[Question #3010] STD or something else?

39 months ago
I recently noticed a small red bump/blemish on the shaft of my penis. This was about 9 days ago. It has gone from very slightly raised to looking like there is dry skin on top. This happened fairly quickly. Say within 4 days. It has reduced a little but the dry, scaly skin remains. When I try to get the skin off, it looks more like a scab, gets red underneath. Earlier this week, i used hydrocortisone with a steroid and looking at the bump, when it is moisturized, there seemed to be no real bump just a discoloration outline. As I said, when it is dry, it appears very slightly raised with a white scale on top. There was no blister or pustule I noticed. There is only one spot, not a cluster. I don’t have pain except perhaps from picking. Could this be a herpes outbreak or scab? I don’t think it is hpv or molluscum from pictures. 

I had masturbated 2x In the days before this blemish appeared. I had not had sex for 3 weeks prior. And that was with my long term partner. She is definitely negative.  I had sex with another person about 6 weeks before this showed up. Condom Protected. I also had herpes tests about 2 weeks after the sex with my non long term partner. So 4 weeks before this showed up. Both negative. I am mainly worried because this has lasted for 9 days and has not gone away and that the appearance looks a little scab like. 

Please help I am very worried!


39 months ago
So I have spent the better part of a week researching this and my main concern is actually genital warts. If I have a slightly raised, scaly abnormal shaped bump that has changed slightly and reduced in size a bit over a period of 9 days, could this be hpv/genital warts? I posted a pic on reddit and 2 users responded immediately they thought it looked like a wart. But a picture does not accurately describe the progression. I really appreciate your help. Thank you!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
39 months ago
Welcome back to the forum. Thanks for your question. FYI, I reviewed your question and reply from Terri last month and agree with all she said.

As for the present problem, these symptoms are not typical for any STD, including genital warts. In general, warts are not scaly -- but plenty of other genital rashes are. Possibilities include psoriasis, eczema, and many more. (The large majority of penile and other genital skin conditions are not STDs of any kind, even in people at risk for STD, as you may be according to your previous question.) It also is somewhat unusual for only a single wart to appear -- usually there are multiple ones. Finally, a wart is very unlikely to start to regress in size within only 1-2 weeks of first appearance.

Syphilis can cause skin lesions with scaliness, but almost always there would be multiple lesions in the genital area plus a widespread skin rash. 

That said, I cannot guarantee it isn't a wart or syphilis. For sure it isn't any other STD. My advice is that you stop trying to figure it out by online searching or forums like this and see a doctor for professional evaluation. That evaluation probably should include a syphilis blood test if not done since the multiple sexual contacts described in your earlier thread. Most likely you will be reassured it's no STD of any kind, and probably is something not at all serious and probably easily treated.

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

HHH, MD
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39 months ago
Thank you, Doctor,  for your prompt response. 

I am very anxious right now feeling like I have ruined my life and marriage. A couple of clarifications and questions. 

Could this be a wart that is causing dry skin/ scalyness as it pushes out? Could it’s newness be the reason that there seems to be the scale associated with it? Does the location on the shaft - about a third to 40% from the base - give you any concern? Does the fact that it is raised slightly make you think it could be a wart? How long would it take to go from a red blemish to look like a real wart?

Ok - now, assuming this is a wart, a few follow ups. What are my treatment options?

I have been tested multiple times since my transgressions for herpes and hsv and all have been negative. That said, I am worried about infecting my wife with this. Should I wait until I have the bumps checked to resume sexual relations with her? Am I more infectious now with an active wart - assuming I have one ? Do I need to disclose this risk to her? It has been almost 4 weeks sine we have had sex and I had only been with one other person a couple of times since around beginning of sept. 

As I said, I am very, very anxious about this. 

I really do appreciate your help!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
39 months ago
Thanks for the appreciation. But I gave you strong reasons why you probably do not have a genital wart or any other STD, nad yet your are "very anxioius right now feeling like I have ruined my life and marriage." I don't get it. Did you just not understand what I wrote?

"Could this be a wart...." I already said I suppose it could be but all the reasons why it probably is not. Just being raised don't necessarily elevate the suspicion of a wart. Without direct examination, I cannot say more than I have. As for "How long would it take...?", a wart would never start as a red blemish, so the question is unanswerable.

I won't help you speculate on how to treat warts when you probably don't have them.

Your worry about infecting your wife with herpes has no scientific basis.

It seems to me you are feeling guilty about some sexual decisions you regret. Don't confuse those feelings with STD/infection risk from those decisions. They aren't the same. Deal with the former as you need to (counseling? discussing with your wife?), but the latter probably isn't a problem.

I hope you will follow my advice above about seeing a health care provider about your penile lesion. Until and unless you do that, I cannot speculate further and therefore can't help more than I have. Just do it.

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