[Question #7954] Pimple, Wart, Herpes, or No Worry?

50 months ago

Hello doctors. Seven days ago I received condom protected oral from a CSW. Condom was intact during the act and to the best of my knowledge applied appropriately. The situation lasted about three minutes and I checked the providers lips to determine anything unusual. I didn't see anything unusual. Seven days after the event, I noticed one single very small pimple (small than a pencil head) like bump on the top/middle of my penis. It did not hurt to pop and no other pimples are present. Please note I do have oral HSV1 as I get outbreaks on the left side of my lip. So my questions for you are:

1. What is the likely hood this is Oral Herpes?

2. What is the likely hood this is Genital Warts?

3. What is the likely hood this is a pimple?

4. What should trigger me to go see a doctor? For example if the pimple is there for 10 more days or more pimples appear.

5. Should I avoid regular contact with my partner?

Thank you for your time and consideration.

Edward W. Hook M.D.

50 months ago

Welcome to our Forum and thanks for your questions. I'll be glad to comment. The exposure you describe was very low risk. I presume the condom was worn throughout the encounter and covered the area where the pimple you describe appeared. Most CSWs do not have STIs, most single exposures to infected partners do not result in infection and your use of a condom during receipt of oral sex, as long as it was in place throughout the encounter reduces your already tiny risk to virtually zero. This, in response to your specific questions:

1. What is the likely hood this is Oral Herpes?

Your prior diagnosis of HSV-1/oral herpes means that you are not susceptible to re--infection again with HSV-1 (you only get it once, from then on you cannot get infected again although, as you know, it may recur). and HSV-2 is virtually never acquired form receipt of oral sex, even without a condom. HSV- does not spread from one part of the body to another among persons who are already infected. This does not sound like HSV and I would not be concerned and see no need for HSV testing related to it.

2. What is the likely hood this is Genital Warts?

Zero, Genital warts take 2-6 months to become evident and are rarely acquired from oral sex. Further, the condom reduces the chance of you getting HPV from the encounter you describe.

3. What is the likely hood this is a pimple?

This could be a pimple or some other dermatological process. See additional comment below.

4. What should trigger me to go see a doctor? For example if the pimple is there for 10 more days or more pimples appear.

I would not have popped it but what is done is done. Should it recur or new lesions apnea, I would suggest you see a doctor who is familiar with genital dermatology,. This may be your PCP, someone working in a public health sexual health clinic or a dermatologist.

5. Should I avoid regular contact with my partner?

Nothing you have described suggests any need to abstain from unprotected sex with your regular partner

I hope these replies are helpful. If there are further questions of any of this is unclear, please use your up to two follow-ups for clarification. EWH

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50 months ago

Thanks doctor for the information. To the best of my knowledge, the condom was down to the base of my penis. I do have a couple of follow up questions.

1. What is the avg incubation time for genital warts?

2. Have you seen any cases of genital warts from protected oral sex (female provided to the male) ?

3. What should I be on the look out that would separate a wart from a pimple (assuming the 1 in a million chance).

Thanks doctor.

Edward W. Hook M.D.

50 months ago

Straight to your follow up questions:

1. Get an answer to, most warts appear somewhere in the range of 3 to 4 months following an exposure.

2. No, I have not

3. General warts our firm and fleshy in appearance. Pimples typically have fluid within them, in some cases the fluid is clear and others it is yellow and a bit pusy. The two are very different.

Once again, I urge you not to worry about having acquired an STI from the exposure you have described. Hope this helps. EWH

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50 months ago

Thank you doctor. Best of luck in your work.