[Question #2531] Hand To Genital contact

44 months ago
Dear Drs.  
Would you be comfortable stating for me the likelihood of contracting Syphilis or HSV from a single exposure to a brief hand job by a masseuse following a 45 min full body massage in an Asian massage parlor?  I did not notice any sores on hands but was surprised at the situation and honestly didn't look.  

Exposure was ~ 3 weeks ago.  Had some burning and aching sensation in testicles over last few days which has me extremely nervous.  And a  small pimple like spot developed yesterday on skin where penis meets abdomen but I shave and it looked like hair follicle with tiny white head.  Would I know if it was a syphilis chancre ?

Please advise and thank you.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
44 months ago
WElcome to the forum. Thanks for your quesiton.

Of course I'm "comfortable" answering this! My comments should be reassuring:  There is no signficiant chance of acquiring either syphilis or herpes from such an exposure. Hand-genital contact is risk free, and your symptoms don't suggest eitehr one. Chancres don't look like pimples or hair follicle infections. My advice is to move on without worry. No testing is necessary and if you have a regular sex partner, you can safely continue your usual sexual expression with her (or him) without worry.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD
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44 months ago
Thank you for the expeditious response.  I was seriously considering testing for both since I am married and fearful of infecting my wife but advice from you helps assuage my fears.  You'd be surprised (or maybe not) how other -what appear to be reputable sites - state that you should be tested for both infections after hand to genital contact.   

One follow up if I may:  I've also had trouble climaxing over the past week -it's like I have a numbness feeling in my penis when aroused.  Can you think of any other STI that I could have caught that might cause this and the other symptoms I noted (testicle pain, burning sensation)?

You are a gentleman and a scholar.  
44 months ago
Dr Handsfield - 

Hopefully this question and the previous follow up get to you - apologies for asking another follow up before you could respond to the prior one.  

Per the guidelines this will constitute my second and final follow up. 

 If I wanted to get tested for syphilis and HSV due to extreme anxiety can you please tell me the following:

1.  When to be tested - how long after exposure .
2.  The exact name of the tests to be ordered  that will yield the most accurate results.
3.  Odds of a false positive considering this brief  massage (hand to genital) is the only encounter I've had with anyone other than my wife in my entire life

This is a difficult situation for me and your patience means a lot.  I appreciate your time and consideration.

Best wishes.

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
44 months ago
No STD causes reduced feelings in the genital area, e.g. numbness, or trouble achieving orgasm. If these symptoms are in any way related to the massage events described above, it is strictly through an emotional connection, such as genitally focused anxiety over a sexual decision you regret and your fears of STD.

Getting tested for HSV would really not be smart. The tests are not perfect, sometimes giving misleading results; and half of all adults in the US have positive tests for HSV1, so there is a 50% chance you'll have a positive result. There is a very small likelihood of a false positive HSV2 test, but perhaps a 10% chance of a low-positive result that doesn't mean anything but would require additional testing to sort it out and confirm you aren't infected. Also, you need to wait until 4 months after the event to have conclusive testing, and I doubt it is practical (and it certainly is not desirable) to avoid sex with your wife for that long. Accurate syphilis testing can be done any time 6 weeks or more after exposure.

If you decide to go ahead and get tested anyway, be sure you get a type specific IgG antibody test for HSV, but DO NOT have an IgM antibody test, which is offered by many labs but has a very high rate of false positive results. For syphilis, any of the standard tests, such as an ELISA or RPR, are just fine -- whatever the lab offers routinely.

I really think you should not be tested at all. Just move on without worry.

You have one more follow-up comment coming. (We set the limits according to our replies, not the no. of follow-up comments/questions asked.)

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44 months ago
Thank you Dr Handsfield.    A couple of final inquiries.  

1.  Are you aware of a case in your extensive practice where syphilis was transmitted through hand to genital contact?  If not do you think the odds are close to zero?

2.  Would The risk be much greater if the masseuse had performed a massage on someone else before me that was infected and didn't wash her hands prior to my session?

3.  Do you know the % of people that exhibit the classic chancre when infected?

Thanks again for your time and best wishes good sir.


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
44 months ago
1. No. In my 40 years  in the STD business, I have not seen nor have I ever heard even a rumor about hand-genital syphilis  transmission.

2.  Not significantly. Also, currently in the US syphilis is quite rare, so the chance of a recent previous customer had syphilis, or that your massage partner was infected, is very low. 

3.  Probably around 70-80%. 

 You came here for reassurance. I have tried my best to give you straightforward, science-based, unbiased advice.   Trust me: there is no risk of infection. If somehow I were in your situation, I definitely would not get tested for syphilis, herpes, or any other STD and would continue unprotected sex with my wife with no worry at all.  You should suck it up and do the same. 

 Best wishes and stay safe, as you have done so far. 
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