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What Causes Rash On Penis Head Post Unprotected Vaginal Sex?

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Posted on Thu, 26 Mar 2015
Question: I had unprotected, vaginal sex with a woman in Bolivia in July of 2014. Lubrication was insufficient. I had a skin irritation of the penis head in less than a day after the encounter. There were a few blemishes in a line. It got much worse and became a rash covering most of the penis head at the 6 week point. The rash / blemishes have improved greatly. My concern is these sub-cutaneous "strings" which appear in magnified photographs. Is this possibly some kind of parasitic infection?

I have tested negative for HIV, HEP A, HEP B, ghonorrea, syphillis, chlamydia, and candida. I have also tested negative for HSV1 and HSV2 but i am awaiting the results of a re-test because I believe the first HSV tests may have been a false negative. I am also awaiting the results of a urine test for trichomonas.

Absent a diagnosis, I began experiminting with topical anti-fungal remedies. During some of these treatments, a VERY small spec will come to the surface. The last picture is a magnified photo of one such spec. It looks like some kind of flagellated protozoa. Could this be the cause of the "strings"? Do trichomonas infect the skin?
doctor
Answered by Dr. Bharatesh Devendra Basti (37 minutes later)
Brief Answer:
Unlikely trichomonas.Get smear or culture done.

Detailed Answer:
Hi
Thank you for query.I am Dr Bharatesh D Basti answering your query.
Welcome to health care magic.
I have gone through the details and can make out your anxiety.

As all the STDs tests are negative you can allay fears of those STDs.
Now coming to symptoms, it is likely to be fungal or yeast infection.
Wear loose cotton inner wears.
You can clean the area with warm water twice daily.
Apply topical antifungal cream like clotrimazole.

The black spec seen may be hairs or some cloth material or dust .It is unlikely to be trichomonas .Trichomonas is rare to cause symptoms in men.The size of the organism is in microns.The morphology also does not appear like trichomonas.
You can go for smear examination or culture to relieve your anxiety.

You can get back for any clarification.
Thank you
Dr Bharatesh D Basti
Dermatologist and venerologist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bharatesh Devendra Basti (14 hours later)
Thanks Doctor BDB.

I have been treating it as a yeast infection for 6 months with azoles and a host of other homeopathic anti-fungal remedies. It is only now coming under control. It must have been a whopper of a yeast infection! Is it possible that I made it worse through over-treatment?

You are correct in your assessment of my anxiety. As I mentioned in the first inquiry, I am expecting results for a urine Trich test and HSV Ig antibodies tests today or tomorrow.

In the mean time, can you please offer an explaination for these subcutaneous, string-like things that are in the magnified pictures of my penis head? Does it fit the description of any:

parasite?

Virus (other than those already ruled out)?

Bacteria (again other than those ruled out)?

If it is yeast / Candida, could these be hyphae extending in response to treatment with azoles as I have read that they do?

The so called "strings" are the only prominent remaining symptom. My sex / love life is really on hold until I figure all of this out.



doctor
Answered by Dr. Bharatesh Devendra Basti (46 minutes later)
Brief Answer:
Unlikely due to viral or bacterial infection.

Detailed Answer:
Hi
Thank you for follow up query.
I do not see possibility of any bacterial or viral infection .Theye are all in microns.Parasitic infection unlikely.It looks more like dust or hair or cloth material.

Hope for the best for HSV, trichomonas reports.

One of the possibility is fungal infection. Please get a microscopy done and fungal culture too.Treat the partner too for fungal infection simultaneously as recurrence is possible.

You can check for diabetes. Fungal infection can be recurrent or severe in diabetics

You can get back for any clarification else please close the discussion.
Thank you
Dr Bharatesh D Basti

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bharatesh Devendra Basti (8 minutes later)
What is a microscopy? Which type of doctor would perform it?
doctor
Answered by Dr. Bharatesh Devendra Basti (6 minutes later)
Brief Answer:
Examination of sample under microscope.

Detailed Answer:
Hi
Thank you for follow up query.

Your treating doctor will collect the specimen ,like secretions or black spec and send it to microbiologist for smear microscopy and culture.

They will examine it under microscope directly and with different stains and/or culture.
You can get back for any clarification.
Thank you
Dr Bharatesh D Basti
Note: Consult a Sexual Diseases Specialist online for further follow up- Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Bharatesh Devendra Basti

Dermatologist

Practicing since :1998

Answered : 1764 Questions

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What Causes Rash On Penis Head Post Unprotected Vaginal Sex?

Brief Answer: Unlikely trichomonas.Get smear or culture done. Detailed Answer: Hi Thank you for query.I am Dr Bharatesh D Basti answering your query. Welcome to health care magic. I have gone through the details and can make out your anxiety. As all the STDs tests are negative you can allay fears of those STDs. Now coming to symptoms, it is likely to be fungal or yeast infection. Wear loose cotton inner wears. You can clean the area with warm water twice daily. Apply topical antifungal cream like clotrimazole. The black spec seen may be hairs or some cloth material or dust .It is unlikely to be trichomonas .Trichomonas is rare to cause symptoms in men.The size of the organism is in microns.The morphology also does not appear like trichomonas. You can go for smear examination or culture to relieve your anxiety. You can get back for any clarification. Thank you Dr Bharatesh D Basti Dermatologist and venerologist