I am greatful to Dr Handsfield for his recent advice (see question 6722).

My encounter involved receiving unprotected oral and also I rubbed my unprotected penis against her vagina. I must point out that there was brief penetration with just the tip of my penis.

I have been doing my best to relax and move on following the advice of Dr Handsfield. However I would really appreciate some advice on latest development.

Two days ago I started to feel the sensation as though my penis head was icy cold. It also felt like there was something dripping from the urethra but there was nothing there. The tip of my penis has become extremely sensitive, even the slightest touch, for example walking and rubbing against underwear, feels irritating. 24 hours after these sensations I have developed red, slightly raised, blotchy rash on my glans. It does not cover the entire head of my penis, as I believe a yeast infection would. It is spread over the bottom half of my glans. It does not appear as little red dots, more an irritated reddish blotch.  Also, there is no white discharge or clumps as I understand would be expected with yeast infection. It is irritated and itchy. 

I have never, ever had any issues with fungal or yeast infection before. So I am worried I might been experiencing prodrome sensations beforehand and have now developed some kind of outbreak?  Since it was mainly the tip of my penis involved in the genital apposition, it would make sense that the head of my penis would be the site of any herpes outbreak. 

Over night the redness/bumps have reduced slightly although it still feels irritated.  

Further to this, I can feel some burning/numbness in my left foot - possibly indicating reactive arthritis? Also I have noticed that my ejaculate appears to be slightly yellow, possible sign of infection? 

Many thanks for your advice.

I'm sorry you are still worried.  I understand how troubling that can be.  After reading Dr. Handsfield's response to you, I really do agree with him.  He took quite a while to give you a thorough response.  When someone has a sexual encounter with someone who isn't their regular partner, it raises all sorts of issues. Believe me, been there, done that (many moons ago before my marriage) One thing we do is to observe our bodies very carefully.  I'm wondering if you've ever noticed these red areas on your penis before and if you've ever looked this closely before?

I also don't know what might be causing your symptoms, but I know that one of your concerns is herpes, and herpes is my thing.  Herpes would not cause an icy cold feeling of the penis.  It might cause some urethral pain, but that pain would happen during urination, acid urine passing over open lesions in the urethra.  I'm not hearing you say you're having that.  The red raised blotchy areas don't sound at all herpetic to me.  Herpes would present as specific lesions, not a generalized rash.  I've seen lots of both and they are very different.  Yeast would not cause white discharge for clumping in the male - those are mostly female symptoms.  For men, yeast can cause a red rashy appearance, often on the head of the penis, and itching.  This could be what's going on with you - something very mild from a limited encounter such as the one that you describe.  Of course Dr. Handsfield is correct, the oral sex can be a small risk for HSV 1, if you have never in your life had a cold sore on your lip or in your nares.   But if you are truly negative for HSV 1, I would expect perhaps more dramatic symptoms than those that you describe. 

I do not think for a moment that the numbness and burning in your foot is related in any way to this incident. 

If you notice that your ejaculate is markedly different in color than normal, you may wish to be checked for other STI's like gonorrhea and chlamydia, though I think given the very limited contact, that these things are likely either.

This can be such a troubling time, I know, but I doubt that you have herpes and I also think any other STI is likely either.  You're worried and scared.  I get it, but the risk in your situation is really low and your symptoms just don't sound like any STI, at this point.  Obviously, if you develop any specific sores, go and be seen.  But at this point, I think you can sit tight and wait. 

Terri

Thank you so much for your response. Your expert opinion helps to put my mind at rest. I also greatly appreciate the detailed responses from Dr Handsfield - I returned with this new question only to seek some further guidance and it was not a sleight  on the advice he offered.

You are correct in that I am observing my body very carefully, perhaps obsessively.  Over the last three months I have been feeling guilt, anxiety and fear everyday. However I do feel the redness Is something I would have noticed before, particularly the irritated feeling. 

I was tested for Chlamydia, Gonorreah and Trich with a urine sample which came back clear. This, along with the fact that the symptoms ease and then return, is what raised my concerns it must be something viral. 

Of course, I have seen it stated many times that HSV outbreaks can simply present as itchy red spots. It worries me that herpes can be mistaken for almost anything! 

I understand that my encounter was relatively low risk, but how about the unprotected penetration with the head of my penis?

I do not really experience any pain when urinating, more an irritation after I have urinated which lasts for sometime. I also get tingling and itching in my anus most of the time.

It seems as though the skin of my glans has changed permanently, it is constantly dry and the redness comes and goes to a degree. I have read that permanent changes to the skin I.e. redness or white patches can indicate high risk strains of HPV or early stages of penile cancer. This has also really got me concerned. 

I totally understand that you value Dr. Handsfield's advice - so do I!  And it's fine that you are talking with me about herpes specifically. 

The pain that you are feeling post urination does not sound at all related to HSV. 

I would recommend that you consider trying some antifungal cream on the head of your penis as well as some moisturizing cream  (not at the same time) to see if you can get things a bit more back to normal.  I really don't feel that the very small amount of penis contact you had presents a risk for much of anything.  What you are describing about the head of your penis does not sound like HPV or cancer.  I know reading on the internet can be scary and raise all sorts of questions.  Instead of doing that, if you are still concerned, I would advise seeing a dermatologist for an evaluation.  HPV changes don't come and go are your redness seems to do so don't worry if you don't have that particular symptom when you are seen. 

Terri

I have tried some OTC Canestan cream (Clotrimazol) on the head of my penis. It did seem to help a little bit with the itching. Does this indicate that it would be yeast? I wasn’t sure if these creams just contain an active ingredient to reduce itching generally, like taking painkillers for a headache. 

Also, is it common for yeast to linger or reoccur? I have never had any issues with yeast before.

I will take on board all of the advice from yourself and Doctor Handsfield. I think I need to take a step back and look at other avenues for what might cause my symptoms. Perhaps it is stress and anxiety or perhaps it is nerve related. The fact this all happened soon after a sexual encounter, I was convinced it had to be something STI related.

Could I ask, based on all you have read of my situation would you suggest I am safe to continue sex without risk of passing on any infections or virus?

Thanks.

Could this be more indication that this is not due to an STI?

Thanks 

I'm glad that the antifungal helped things get better.  I would encourage you to use it twice a day for two weeks, continuously.  The improvement definitely indicates it could be a fungal problem, for sure.  I don't give advice about whether someone should start having sex with a regular partner again, but I can say that your risk was very very low, your symptoms do not sound herpetic to me.  The other thing is, with regards to your other question, I'm thinking that some of these symptoms sound like possible prostate issues (not the shower part).  You could get this checked out and see how things are with your prostate.

Terri