[Question #777] Slight red rash on testicle and constant dry skin on penis problem.

100 months ago

Hi there,

I am wondering if anyone can help me on this one, basically I have been having rashes on my penis and testicles over the last 10 years on and off, I keep getting checked for STD's and every test comes back negative. I visit my Gu clinic regularly and they cannot seem to identify the root cause of the problem, some say it's fungal infections, dry skin etc but I cannot seem to get a definitive answer as to why this keeps happening to me.

As for my question for this particular issue, I have two issues, one is a small slightly red area on my left testicle, the skin texture is also different to the rest of the skin. The area is not painful, itchy, sore or anything, it bears me no discomfort whatsoever except for that I can see it. I spoke to another online doctor who theorised that it was a fungal infection, but how can it be if it doesn't itch? Unless you get fungal rashes that don't itch. I repeat, this is completely painless. Also sometimes you can hardly see it, o

My 2nd issue, is that over the last 6.5 months I have had a dry skin rash on the head of my penis, again no discomfort, pain, soreness or any of that nature, however the area that's slightly red does flake every time I masturbate. Now just recently the area that was effected has cured, however I now have another very slight area that is effected again by the same problem.

What is happening to me? Why do I keep getting these rashes every so often? I just want to point out that I do regularly use sexual services like escorts, and during these services I part take in unprotected oral sex and protected sex, but I do get myself checked regularly, but the tests continue to come back negative, also the rashes started to appear before I have sex for the first time.

Any solution to these problems would be greatly appreciated, thank you into looking into my problem and I am interested to talk further with whoever comes back to me. I can attach a picture of the effected area upon request of the first issue.

H. Hunter Handsfield, MD

100 months ago

Welcome to the forum and thanks for your question. Unfortunately, I don't think we can help very much. This is a forum for STDs, not genital symptos in general. Our expertise is in STDs, not in genital dermatology or other non-STD conditions.

The large majority of genital skin conditions are not STDs. On my bookshelf is an Atlas of Genital Dermatology. Of more about 300 pages, only 15 are on STDs. And from your description, I am confident that no STD explains your symptoms. Presumably you have seen a dermatologist, yes? What did s/he say about the problem. If you haven't been in the care of a dermatologist, you certainly should consult one now. As for photos, we don't accept or view them on this forum. From our standpoint, that comes too close to practicing medicine from afar, which we cannot do.

Having said all that, I would guess you have some sort of allergic problem, or perhaps eczema. In any case, I am quite confident your problem isn't dangerous, however uncomfortable and inconvenient it may be.

I'm sorry I can't be of greater help. Best wishes in working it out.

HHH, MD

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100 months ago

Dr. Handsfield, Thank you kindly for getting back to me on this. The reason why I posted this question on here, is that I regularly seek escort services, and from your expertise I wanted to ask you if any of my symptoms could possibly originate from an escort encounter. You have responded to say that none of my symptoms even come close to STD like infections, and even for that I have peace of mind and gratitude that an expert such as yourself has granted me that assurance. For this service I am entitled to two follow up questions, so my first follow up question is 'with your wealth of knowledge, can you really catch a serious STD from unprotected oral sex from an escort, and protected sex?' The reason why I ask this is that the answer to this question to this day is extremely unclear, and I read from your answer to someone else's post that in your 30 years in this field of research, you have never encountered someone catching an infection from salival contact, by all means correct me if I am mistaken. So far I am under the belief that you can only catch something orally if the girl has a cut in the mouth, otherwise the risks are minuscule, but again please correct me if I am wrong again. I know of punters who have seeked escort services in the numbers of hundreds over decades, and they are still perfectly healthy, as I believe I am to this date and I personally have never read a case or spoke to anyone who has caught anything from an escort, and if it all it is possible, than what's the risk ratio? 5%, 10% or what would you say is the risk percentage if there is one?

H. Hunter Handsfield, MD

100 months ago

Thanks for the follow-up. I'm happy to clarify.

I'm sure I have seen significant STDs once in a while in patients following oral sex by an escort. But I would rarely know for certain -- in the STD clinic we don't routinely ask whether the patient had sex with an escort or someone else, and most with STDs have had multiple potential exposures. But uncommon things happen, so in my 4 decades of STD work, I'm sure it has happened. But so what? Rare things happen. It doesn't raise your chance of being struck by lightning strike if I care for a patient who was. You are over-reading previous statements; saliva per se is probably is rarely the issue.

As for belief that "you can only catch something orall if the girl has a cut in the mouth", I don't know where that comes from. Gonorrhea and herpes, for example, occur all the time without this circumstance. At the same time, that you know many persons who have had escort exposures and never were known to catch an STD is also a valid experience. It reflects the low risk of such activity. But low isn't the same as zero. There is no way to have multiple sexual partnerships, over many years, and be at zero risk of any STD. You ARE at risk -- it's just not very high. The way to look at this is that the risk for any single exposure is very low. But just as the lifetime risk of lightning strike (in US residents according to the National Safety Council) is one chance in 17,000, people do die of lightning strikes. Therefore, given your sexual lifestyle, you should be having routine STD/HIV testing (e.g. gonorrhea, chlamydia, HIV, syphilis) from time to time, perhaps every year or so, depending on frequency of such exposures. There are no data on which to base a numerical estimate for your risk, however.

All of which is irrelevant to the symptoms you described in your opening question.

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100 months ago

Dr, handsfield thank you so much for clearing this up, its made me feel alot better. As i am entitled to one more question as part of this service i want to ask one more thing. Intermitently when i urinate, i get a feeling of discomfort, but i only get this sensation as the pee comes out, there is no discomfort, burning or pain whatsoever during urination, i repeat i only get this feeling as the urine starts to come out. Its noy like ouch or anything its just not seamless. When i ejaculate, i dont get this problem its only during urination. Also i get a very mild burning sensation after i have finished urinating. In your experience is this symptom something i should be concerned about? I had a urine test at my gp and they found no infections, however their tests dont pick up the same infections as our local sexual health clinic, hence just this morning i am here to get checked so i know im clear from all angles. There is no discharge or anyother symptoms and like i said no pain whatsoever while the pee is coming out, only as first comes out. As i may not get the opportunity to message you again, i thank you for your advice and expertise on my questions.

H. Hunter Handsfield, MD

100 months ago

FYI, up to two follow-up comments or questions are permitted for clarification of the original question, not to invite two entirely new questions.

I'll just say that variations in bladder senstation, discomfort or other feelings during urination, or urinary frequency are not caused by any STD. They are experienced by all persons from time to time and influenced by urine concentration, acidity, and perhaps diet, i.e. patterns of food and fluid intake. Anxiety, perhaps expecially about STD, sexuality, etc may magnify such sensations. There is nothing in your description that implies an STD or any other infection.

Best wishes and stay safe.

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