[Question #6870] Oral/Crabs

11 months ago
Hello, this last tuesday I made a bad decision to visit a CSW. We both got naked. During my visit she had me lay on my stomach naked to receive a massage with lotion and then had me flip over. She mostly used her hands and only gave me oral for less than 30 seconds. At that point I noticed that the blanket I was laying on was saturated with lotion (probably from other previous clients), the sheet felt cold and moist as if there was a ton of lotion on it. I told her to finish with her hands. There was no vaginal or anal sex. What are my risks for anything being transmitted from the unprotected oral and what are my risks from catching crabs from laying on the blanket. Do you see any need to get tested for Ghonerra or clyhmida? I am a pretty hairy guy on my chest and the pubic area. I should also note that this CSW pretty much looked like a crack head. 

Would buying an OTC public lice treatment as a preventative measure be a good idea? It's been 3 days and I show no signs of any symptoms of any sti's to my knowledge. Can crabs transfer from the blanket to leg hair or chest hair and eventually work their way to my pubic hair? Would it be wise to use the OTC treatment on all body hair aside from my head? 
Edward W. Hook M.D.
Edward W. Hook M.D.
11 months ago

Welcome to the Forum and thanks for your question.  I'll be glad to comment.  Before I get to specifics, let me say that most commercial sex workers (CSWs) do not have STIs, that even when they do exposure to an infected sex partner does not lead to infection most of the time and that amongst possible penetrative sex acts, oral sex is, in a relative sense, lower risk than vaginal of anal sex.  Is response to your specific questions:

1.  The most common STIs to acquire from receipt of oral sex are non-gonococcal urethritis or gonorrhea.  Chlamydia is very rarely acquired in this way.  If you do not already have HSV-1 (cold sores) there is a very low risk of getting genital HSV-1 from receipt of oral sex.  There is no appreciable risk for syphilis from the situation that you describe.

2.  Regarding crabs, again this risk is very, very low - even if the situation you describe in which the bedding had apparently been re-used and had lotion on it.  Crabs are rare.  Interestingly, the hair on a person's head has a different shape from pubic hair and, as a result, head lice do not cause pubic infection and vis versa.  The risk of getting lice from the sort of exposure you describe is so low that I would specifically recommend against purchasing and using OTC public lice treatment.  The medication is probably not needed and has side effects (local rash, etc,).

I hope that this information is helpful.  EWH

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11 months ago
Thanks for the quick response and professional advice. 

Do you see any need for testing based on these low risks? I just dont want to spread anything to my girlfriend. 

As far as the crabs go, when would I be safe to know that I did not get them from that encounter? I read it could take up to 5 days minimum to show symptoms but what would be the maximum amount of time before i can say I'm good? 
Edward W. Hook M.D.
Edward W. Hook M.D.
11 months ago

It's not clear to me whether your exposure was three days ago or 10 days earlier.  If its been more than a week and there are no symptoms, give the low risk and fact that gonorrhea and NGU are typically symptomatic, I would not worry about testing.  If the exposure was just this past Tuesday, I'd wait a bit to make sure that symptoms do not occur (about a  week, total).  In your situation, no symptoms, no need for testing. 


I really would not be worried about crabs.  EWH

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11 months ago
It was tuesday the 21st. I'll wait a full week before doing anything intimate. Thank you for your help. Have a good weekend 
Edward W. Hook M.D.
Edward W. Hook M.D.
11 months ago
Thanks.  Glad my comments have been helpful.  EWH---