Dr. Madhav Tiwari
General Surgery
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I had unprotected oral sex from the escort. Right after, I panicked, used a hand sanitizer on my penis, and washed it with alcohol-based handwash. So I made quite a few mistakes here. Since then, I have had a bit of discomfort in the genitals. After six days, I woke up with blisters on the tip and underskin. See the picture (attachment removed for the protect the patient's identity). But the same day evening, approximately 12 hours since the previous picture were taken, the blisters disappeared. I used no cream or medicine or touched the area. From the next day till today, it is pretty much the same. I still have discomfort in those red-rashed areas. I am waiting for a doctor's appointment by the end of this week. What are you thinking? Is this irritation from alcohol-based products or herpes?
Thank you.
Hi,
Welcome to icliniq.com.
Because of your history of using alcohol-based sanitizer, it is very difficult to say whether this is a skin reaction or a herpes lesion. The only thing that goes against herpes is how quickly it disappears. Usually, herpes lesions will be extremely painful and leave ulcers or erosion when they resolve, which does not seem to be the case in your situation. The only way to be sure (however, not 100%) is to get an ELISA (enzyme-linked immunoassay) test for herpes. However, if you want to wait and watch, that is fine too. If these lesions pop up again, we can almost be certain that this is herpes. In the meantime, please avoid sexual contact with any partner for at least a month. When you engage in sexual contact, be it oral or vaginal, please use a condom for the next three months.
Thank you.
The Probable causes
Investigations to be done
Differential diagnosis
Treatment plan
Preventive measures
Patient's Query
Hi doctor,
Thank you for your answer.
I am due to receive a testing kit from a local STD clinic for various STDs. Right now, you can barely see anything in previously affected areas. I still have a mild burn-in, though. I have no pain inside the penis, but I feel unusual pressure in the bladder. I am passing urine as normal, with no pain when doing so. Based on all the symptoms, timeline, and pictures provided (attachment removed to protect the patient's identity), what I am having or feeling now is this a herpes, a chlamydia, or syphilis irritation? Any other observations or possibilities? I do not have any other symptoms.
Thank you
Hi,
Welcome back to icliniq.com.
My first differential diagnosis would be herpes, but for your sake, I hope it is just an allergic reaction to the alcohol-based sanitizer. If you have a burning sensation, you could get some Lignocaine gel (local anesthetic) and apply it over the area several times a day. It will provide you relief from the burning sensation. Do follow up once you have had your STI (sexually transmitted infection) test results back.
Thank you.
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General Surgery
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