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What could cause open ulcers near penis head after sex and could it be herpes?

DOCTOR OF THE MONTH - Dec 2013
Dec 2013
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Dermatologist
Practicing since : 2002
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I have developed a few open ulcers near the head of my penis. I had unprotected sex rigorously Sunday and Tuesday night. Wednesday morning my penis was sore. Later that day I masturbated. I may have done it more than once. On Thursday I masturbated 2-4 times without lubrication. Thursday night I got an erection in my sleep and felt pain near the head of my penis. On Friday I noticed what I initially thought were tears and a smell coming from the area. Since that time the tears now look like ulcers. They are only slightly painful at times in the shower. They do not hurt when touched, sitting here or when antibacterial gel was applied. Im concerned it is herpes but I've never tested positive for herpes and I never noticed blisters. Can you get ulcers from herpes without blisters? My partner says she is clean and has only been unprotected w me since being tested. I have never tested positive either. I got tested today but I am freaking out. Could these sores be from trauma to the skin of my penis? If so, how confident are you that the trauma is the cause?
Posted Sun, 5 Jan 2014 in Skin Hair and Nails
 
 
Answered by Dr. Sanjay Kumar Kanodia 26 minutes later
Brief Answer: Kindly send good resolution pictures Detailed Answer: Hello, Welcome and thanks for posting your query to healthcare magic. I can understand the concern for the ulcers on penis. After reading the query herpes can be one strong possibility. But to reach to the exact diagnosis of any of the condition I would suggest you to send good high resolution pictures of the area. It would be best if you can send few good resolution pictures of that area so that I can analyze it better. For that you have a feature to upload images by yourself at the right side of the query page. Or else, you can send as an attachment to YYYY@YYYY with the subject as "Attn: Dr. Sanjay Kumar Kanodia. Hope to hear soon from your side to help and guide you best for your condition. With good health wishes, Dr Sanjay Kumar Kanodia MD- Dermatology & Sexually transmitted diseases
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Follow-up: What could cause open ulcers near penis head after sex and could it be herpes? 2 minutes later
I attached a picture. I have not had unprotected sex w someone who has herpes.
 
 
Answered by Dr. Sanjay Kumar Kanodia 1 hour later
Brief Answer: Frictional ulcer with secondary infection Detailed Answer: Hi, Welcome again and thanks for posting good resolution pictures for the reference. After thoroughly analyzing the pictures and correlating the important facts provided by you I can make out that these are frictional ulcers with secondary infection in the same. Herpes in your case is of least possibility. These ulcers erupted due to friction as well as poor hygiene of the area resulting in cuts to form ulcers and then secondary infection. To tell you medically the important facts regarding not a possibility of herpes: - The ulcers erupted in 4 days of period of unprotected sex. It is practically least likely possible to get herpes ulcers in 4 days after sex. - There were no any vesicles present in your case. In herpes there is always presence of vesicles. These are always present but for only less than 24 -48 hours. In your case you directly saw raw areas rather than vesicles. - There is watery discharge without any smell in the herpes lesions. In your case there was smelly discharge which shows more of secondary infection by bacteria after the cuts which formed ulcers. - There is no pain or burning in your ulcers. Herpes is basically accompanied by itching, pain or burning or all of the symptoms. - The most important part is the picture for which I was waiting for. It is hallmark of herpes ulcer to be very superficial ulcers in a grouped form which are basically rounded and are more than 5 to 10 in number. In your case I can see linear deep ulcers which are less than 5 in number. So going through all these facts I assure you that your case is not herpes. In medical science we see so many of the variations but in dermatology & Sexually transmitted diseases - it is the physical appearance of lesions which is most important. SO you should not be worried about the herpes. Though I would like to suggest that for the peace of your mind if you want you can further confirm it by blood test for herpes 1 & 2 IgM and IgG. I further suggest you : - to go for a course of antibiotic by mouth under dermatological advise. - Clean the area gently and thoroughly with mild soap for two to three times. Do not rub the area. Be gentle!!! - Do not apply any other cream or any other stuff. You can apply a plane antibiotic cream such as mupirocin or fucidin. Apply in a very very thin layer so that it should not be visible to the naked eye. Apply it for just two times a day. - Do not try to unnecessarily touch or pinch or scratch the area as it can lead to further infection. - Avoid sex for next 7-14 days and even masturbation too. I hope you must be relaxed now. If you have any further queries I will be happy to help. With good health wishes, Dr Sanjay Kumar Kanodia MD- Dermatology & Sexually transmitted diseases
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Follow-up: What could cause open ulcers near penis head after sex and could it be herpes? 11 hours later
A doctor I've seen in person thinks it may be herpes. You calmed me down and now I'm freaking out.
 
 
Answered by Dr. Sanjay Kumar Kanodia 11 hours later
Brief Answer: Kindly see details below Detailed Answer: Hi, Welcome again to the forum. As I said previously that the pictures are not in favor of herpes. Even if you have showed it to a doctor and the possibility of herpes is kept on then the best mode to get rid of your anxiety is by going for blood tests as mentioned before for herpes. You can further confirm it by blood test for herpes 1 & 2 IgM and IgG. It is a very simple test and within few hours you will be out of your dilemma. Do give me a follow up for the same. With good health wishes, Dr Sanjay Kumar Kanodia MD- Dermatology & Sexually transmitted diseases
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Follow-up: What could cause open ulcers near penis head after sex and could it be herpes? 32 minutes later
I got a blood test and swab test done. I was given an antibiotic for infection. However, this evening is the first time there has ever been a slight stinging to the area. No hard scabs are present. Does this mean anything?
 
 
Answered by Dr. Sanjay Kumar Kanodia 1 hour later
Brief Answer: Stinging is a normal feeling in healing Detailed Answer: Hi, Thanks for your follow up. This is good that you have gone for the blood test as well as the swab test. The blood test will relieve all you anxiety regarding herpes. The swab test will guide the type of bacterial infection on the ulcers. The stinging feeling is due to the part of healing in the ulcers. It is usual and quite expected feeling to have stinging at this area. SO do not worry about the same. Relax yourself and wait for the results of the tests. With good health wishes, Dr Sanjay Kumar Kanodia MD- Dermatology & Sexually transmitted diseases
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Follow-up: What could cause open ulcers near penis head after sex and could it be herpes? 2 minutes later
So is it a good sign or indication I don't have herpes because my body is reacting to the medication in such a manner? Thank you for all your help.
 
 
Answered by Dr. Sanjay Kumar Kanodia 3 minutes later
Brief Answer: good sign of healing Detailed Answer: Hi, It is obviously a good sign that now the ulcers are progressing towards healing. It has no relation with the presence or absence of herpes. It is a normal sequel in healing and shows a very good immunity. So do not worry. Keep yourself calm. I can understand your part of concern very well and brotherly want to say to reassure yourself. Dr Sanjay
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