month)…..At some point your luck will run out no matter how cautious and safe one is. Is this a fair assessment?

Thanks!

Edward W. Hook M.D.

2 months ago

Your summary is correct. If you regularly have new/casual partners it’s reasonable to periodically get screened at sites of exposure. Testing however is always a personal choice. EWH---

2 months ago

I understand I’m at my third reply and this thread will be closed out…

Being that in the last couple of months, I’ve had sex using a condom, received

unprotected oral, and performed cunnilingus a few times on different CSWs……. Would it be wise to test? If so, will a panel from an STD test service due? Or, would I need tests that are more comprehensive? Or, unless I have specific symptoms… mouth sores indicating herpes, pain in genitals, etc. … can I assume I’m okay?

Edward W. Hook M.D.

2 months ago

As I said, the decision to test is always a personal one. Personally, 3 episodes of cunnilingus over a several month period would not worry me and I probably would not both to test. If you do choose to test, the most important test, given that your only unprotected exposure is cunnilingus would be a throat swab for gonorrhea which is typically automatically accompanied be testing of the same specimen for chlamydia. Should you also receive unprotected oral sex from a casual partner, you might wish to also get a urine test for gonorrhea as well. Either way I would not be worried about the need for other blood tests, etc. As I said however, everyone's threshold for testing varies and is impacted by their perceptions of their partner's risk, etc.

Hope this is helpful. Thanks for your questions and wishing you happy holidays. EWH

---