[Question #4552] Hand sanitizer effectiveness

27 months ago
Hello,

On a handful of occasions over the last few months, including today, I've received unprotected oral sex on my uncircumcised penis with (high end) escorts. Each episode was quite brief, lasting less than 30 sec, and did not involve any biting or scratches. Also, my foreskin covered the glans throughout, in case that's relevant. I checked their mouths beforehand and saw no obvious signs of warts or anything suspicious. Afterwards, I apply hand sanitizer all over my penis.

My two questions are:

1. Does hand sanitizer help neutralize the bacteria/viruses that could be transmitted by mouth-to-penis oral sex? I searched the message board, but couldn't find a direct answer.

2. I've seen repeatedly here that "oral sex is safe sex", but also that HSV1 and gonorrhea are possibilities. Please let me know what testing strategy you would recommend, and whether my understanding is correct.

Lastly, a BIG thank you to the medical professionals here. Your compassion, knowledge, and service are very much appreciated and respected.

Best Regards
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
27 months ago
Welcome back to the forum. Thanks for your question.

Taking the second question first:  Our (especially my own) comment that "oral sex is safe sex" does not mean it is completely risk free. No sex with another person can be said to be enitrely risk free (leaving aside self masturbation, phone sex, etc), and we have never stated or implied that no STDs are ever transmitted by oral sex. Of course they are. But the risks from oral sex are far lower than for unprotected vaginal or anal sex, and virtually zero for some but not all STDs. Your exmpales of gonorrhea and HSV1 are exactly right. Still, the chance of acquiring either of them after any signle oral sex exposure probably are well under 1 chance in a thousand, as a rough tuess. (Gonorrhea recently has become somewhat controversial in this regard, with some researchers proposing that oral sex and even kissing are more common transmission routes than previously believed. But most experts remain skeptical about their conclusions.)

Most hand sanitizers are alcohol based (e.g. Purel). Most likely they inhibit or kill most STD bacteria and viruses. However, using them still might not be a good idea. Alcohol is irritating, and it is theoretically possible that microscopic tissue injury caused by alcohol might increase the risk of infection. A gentle soap and water wash might be preferable. That said, the risk from oral sex probably is low enough that it doesn't much matter.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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27 months ago
Hi Dr. Handsfield,

Thank you so much for your prompt and informative reply. Even considering the substantially lower odds of STI transmission via oral sex, I'll seriously consider going the protected, versus unprotected, route in the future for oral sex.

My only follow-up would be whether you recommend I should get tested soon for HSV1/gonorrhea etc...?

Best Regards
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
27 months ago
Some STDs often are asymptomatic, but this is rare for both gonorrhea (urethral infection) and herpes due to HSV1. Absence of symptoms within a few days is strong evidence you weren't infected . Testing for any STD is generally not recommended after any single oral sex exposure in absence of symptoms. I certainly woudn't do it if I were in your shoes, and would continue unprotected sex with my wife, without worry.---