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What are the chances of STD transmission through prostate massage?

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Posted on Mon, 1 Jun 2015
Question: Hi - about two weeks ago I had a prostate massage. Sex worker never took off her pants, but used her finger iwth lotion, touching my anus and penis and scrotum. At one point she licked my scrotum. Two weeks later I have a burning sensation in my scrotum. I have no burning orother symptoms that I can tell. Could it be herpese or some other STD?
What are the risks? Thanks
doctor
Answered by Dr. Kakkar S. (27 minutes later)
Brief Answer:
No risk of an STD

Detailed Answer:
Hello. Thank you for writing to us

I have taken note of your query and I have understood your concern.

There is no risk of an STD, whatsoever, from using her hand Or finger.

Licking too is considered safe provided she did not have any oral sores Or ulcer at that time and more so if scrotal skin was intact and there were no breaks or something like that.

Therefore you need not worry about any STD.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kakkar S. (41 minutes later)
Thankyou doctor -
Is it possible to transfer herpes by licking? I read that initial herpes requires penis contact becaus ethe virus needs to "rub in". If I did have an open lesion (which I don't think I did), could herpes transfer that way? And if so, how soon would I notice a problem? It was two weeks and now tehre is reddness and some small white postules.

What other skin issues could cause this? Could jock itch cause white skin postules?
doctor
Answered by Dr. Kakkar S. (28 minutes later)
Brief Answer:
Upload a few Images

Detailed Answer:
Hi.

Licking generally is considered to have a very low risk because there would be less chances of inoculating the virus through this act.
However, presence of active oral sores Or compromised skin may present a slightly higher risk because of either higher viral load Or ease of inoculation.
Genital herpes may manifest with sores within a few days of infection (incubation period is 2-12 days).
You have been using an OTC antifungal already. The pustules could be due to a bacterial skin infection Or it could also be due to irritation to the topical antifungal cream.
Kindly upload a few good clarity Images for my review.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kakkar S. (2 minutes later)
Uploaded some photos
doctor
Answered by Dr. Kakkar S. (35 minutes later)
Brief Answer:
Scrotal dermatitis

Detailed Answer:
Hi.

I have reviewed the Images.
I can see redness of scrotal skin and this looks like a dermatitis rather than Genital Herpes. The skin looks compromised and raw.

I suggest you to avoid antiseptics, dettol, savlon, alcohol etc for this area. You may cleanse this area with a mild soap.

Topically I would suggest that you use a moderately potent topical steroid+antibiotic combination ointment, twice daily e.g fluticasone propionate 0.05%+ mupirocin 2% ointment Or another similar combination.

I would also suggest a course of an Oral antibiotic e.g Amoxycillin thrice daily for a week. This would take care of any superimposed bacterial infection.

An OTC oral antihistamine e.g cetrizine 10 mg once daily will provide you symptomatic relief from itching and discomfort.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kakkar S. (1 hour later)
Thankyou doctor -
A few mor items:
1) I read that herpes incubation is 4 days or 2-12. First discomfort was at 14 days. Would this rule out herpes?
2) Pain is still sharpest in the area where I believe tehre was a cut, but it's hard to tell because I cannot see in that region.
3) Skin is definitely raw and it feels burning. Is this a herpes symptom?
4) I submitted a blood and urine STD test and herpes is one of the tests. I will post results when I get them. How accurate are herpes blood tests?

Thankyou so much for the help.
Just got tests back for about half of the STDs:

Herpes 2 - Negative
Herpes 1 - Positive
HIV - Negative
Syphillus - Negative

Other tests pending (Hep, Clam, Gon) but not that worried since no symptoms.

How accurate is the herpes 2 test? I have had cold sores in the past, so not surprising I have HSV1.

I am posting to this to other thread as well.
If you could please answer on this or other that would be great.
You have been very helful and I will be sure to rate positive.
doctor
Answered by Dr. Kakkar S. (9 hours later)
Brief Answer:
Too early to test for Hsv type although the image does'nt look like herpes

Detailed Answer:
Hi.

Good morning. Sorry for some delay in my reply. It was night here in XXXXXXX

The range of incubation period of herpes is 2-12 days. Average incubation period is 3-4 days. It means, the sores may appear as early as 2 days after infection, they may be delayed for 12 days, however, on an average they appear after 3-4 days of infection.

However, infection with herpes virus may be clinically silent and we cannot surely rule out herpes infection even if one does not experience clinical episode within the expected time period.
Therefore the need for appropriate laboratory testing to rule out possibility of infection. However, lab tests need to be done at appropriate time after a possible infection in order to have relevance.

Blood tests (ELISA) for herpes detect the presence of circulating antibodies to
the virus. Antibodies take some time to appear after infection.
ELISA for herpes may be falsely negative if done just 2 weeks after a possible infection. This is too early.
The earliest the test should be taken up is 4 weeks Or 1 month considering that the upper range of incubation period for herpes is 12 days by which a clinical episode is expected.
Circulating antibodies usually appear another 2 weeks later.

Therefore I suggest you to repeat test for Type 2 Hsv after 2 more weeks.

Anyways after looking at the Images this does not seem like herpes. This is more like scrotal dermatitis.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Kakkar S.

Dermatologist

Practicing since :2002

Answered : 8967 Questions

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What are the chances of STD transmission through prostate massage?

Brief Answer: No risk of an STD Detailed Answer: Hello. Thank you for writing to us I have taken note of your query and I have understood your concern. There is no risk of an STD, whatsoever, from using her hand Or finger. Licking too is considered safe provided she did not have any oral sores Or ulcer at that time and more so if scrotal skin was intact and there were no breaks or something like that. Therefore you need not worry about any STD. Regards