[Question #2480] Is this STD

44 months ago
Please can i have advice.

Just under 3 weeks ago i had sex with a sex worker.  It was unprotected oral and protected vagina.

I had a gonorrea and chlamydia test after a week which was negative.  About 10 days after i noticed a little dark spot on the ridge of penis head. It is prob about 1mm.  It didnt hurt i think but my penis head has been a bit sore and i had dribbling urine.  I examined closer today (about 18 days) and it looked like 2 smaller spots are there just under in a line and the 1st is there but doesnt seem to have changed that i can see. I was surprised because my head was covered how i could get a spot there.  When i examine closer i cant tell if the spot is on or under skin.

I went to get it examined today at the sex clinic.  The nurse said it doesnt look like herpes because it normally gets sore and blisters, he also said it didnt look like a wart or syphillis.  The advice was to keep an eye and come back if it gets worse but they do see people come in with spots and no answer to what it is.  He said to get a full clean bill in 3 months for all tests.

Unfortunately i have a wife.  I cannot confess and i realised now i have made a huge mistake to risk losing her.  I havent had sex with her in 3 weeks and she already asking questions.  I have some questions

1) does this sound like an std?
2) what are symptoms of an std that causes a spot/spots from my exposure?  Could it be herpes or warts etc?
3) when can i do the tests to be certain, in the UK they dont really test for herpes
4) can you get spots on ridge of penis head that arent std?  It doesnt look like the pearly penis spots
5) do i need to wait 3 months for all clear, i think i would need to confess to my wife if i do





Edward W. Hook M.D.
Edward W. Hook M.D.
44 months ago
Welcome to the Forum.  I'll be glad to comment.  The exposure you describe was low risk for STI and as you were told in the clinic, the description of the lesions you describe do not sound typical of any STI.  On occasion persons with develop dilated blood vvessels, called hemangiomas whihc appear as small painless red spots of the sort you describe.  You could probably Google the term and find a picture.  If this is what is present they are benign processes which can persist but are not a reason for concern.  They may also occur as a result of unintended trauma from repeated self-examination.  Your tests for gonorrhea and chlamydia are definitive and, as I said, the lesions do not sound like an STI.  In answer to your specific questions:

1) does this sound like an std?
See above.  No.
2) what are symptoms of an std that causes a spot/spots from my exposure?  Could it be herpes or warts etc?
As you were told, herpes lesions tend to appear first as small "water blisters" which then form ulcers in a day or two after appearance.  Warts typically take several months to appear.

3) when can i do the tests to be certain, in the UK they dont really test for herpes.
I would not recommend herpes testing and think the best course is observation.  What you describe does not warrant testing.

4) can you get spots on ridge of penis head that arent std?  It doesnt look like the pearly penis spots
Absolutely.  Textbooks of dermatology devote less than 10% of their text to STIs.  Most genital lesions are not STIs.  A dermatologist might give you a timely answer of you desire.

5) do i need to wait 3 months for all clear, i think i would need to confess to my wife if i do.
I do not see a medical need for confession.  You are clearly concerned and, for that reason, my advice would be to see a dermatologist to get a final opinion on this.  If you do see a dermatologist, I would urge you to be truthful in your interaction.

I hope these comments are helpful.  EWH
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44 months ago
Thank you for the advice, i guess i was anxious and checking repeatedly every day to be certain i was ok.  i think what concerned me the most was the nurse today felt a bit non committal and saying come back if it gets worse, really just saying it doesnt look like herpes but i guess i was hoping for a this is 100% not herpes answer but i guess that could be my anxiety again overlooking it?

so it cant be warts because too soon, herpes would blister and burst (the first spot definitely hasnt done that it looks the same for the last week).  i have googled and doesnt look like syphilis at all, assume definitely not worth testing for that (when could I if i wanted to?)

i think i will go to the dermatologist to see what they say, would you recommend i do this to be clear what the lesion is outside of being an std?

when do you feel it would be safe for me to start to have unprotected sex with my wife again, after i have seen the derm?



44 months ago
Sorry i forgot to add at nearly 3 weeks even if this lesion is not an STI, am i out of the risk zone got herpes now appreciate it was low risk
Edward W. Hook M.D.
Edward W. Hook M.D.
44 months ago
Clearly you are worried about this.  I think that seeing a dermatologist would relieve your concerns and help resolve your concerns.

Three weeks is too long an interval for this to be herpes. 

Personally, I would not be worried about having unprotected sex with your wife but my sense is that your anxiety would be better served if you saw a dermatologist.  EWH
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44 months ago
Hello, back for a final question.

I am still awaiting to see a Dermatologist, turns out it isn't too easy in London to get one quick!

The 3 black spots are still there no change, I am accepting that this isn't an STD now but will still get the check to find out what it actually is.

I tried to see the NHS to check the spots again but I can't get an appointment yet.  I did do a Chlamydia and Ghonnorea test at 18 days with a self test kit provided by the NHS as they advised I should as previous test was 7 days.  This was negative as expected.  I did a finger prick HIV but they said I didn't provide enough blood to test..  I was doing quite well but this has got my anxiety up a bit because I thought I gave enough.  (they text to call for results which gave me a panic attack as I knew the Chlam/Ghon tests were very likely to be clear, wish they didn't do that as asking to call is normally bad news :(

I am at day 26 since exposure and the only thing I want to confirm now is HIV and Syphillis to be 100% clear.  I have had headaches over the last week, had hot body temperature as if I were a bit unwell off and on but not badly and the odd sore throat, also sore lips and odd itchy skin.  I haven't had a body rash.  I checked online for HIV ARS and I don't know if these symptoms could be that, from your experience doctor is HIV ARS typically quite bad?  From your experience is my risk low for HIV, this is my first sex worker experience, do you see people get HIV often from these single protected exposures?

When can I get the tests so I can confirm I am clear from STDs and move on with my life and be normal with my wife?




44 months ago
Just to be clear, the finger prick test for HIV was one where you prick it and fill a tube with blood to a line.  I am not sure what type of test it was.
Edward W. Hook M.D.
Edward W. Hook M.D.
44 months ago
Tests for syphilis and the most widely recommended tests for HIV (combination HIV antigen/antibody tests)mill not technically be entirely definitive until 6 weeks after your exposure.  Given the very low risk nature of the event and your findings to date I really still see no need for concern and no need for you to avoid unprotected sex with your wife.

There is no reason for panic because you collected an inadequate specimen.  If you must have an absolute result for HIV at this time, you could get and HIV PCR test.  These tests are expensive, have a slightly higher false positive rate than the combination tests, and in my opinion are unnecessary.  

Headache and "warm feeling" are not signs of the ARS.  Your symptoms are far more compatible with unchecked anxiety than recently acquired HIV.

This is my third reply to your questions.  Thus, as per Forum Guidelines, this thread will be closed shortly.  I wish you the best and hope my comments have been helpful.  EWH
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44 months ago
Thank you very much