Common STD Incubation Periods

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STD Incubation Period. The incubation period for the various STIs (Sexually Transmitted Infections) is a common question asked by patients in our clinics. It refers to the time between acquiring the infection and the presentation of symptoms. This is different from the window period, which refers to the period after infection in which no current available tests are sensitive enough to detect the infection. The window period for the various STIs depends on which tests are used. 

As different STIs have different incubation periods, it is not easy to answer the question when symptoms will appear after a particular risky exposure. I will list below the common STIs tested for, their incubation and window period as well as possible initial presentation. 

The following are the Common STDs and their incubating periods:

#1 STD Incubation Period – Human Immunodeficiency Virus (HIV)

Early HIV infection refers to approximately 6 months after initial acquisition. It is estimated that 10 to 60 percent of all early HIV infections are asymptomatic, or without any symptoms. For early symptomatic HIV infection, the usual incubation period is around 2 to 4 weeks, although incubation periods as long as 10 months have been observed.

Acute symptomatic HIV infection present with a collection of signs and symptoms known as Acute Retroviral Syndrome (ARS). The most common findings for ARS are fever, sore throat, rash, swollen lymph nodes, body aches and pains. However, all these symptoms are not specific to acute HIV infection, hence please do not panic if you observe these symptoms after a risky encounter. See your doctor for further advice and testing

The Window period for HIV testing depends on the test that is conducted. The initially 10 days after exposure is known as the eclipse period, for which there are no tests that can pick up any infection. The earliest tests that can be done with conclusive results are the HIV ProViral DNA test or the HIV RNA PCR test, which can pick up possible acute infections 10 days after exposure.

4th Generation HIV tests will be conclusive around 28 days after exposure, while 3rd Generation HIV tests will be conclusive around 90 days after exposure. 

Anonymous HIV Testing is available at our Robertson Walk Branch. HIV Test results in 20 mins.

#2 STD Incubation Period – Syphilis

Approximately 50% of patients diagnosed with syphilis do not have any symptoms. This is because syphilis has 3 stages of infection: Primary, Secondary and Tertiary Syphilis and Primary and Secondary syphilis might have symptoms that are so mild that they are ignored by the patient.

Primary syphilis presents with a painless ulcer on the genitalia, known as a chancre. The incubation period for a chancre appears to range from 3 to 90 days, with an average of around 21 days. The chancre will heal within 3 to 6 weeks even without treatment. Within weeks to a few months after the chancre appears, around 25 percent of untreated individuals will develop Secondary Syphilis.

Secondary Syphilis can present with a widespread rash, ulcers, patchy hair loss, swollen lymph nodes, weight loss and fatigue. The infection subsequently goes into a latent phase lasting for years for which there are no signs or symptoms. This is the reason why the majority of syphilis picked up on routine screening are asymptomatic.

Neurosyphilis occurs when the infection reaches the central nervous system i.e. the brain or spinal cord. Neurosyphilis can occur at any stage of infection, but tends to occur in tertiary syphilis. Therefore, neurosyphilis can occur within a few months, but could also develop after 10 to 30 years, of a syphilis infection. 

The window period for syphilis testing depends on the stage of syphilis infection. The blood tests (FTA-ABS and TPPA) will be positive around 1 to 2 weeks after chancre formation. 

#3 STD Incubation Period – Hepatitis B and C

The majority of hepatitis B and C infection are asymptomatic. It has been estimated that around 30 percent of acute hepatitis B infection and less than 25 percent of acute hepatitis C infection are symptomatic. Symptoms of acute infection tend to be very mild and may include the following: Fever, Fatigue, Nausea/vomiting, Dark Urine, Pale stools and abdominal pain. 

The incubation for acute hepatitis B infection is estimated to be around 1 month to 4 month, while the incubation period for acute hepatitis C infection is estimated to be from 2 weeks to 3 months.

The window period for both hepatitis B and C testing for antibodies is on the average about a month. It will be much shorter if alternate tests such as the Hepatitis C RNA PCR test for Hepatitis B Viral Load are used instead.

#4 STD Incubation Period – Genital Herpes

Genital herpes is caused by both Herpes Simplex Virus 1 or 2 (HSV1/2). Genital herpes infections often do not have symptoms or mild symptoms that go unrecognized. It is estimated that one third of patients with new infections do not have symptoms. The initial presentation of symptoms range from severe with painful genitalia ulcers, painful urination, painful lymph node swellings and fever. However, patients also can have mild or no symptoms as well. The initial presentation does not depends on the type of virus (HSV1 vs HSV2)

The incubation period for genital herpes is around 4 days, with a range from 2 days to 12 days.

For asymptomatic infections, HSV 1/2 Antibodies will start appearing in the serum starting from 3 weeks and majority of patients would have antibodies by 16 weeks. The window period for testing for asymptomatic patients is hence from 3 weeks to 16 weeks. For patients with symptoms of the painful genital ulcers, the test of choice is Nucleic Acid Amplification Testing (NAAT) for which a swab of the ulcer is taken and tested for HSV DNA. There is no window period for NAAT.

Rapid Herpes Testing with Next Day Results is available in all DTAP Clinic in Singapore.

#5 STD Incubation Period – Gonorrhea

Gonorrhea causes different symptoms for men and women. For women, the cervix is the most common site of infection and the common symptoms are vaginal itch and discharge. Some women also have heavier periods or bleeding in-between periods. If the infection has ascended beyond the cervix into the uterus, this is a potentially more dangerous condition known as Pelvic Inflammatory Disease (PID) for which abdomen pain and fever are common symptoms. Up to 70 percent of patients with cervical gonorrhea infection are asymptomatic. 

For men, urethritis is the most common presentation of gonorrhea infections. It is characterised by purulent urethral discharge and painful urination. In contrast to infections in women, the majority of infections in men are symptomatic. 

In women, the incubation period for genital infection is around 10 days. In men, the incubation period for symptomatic infected men is around 2 to 5 days, with 90 percent of these individuals with symptoms of urethritis by 2 weeks.  

The accepted standard for testing for gonorrhea infection is NAAT, a urine sample for men and a cervical swab for women. As NAAT is able to detect low numbers of organisms with good accuracy, there is no window period for NAAT testing.

Rapid Gonorrhea & Chlamydia Testing with Next Day Results is available in all DTAP Clinic in Singapore.

#6 STD Incubation Period – Chlamydia

Chlamydia causes similar symptoms as gonorrhea in both men and women. In women, the cervix is also the most common site of infection with a proportion of patients having a urethra infection as well. However the majority of infected women, around 85 percent of patients are asymptomatic with neither signs or symptoms.

Symptoms of chlamydia infection are similar to gonorrhea in men as well, with a clear to mucoid penile discharge and painful urination. The proportion of asymptomatic infection varies as well in men, ranging from 40 to 96 percent with no symptoms. 

The incubation period for symptomatic infection ranges from 5 to 14 days after exposure for both men and women.

The gold testing for testing for chlamydia infection is NAAT as well. There is no window period for NAAT testing.

Rapid Gonorrhea & Chlamydia Testing with Next Day Results is available in all DTAP Clinic in Singapore.

  Asymptomatic/Mild Infections (%) Incubation Period Sample Types Window Period
HIV 10 to 60 2 to 4 weeks Blood Proviral DNA : 10 days
RNA PCR : 12 days
4th Generation Ag/Ab :28 days
3rd Generation Ag : 90 days
Syphilis 50 3 to 90 days
Average 21 days		 Blood FTA-ABS : 1 to 2 weeks after chancre
Hepatitis B Majority Asymptomatic 1 month to 4 month Blood HbsAg : 1 month
Hepatitis C Majority Asymptomatic 2 weeks to 3 month Blood Anti-HCV Ab : 1 month
Herpes 70 2 to 12 days
Average 4 days		 Blood/
Swab		 HSV 1/2 IgG : 3 to 16 weeks
HSV DNA PCR : No window period
Gonorrhea Women: 70
Men: Majority Symptomatic		 Women:10 days
Men: 2 to 5 days		 Swab/
Urine		 Gonorrhea DNA PCR: No window period
Chlamydia Majority Asymptomatic 5 to 14 days Swab/
Urine		 Chlamydia DNA PCR: No window period

If you like to speak to our doctors on your STD concern, please visit any of our clinics in Singapore & Malaysia.

You can also email us at hello@dtapclinic.com.sg, or call any of our clinics for an appointment

Also on this site: HIV Screening, HIV Test Clinic Singapore, STD Clinic Singapore

 
 
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Common Causes Of Bumps & White Spots On Penis & Foreskin

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This situation may be familiar to many men: while taking a shower one day, you happen to notice some white spots on your foreskin. You do a double take as you lean down to inspect your manhood. What could it be? How long have they been there? The questions are aplenty as you instinctively reach for your smartphone to begin a Google search.

There are many conditions that can cause white spots to develop on the penis and foreskin. Some men may be born with them, while others may develop them as a result of poor hygiene practices or sexually transmitted infections (STIs). It is important to know what the white spots are due to, as not all conditions require treatment. Listed below are some common causes of white spots on the foreskin and penis.

Pearly Penile Papules

Pearly penile papules (PPP) are small, dome-shaped or projection-like bumps that are located just below the head of the penis, usually arranged in a neat row. They can be white, flesh-coloured, yellow or translucent in colour. They do not cause any pain or itch. PPP is considered as a normal variant of the male penile anatomy, and are harmless bumps. It is not cancerous and there is no cancer risk. It is not a sexually transmitted infection and is not contagious. It is common and can occur in up to 38% of young men up to age 25.

PPP can be left alone and does not require treatment. However, for men who find them unsightly, they can be removed. Treatment options include laser therapy, cryotherapy and electrosurgery. 

READ: What are Pearly Penile Papules?

PPP

Fordyce Spots

Also known as Fordyce glands, these are harmless, small white or yellow bumps that are found on the foreskin. They are basically enlarged sebaceous glands, and can occur alone or in clusters. They do not cause any pain or itch. Fordyce spots can also commonly occur on the edges of your lips or on the inside of your cheeks.

Just like PPP, Fordyce spots are not cancerous and infectious, and also does not require treatment. Similarly, they can be removed if men find them unsightly. Treatment options include topical retinoid cream, oral isotretinoin, laser therapy and electrosurgery. 

Tyson’s Glands

Also known as preputial glands, Tyson’s glands are modified sebaceous glands that are found on the inner surface of the foreskin. They occur in pairs and are located on either side of the frenulum. These glands are also present on the hood of the clitoris in females. Tyson’s glands are normal structures and do not require treatment.  

Skin Tags

Skin tags are small, soft, flesh-coloured growths on the skin. They usually have a stalk and hang off the skin, and can vary in size from a few millimetres up to several centimetres. They tend not to grow on the penis itself, but rather, around the groin and scrotum. They often grow in areas where the skin folds and rubs against itself, and as such they are often also found on the neck, armpits, eyelids and under the breast. They affect men and women equally. Obesity, diabetes and pregnancy can increase the chances of occurrence.

Skin tags are benign tumours of the skin and do not require treatment. Occasionally, they may fall off on their own. People often wish to get them removed for aesthetic reasons, or if the skin tags are large and get in the way. Treatment options include cryosurgery, electrosurgery, ligation and excision.  

READ: Skin

Balanitis

Balanitis is inflammation of the foreskin and head of the penis. Spots can appear on the penile head or foreskin, and can be white or reddish. Other symptoms include redness, pain, itching, discharge, swelling and difficulty with retraction of the foreskin, and sometimes pain when passing urine. 

Balanitis can affect as many as 1 in 10 males, and can occur at any age. It is more likely to occur in uncircumcised men. The most common cause of Balanitis is a bacteria or fungal infection, or a combination of both. This can result from inadequate personal hygiene and/or phimosis (tight foreskin). There are non-infectious causes for balanitis as well. Risk factors for recurrent balanitis include diabetes, HIV and other sexually transmitted infections. 

To investigate balanitis, your doctor may perform swab tests to identify the responsible organism. Treatment involves topical and/or oral anti-fungal and antibiotics. The long term solution to balanitis is a circumcision.

READ: Causes, symptoms and treatment of Balanitis.

Balanitis

Pimples

Pimples develop as a result of the pores of our skin being blocked by dead skin cells, sebum and other debris. The sebaceous gland continues to produce sebum and build up under the blockage, allowing bacteria to grow in the area, resulting in inflammation, infection and pain. They can occur anywhere on the body, including the penis.

Pimples can be left alone and usually resolve on their own without treatment. It is important to resist the urge to pop the pimples as this may lead to superimposed infection, scarring and hyperpigmentation. However, they may end up self erupting and discharge small amounts of pus. Treatments for pimples include topical over-the-counter creams such as benzoyl peroxide, antibiotic creams and, if more severe, oral antibiotics.

READ: Skin

Folliculitis

Folliculitis is an inflammation or infection of the hair follicles. It can occur anywhere on the body, including the penis, where it is frequently seen at the shaft or base of the penis, or the pubic area. Folliculitis tends to result from shaving, waxing or chafing of the hair follicles. The damage to the hair follicles allows bacteria to enter. Sometimes, ingrown hairs can also occur from hair removal treatments, eventually leading to folliculitis as well. Folliculitis can be painful and/or itchy. Treatment options include topical and/or oral antibiotics. 

READ: Common causes of penile itching and pubic itching

Genital Warts

Genital warts are caused by the Human Papillomavirus (HPV). HPV is the most common sexually transmitted infection and can be spread via vaginal, oral or anal sex. They appear as flesh-coloured growths over the genitals that can cluster and resemble a cauliflower. Most of the time they do not have any symptoms but can sometimes itch. Bleeding can also occur during sexual intercourse. 

READ: Causes, symptoms and treatment for Genital Warts
READ: How to get rid of Genital Warts

Left alone, the warts can remain the same or increase in size and number. They will disappear once the body has shed the virus completely, typically over a course of 1 to 2 years. Treatment options include topical medications such as imiquimod, cryotherapy and electrosurgery. Vaccines are available to help prevent HPV infection, consider getting a HPV vaccination. 

READ: HPV Vaccination For Men
READ: Rapid HPV Testing

Genital-Blisters-Genital-Warts-and-Genital-Ulcers-Causes-Treatments

Genital Herpes

Genital herpes is caused by the Herpes Simplex Virus (HSV) and is a sexually transmitted infection. Itching of the penis is usually the first symptom, and can occur in other areas such as the scrotum, groin, buttocks and anus. Shortly after, tiny clusters of painful blisters develop, which can then rupture and form shallow ulcers with crusts. Other symptoms include painful urination, enlarged groin lymph nodes, fever and body aches. The virus can lie dormant in the body for years without causing any symptoms, therefore some people may not even be aware that they are infected. 

Genital herpes can be diagnosed via swab testing of the lesions. When there are no symptoms, no treatment is required. Flares can be treated with oral and topical antiviral medications. There is unfortunately no cure for genital herpes, as the virus will permanently remain in the body.

READ: Rapid Herpes Testing

Herpes-Simplex-Virus

Molluscum Contagiosum

This is a benign infection of the skin caused by the Molluscum Contagiosum virus, resulting in painless, small, shiny pearl-shaped lesions. They can happen anywhere on the body as a result of physical contact, but when they occur on the genital area, it is usually as a result of sexual contact. The virus is thus spread via sexual contact, or even to another part of the person’s own body, from scratching the lesions and touching another part of the body. They can appear alone, or in clusters. They usually do not cause any symptoms, but can sometimes itch. 

Left alone, the lesions will eventually disappear once the body has shed the virus completely, typically over a course of several months to a year. Treatment options include topical medications such as salicylic acid, cryotherapy, laser therapy and curettage.

READ: Everything you need to know about Molluscum Contagiosum

Molluscum-Contagiosum-Water-Warts

In conclusion, do not panic if you notice white spots on your penis, as not all white spots require treatment.  Speak to your doctor for advice on white spots or bumps and request for an examination. 

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Lymphogranuloma Venereum (LGV )

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What is Lymphogranuloma venereum (LGV)?

Lymphogranuloma venereum (LGV) is an uncommon sexually transmitted disease (STD) caused by Chlamydia trachomatis.  It is rare in industrialized countries. LGV is more commonly seen in third-world countries, including certain areas of Africa, Southeast Asia, India, the Caribbean, and South America.

However, in recent times, more cases of LGV have been noted in first-world countries.

What is Chlamydia VS Lymphogranuloma venereum (LGV)?

Chlamydia trachomatis is the name of the bacteria that causes Lymphogranuloma venereum (LGV).  LGV refers to clinical disease.

Not all subtypes of Chlamydia cause LGV. Of the 15 known clinical serotypes, only the L1, L2, and L3 serotypes cause LGV.

These serotypes are more virulent and invasive compared to other chlamydial serotypes.

What are the signs and symptoms of LGV?

Lymphogranuloma venereum (LGV) occurs in 3 stages:

First Stage of LGV

In the first stage, LGV presents with self-limited genital ulcers which may appear anywhere from 3 days to 1 month after exposure. This may be small and/or painless and may be missed by the patient. It may even look like a herpes infection.

Also See: Syphilis Symptoms – Painless Sore & Rashes

The Second stage of LGV

In the second stage, the patient usually presents with painful lymph node swelling in the inguinal and/or femoral groups of lymph nodes, usually appearing 2-6 weeks after exposure.

Other groups of lymph nodes may be involved as well, such as the armpit or neck lymph nodes. Painful, swollen lymph nodes may coalesce (join together) to form buboes, which may rupture in as many as one-third of patients.

Those that do not rupture harden, then slowly resolve. The second stage may be associated with back pain, joint pain, inflamed eyes, cardiac inflammation, lung inflammation or liver inflammation if the bacteria disseminate from the local area of infection.

Last Stage of LGV

In the last stage, patients with LGV may present with rectal ulcerations and symptoms of inflammation of the rectum which include bloody purulent anal discharge, rectal pain and the feeling of incomplete evacuation after passing stools.

This is more common in patients participating in receptive anal intercourse.

This may occur many months or even years after the initial infection. This can cause lasting damage to infected tissue and general health.

Scarring, swelling and deformity in infected areas have also been reported. It may affect your gut as well, resulting in significant morbidity.

Having genital sores, cold sores or cauliflower-like warts around your genital area?
These are signs and symptoms caused by the Herpes Simplex Virus and Human papillomavirus (HPV).
Not all STDs will display signs and symptoms. Other typical signs & STD symptoms of Sexually Transmitted Infections (STIs) are as followed.
Read: STD Symptoms of Different STDs

Is LGV Associated with Other Subtypes of Genital Ulcer Diseases such as Herpes Simplex Virus 2 (HSV-2), Syphilis, and Chancroid?

Lymphogranuloma venereum (LGV) is one of the causes of genital ulcer diseases that includes other STDs, such as Herpes Simplex Virus 2, Syphilis, and Chancroid. Any other form of STDs increases your risk of contracting another STD, including LGV.

How is Lymphogranuloma venereum (LGV) Transmitted?

LGV is almost exclusively transmitted through sexual contact.

Infection occurs after direct contact with the skin or mucous membranes of an infected partner. The organism does not penetrate intact skin.

The organism then travels by lymphatics to nearby lymph nodes, where it replicates within a type of white blood cell known as macrophages and causes systemic disease.

Can Sharing of Sex Toys Transmit Lymphogranuloma venereum (LGV)?

As long as the Chlamydia bacteria is present on the surface of the sex toy, and was introduced to the anogenital mucous membranes on the anus, vagina or penis, the infection can be spread.

It is thus important to make sure that sex toys are clean. It is also important to keep your sex toys clean.

How about Rectal Douching or Vaginal Douching?

Rectal and vaginal douching does not cause LGV, as if the surfaces of the douching tool is clean, there will not be the Chlamydia bacteria.

Having said that, most doctors do not recommend vaginal douching for ladies, as it may affect the normal flora of the vaginal cavity.

How Do I Test for Lymphogranuloma venereum (LGV)?

Laboratory diagnosis ultimately depends on detecting Chlamydia in the lesions/ulcers.

We can do a swab test of any lesions and do a urine test to see if Chlamydia is present or not.

What are the treatments for Lymphogranuloma venereum (LGV)?

LGV can be treated with antibiotics. However, a longer course has to be given (3 weeks). Your doctor will choose the appropriate antibiotic for you.

Sex partners who have had contact with the patient within the past 60 days should be evaluated and treated if symptomatic. If no symptoms are present, they should be treated for exposure, usually with shorter courses of antibiotics.

It is possible to be re-infected with LGV again after being successfully treated. Make sure all of your sexual partners have also been treated.

Is LGV more prevalent in MSM? How about other groups (Heterosexual & WSW)?

LGV has been postulated to probably affect both sexes equally, although it is more commonly reported in men. This could be because early signs and symptoms of LGV are more apparent in men and are therefore might be diagnosed more readily. Men typically present with the acute form of the disease, whereas women often present later.

Most cases in Europe and North America have been identified among white, frequently HIV-positive Men-Who-Have-Sex-with-Men (MSM) patients presenting with proctitis.

What are other STDs prevalent in Men Who Have Sex with Men?

Receptive anal sex carries the highest risk of contraction of all forms of STDs. STDs, in general, can affect everyone regardless of gender, age or sexual preference. If you are involved in sexual activity and have been exposed to an STD, you can contract it.


It is therefore important for you to get regularly tested for all STDs as long as there has been a new sexual encounter.

The best way to reduce the contraction of an STD from a sexual exposure is to use a condom. The proper usage of a condom (right size and fit) is equally important.

If you have experienced the above symptoms and wish to speak to a doctor, please visit us at our clinics. Alternately,  call us or email us for an appointment.

Learn More about Other STDs & Other STD Symptoms

Also on DTAP: hiv screening, hiv screening singapore

Common Causes of Penile Itching and Pubic Itching

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A myriad of conditions can cause a man to have penile itching or pubic itching. The excruciating urge to scratch and relieve that itch at such an inconvenient part of the body can be a major source of embarrassment to some. When severe, it can result in extreme discomfort in the day, and disrupt one’s sleep at night.

 

Here are some of the causes of Penile Itching and Pubic Itching:

 

6 Common Causes of Penile Itch:

 

1. Balanitis

Balanitis is a common infection of the foreskin and head of the penis. It is caused by bacteria or fungus, or a combination of both.

Symptoms include redness, swelling, discomfort, penile itching, and sometimes pain when passing urine.
(See: Penile Infection, Infection of the Penis)

When fungal infection (candidiasis) is present, a whitish cottage cheese-like discharge can be found under the foreskin. Balanitis is often hygiene related, but can also be caused by STDs. It is more likely to occur in uncircumcised males.  Watch: What are the causes of Foreskin Infection (Balanitis)

2. Genital Herpes

Genital herpes is caused by the Herpes Simplex Virus (HSV). Itching of the penis (penile itching) is usually the first symptom and can occur in other areas such as the scrotum, groin, buttocks and anus.

Shortly after, tiny clusters of fluid-filled blisters or ulcers can develop and these are usually painful. Other symptoms include painful urination, enlarged groin lymph nodes, fever and body aches. The virus can lie dormant in the body for years without causing any symptoms, therefore some people may not even be aware that they are infected.

Read: Genital Blister, Genital Ulcers & Genital Warts & Causes of Oral Herpes (Cold Sore)

 

3. Genital Warts

Genital warts are caused by the Human Papillomavirus (HPV), a sexually transmitted disease. They appear as flesh-coloured growths that can cluster and resemble a cauliflower. Most of the time they do not have any symptoms but can sometimes itch. Bleeding can also occur during sexual intercourse.

Read: Genital Warts Treatment

 

4. Contact Dermatitis

Contact dermatitis is a skin reaction to contact with an irritant. This can happen anywhere on the body, including the penis. When this happens, it is usually caused by latex condom usage. The skin of the penis can turn red and itchy.

Sometimes the skin can break causing serious discharge, and bacterial infection can occur. Mild cases can be treated with a corticosteroid cream. Non-latex condoms can be used if you have a latex allergy.

 

5. Urethritis

One of the causes of penile itching is Urethritis. Urethritis refers to inflammation of the urethra, the tube that carries urine from the bladder to outside the body. This condition most often causes pain or itching in the penis, which worsens when passing urine.

Other symptoms include urethral discharge, urinary frequency or urgency, difficulty urinating, and blood in the semen. Urethritis is most commonly caused by a bacterial infection and can be sexually transmitted. See other STD Symptoms 

 

6. Psoriasis

Psoriasis on elbows.

Genital psoriasis often occurs alongside psoriasis of the skin. Skin cells develop at an extremely fast rate, resulting in the accumulation of skin cells on the skin surface, building up into itchy, red plaques of scaly skin. See Psoriasis Treatment

5 Common Causes of Pubic Itch

 

1. Jock Itch

Also known as tinea cruris, jock itch is a fungal infection of the skin in the genital area, groin and buttocks. The rash is usually itchy, red, scaly and ring-shaped. It tends to occur in people who sweat a lot and/or are overweight.

 

2. Pubic Lice

More commonly known as crabs, these are tiny parasitic insects that attach to the hair and skin in the pubic region. Pubic lice can be easily spread via sexual contact or other forms of close contact, and can spread to other body areas with coarse hair such as beards, armpits and chest hair. It is also possible for pubic lice to spread by using an infected person’s clothes, towels, or bed.

 

3. Folliculitis

This is a condition in which hair follicles become inflamed and is usually caused by bacterial or fungal infection, or inflammation from ingrown hair. Initially, the affected hair follicles may have small red bumps or white-headed pimples, but can swell and become painful and subsequently develop into crusty sores.

 

4. Contact Dermatitis

As mentioned earlier, this condition can also occur in the pubic area.

 

5. Molluscum Contagiosum (mo-LUS-kum kun-tay-jee-OH-sum)

Molluscum Contagiousum is a benign viral infection of the skin and is caused by the molluscum contagiosum virus, resulting in painless, small, shiny pearl-shaped lesions. They can happen anywhere on the body as a result of contact, but when they occur in the genital area, it is usually as a result of sexual contact. They can appear alone or in clusters. They usually do not cause any symptoms, but can sometimes itch.

If you need to speak to our doctors, please visit our clinics.  Alternatively, you can email us hello@dtapclinic.com.sg or call us for an appointment.
Take Care.

Other Read:

6 Common Causes of Penile Discolouration

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Most men tend to not pay regular attention to their general skin condition, but when it comes to matters of the penis, it is almost always a cause for immediate concern; after all, it is the source of our manhood. More often than not, any unusual appearance such as discolouration, dry skin, red spots or bumps may result in considerable anxiety.

It is not uncommon for men, especially those with darker skin, to have slight variations in the colour of the penis. In fact, for men of all races, it is normal for the penis to be slightly darker than the skin on the rest of the body. This applies also to the labia of women.

When an adolescent male or female undergoes puberty, the body produces the sex hormones, testosterone and oestrogen, which results in the development of secondary sexual characteristics. Excess levels of these hormones in the genitals respond to melanocytes, the skin cells that cause pigmentation. These physiological changes are responsible for darker genitalia in both men and women.

Mild penile discolouration is generally nothing to worry about. In fact, during sexual arousal, the penis can take on a reddish, sometimes almost purplish colour, due to increased blood flow to the organ. However, there are other causes of penile discolouration that may be more severe and require treatment.

 

6 Common Causes of Penile Discolouration

1. Contact Dermatitis

Contact dermatitis is a skin reaction to contact with an irritant. This can happen anywhere on the body, including the penis. When this happens, it is usually caused by latex condom usage. The skin of the penis can turn red and itchy. Sometimes the skin can break causing serous discharge, and bacterial infection can occur. Mild cases can be treated with a corticosteroid cream. Non-latex condoms can be used if you have a latex allergy.

 

2. Penile Injury

A penile injury can lead to rapid discolouration due to bruising, in the form of purple, dark brown or even greenish hues. Sometimes, a red patch with prominent blood vessels just under the surface of the skin can occur due to a hematoma. This usually fades after several days and treatment is typically not necessary.

However, if there is severe pain along with the discolouration after a traumatic episode, immediate medical attention is required as this could be due to a penile fracture, which is a more severe issue.

 

3. Lichen Sclerosus

Lichen sclerosus is a lifelong condition that can go through periods of remission and flare-ups, and is characterised by white patches on the penis. It is more common in those who are uncircumcised. In addition to blotchy white spots, the skin of the penis can also become itchy, fragile and tear or bleed easily. Other symptoms include painful sex and an inability to retract the foreskin fully.

The cause of lichen sclerosus is unknown, but an overactive immune system or an imbalance of hormones may play a role. It is not contagious and cannot be transmitted through sexual intercourse. Treatment usually includes a strong steroid ointment applied directly to the affected skin. If only the foreskin is affected, circumcision may be advised.

 

4. Penile Melanosis or Post Inflammatory Hyperpigmentation (PIH)

Penile melanosis, or PIH, is a benign condition simply caused by overproduction of melanin, in which the skin can appear in a wide variety of colors including different shades of brown, grey or even blue.

Overproduction usually occurs after an injury to the skin of the penis, the most common being excessive rubbing of the penis from vigorous sex or self-pleasuring. It will fade over time, or if a man is bothered by it, possible treatments such as topical retinol (vitamin A) every night before bed, laser therapy, or microdermabrasion can help to reduce the discolouration.

 

5. Sexually Transmitted Diseases (STDs)

Purple sores on the penis can occur as a result of genital herpes or syphilis. These STDs can be accompanied by other symptoms such as pain, fever, itchiness, burning, and fatigue. If STD is suspected, it is imperative to head to a clinic to see a physician as soon as possible to be tested and get treated.

Also Read

 

6. Penile Cancer

Penile cancer tends to start on the skin of the penis and spreads towards the deeper tissues. 95% are squamous cell carcinomas, while penile melanoma accounts for 0.7%. Penile cancer is rare and the cause is not entirely known, but risk factors include smoking, HIV and high risk strains of Human Papillomavirus (HPV) infection. Symptoms include changes in the colour and thickness of the skin of the penis, foul smelling discharge under the foreskin, and abnormal non-resolving growths or ulceration of the penis. A diagnosis of penile cancer requires an urgent biopsy.

 

There are other conditions that can cause penile discolouration. It is important to determine the exact cause as treatment varies according to the cause. It is always best to visit a doctor for a physical examination and proper evaluation.

If you need to speak to our doctors , please visit our DTAP Clinics.  Alternatively, you can email us hello@dtapclinic.com.sg or call us for an appointment.

 

Take Care.

 

Other Read:

Also on Dtapclinic.com: HIV Test Singapore, STD Test Singapore, Anonymous HIV Testing

Bumps on Vaginal Area – Vaginal Lumps & Vaginal Bumps

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Lumps and bumps over the external genitalia (the vulva) or vagina are a fairly common concern that ladies may have. These can be normal or benign, or due to infections, sexually transmitted diseases, and less commonly, due to cancers (malignancy).

Here are some of the Causes of Vaginal Lumps & Bumps:

1) Benign bumps

Causes of benign bumps in the genital region include vestibular papillomatosis, Fordyce spots, ingrown hairs and folliculitis, various cysts (sebaceous cysts, Bartholin cysts).

Vestibular papillomatosis

This is a variation of normal anatomy. Vestibular papillomatosis appears as multiple, symmetrical, tiny bumps or finger-like projections over the labia minora and vestibule (vaginal opening). This can often be mistaken for warts and may thus be an undue cause for worry but there are features which help differentiate it from warts. No treatment is required for vestibular papillomatosis. It is harmless and it is NOT due to infection and cannot be spread to your sexual partners.

Fordyce spots

These are due to enlarged oil glands, which appear as tiny (1-3mm) whitish or yellowish bumps over the labia minora. These can also occur in other parts of the body, for instance around the edges of the lips or on the penis in men. They are completely harmless and painless and are part of normal anatomy. There is no need for any treatment or worry.

Folliculitis and ingrown hairs

Ingrown hairs may manifest as bumps, particularly in someone who shaves. Both ingrown hairs, as well as hair follicles, can get infected (known as folliculitis), resulting in small, red, tender bumps. Usually, topical creams will suffice for treatment.  Good hygiene, particularly relating to hair removal, is helpful in reducing the risk of folliculitis.

Cysts

Cysts are small round bumps that can be felt underneath the skin. These may arise from structures in the skin layer itself e.g. sebaceous cysts, or from glands which are found in the genital region near the labia minora (Bartholin’s glands).

Sebaceous Cysts

Sebaceous cysts are the result of oil glands which get blocked. They are painless unless they become infected. Most of the time, they can be left alone—but in the event of infection or if they become too large, incision and drainage or removal may be necessary.

Bartholin Cysts

Bartholin cysts are the result of Bartholin’s glands which are blocked. These cysts can enlarge, become infected and tender. They also have a tendency to recur and a minor surgery to remove them may be required.

2) Infections and Sexually Transmitted Diseases (STDs)

Warts

These are caused by certain strains (type 6, 11) of the Human Papilloma Virus (HPV). They appear as small skin-coloured bumps or irregular, cauliflower-like skin growths. They and can occur in isolation but are usually multiple. Genital warts usually appear anytime between weeks to 8 months (average 3 months) from the time of HPV infection and are highly infectious. The clinical course of warts can vary – in some individuals, genital warts may spontaneously resolve, while in others they may stay the same or increase in size and number.
The treatment of genital warts does not remove the underlying HPV infection and the only medication available against this is the HPV vaccine. The HPV vaccine protects against future infection but does not get rid of existing strains, so it is best to get vaccinated as soon as possible before one is exposed to more strains of HPV.
Read: Cervical Cancer, PAP SMEAR & HPV Vaccination – What you need to know

Molluscum contagiosum

This is skin infection caused by the Molluscum contagiosum virus which causes multiple small, pearly white or skin coloured bumps, sometimes with a central dimple (“central umbilication”). These are painless, non-itchy and can occur not just in the genital region but elsewhere on the body as well. The virus is spread through direct skin contact, or through contaminated clothing and towels. These lesions are harmless and will generally resolve within 6 months to a year (occasionally longer). Treatments available to address these bumps include topical medications like imiquimoid cream, freezing, and electrosurgery (laser).

Herpes

One of the stages of genital herpes is painful genital blisters – red bumps which eventually become fluid filled and later burst to form ulcers. Genital herpes is caused by the Herpes Simplex Virus which can be transmitted through secretions such as saliva or genital fluids. There is no cure for herpes, but antiviral medications are prescribed when an individual has a painful flare of blisters and ulcers.

Read: Genital Warts, Genital Blister & Genital Ulcer – Causes and Treatments
Read: Syphilis Symptoms – Painless Sores & Rashes

3) Malignancy

Vaginal cancer

Vulval or vaginal cancer are rare but serious causes of a vaginal lump or bump. These may be accompanied by other features such as persistent itching, pain, a persistent ulcer, and abnormal vaginal bleeding or discharge.

Melanoma

Vaginal melanoma (a type of cancer of the skin) can appear as a pigmented lump which may be associated with itching, bleeding and pain.

Malignancies tend to occur in older women but as their symptoms can be rather nonspecific, it is best to get any abnormal lump/bump checked.

If you wish to speak to female doctors if you have experienced the above signs and symptoms, call us or email us for an appointment at hello@dtapclinic.com.sg.

Take Care!

Other Reads:

  1. What Is the Cause & Treatment For Oral Herpes (Cold Sores)
  2. How Late Can a Period Be (Delayed Menstrual Cycle)
  3. 10 Causes of Abnormal Vaginal Lumps and Bumps
  4. 11 Causes of Dyspareunia (Pain During Intercourse)
  5. What You Need to Know about HPV Vaccination, Cervical Cancer & Pap Smear
  6. Why Do I Have Abnormal Vaginal Discharge
  7. What is HPV Vaccination – Gardasil 9
  8. Sex During Period (Sex & Menstruation) What To Know

 

10 Causes of Penile Pain – Ouch! Pain in the Penis

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For men, the penis is one of the most, if not the most important organ. So if there are any signs of pain or discomfort, it usually causes a lot of worry and anxiety. However, pain in the penis can be due to many different conditions. Some are harmless, others may need immediate treatment.
So I have listed below some of the common causes of penile pain so that you can know when you need to rush to see the doctor or only come in the following Monday.

Top 10 Causes of Pain in the Penis:

Penile Infections

 1) Balanitis

Balanitis refers to inflammation of the foreskin which can be caused by fungal or bacterial infections, and irritants such as soaps, powders or creams that are applied over the foreskin. People that have diseases which compromise the immune system, such as Diabetes and HIV, may be more prone to this condition.
The pain caused by the inflammation is usually not severe but it can be throbbing, itchy and rather uncomfortable. This can be easily treated by treating the cause or avoiding the irritant.
See: Treatment for Penile Infection

2) Herpes

Herpes is one of the most common Sexually Transmitted Diseases STDs. This infection is transmitted through skin to skin contact and is usually caused by 2 different viruses called HSV 1 and HSV 2, which are usually known to cause lesions in the mouth and genital areas respectively. However, during oral sex, the virus can be passed on from the mouth to the penis causing genital herpes.
They usually present with painful blisters or ulcers over the skin and can be painful or at least very sensitive to touch. It can be treated with anti-viral tablets although it will keep recurring throughout a person’s life.
See: Everything You Need to Know about Herpes Simplex Virus

3) Chancroid

Chancroid is caused by a bacteria called Haemophilus Ducreyi and is transmitted through sexual intercourse. It commonly presents with a single large painful ulcer on the penis along with enlarged and tender lymph nodes in the groin region.
Chancroid is an infection that is usually caught via sexual contact. This can be treated with antibiotics once the diagnosis is established by your doctor.
See: The causes of Genital Blister and Ulcers

4) Urethritis

This is an infection of the urinary tract along the penis, through which the urine is passed out from the bladder. When an infection occurs along this tract it results in pain when urinating or discharges from the tip of the penis. Sometimes even when not urinating, one can feel the pain along the urethra itself.
Urethritis can be caused by Chlamydia, Gonorrhea, NSU or Herpes which are very common infections that can be transmitted through sexual intercourse. A simple urine test and sometimes a urethral swab can be performed to found out the exact cause and in most cases, it is easily cured with antibiotics.
See:  What are the causes of Abnormal Penile Discharge

5) Prostate Infections

When the prostate is involved during a urinary tract infection it can cause severe pain during urination and sometimes fever and shivering. This sometimes is difficult to diagnose and may involve the doctor placing a finger up the anus to feel for any tenderness in the prostate gland. Moreover, it usually requires a longer course of antibiotics.
See: The Causes, Testing and Treatment of Prostatitis (Prostate Inflammation)  

Trauma to the Penis

6) Penis Fracture

The penis is made out of erectile tissues and blood vessels. Although there is no bone in the penis, during an erection it can be as hard as bone. The term penis fracture is used when there is an injury to the erectile tissue inside the penis. It usually happens during sexual intercourse when the penis accidentally fully or partially slips out of the partner and the partner sits back down on the penis which injures it.
This will result in a sudden onset of pain and in certain cause you may even hear a snapping sound. When this occurs you should go to the emergency department immediately because it is a medical emergency.

7) Torn Frenulum

The frenulum is a thin strip of skin connecting the head of the penis to the foreskin. This can break during intercourse, especially when it’s rough, and result in pain and a lot of bleeding. The pain can last up to a few days as the frenulum heals. The healing time varies and it may get repeatedly injured during subsequent intercourse. When it started to occur more frequently, a simple surgical procedure may be done to fix the frenulum.
Frenulum breve, or short frenulum, is a condition in which the frenulum of the penis is too short and thus restricts the movement of the foreskin.
See: Frenulum Breve Treatment or Penile Frenulectomy

Others Medical Condiction that Causes of Penile Pain

8) Peyronie’s Disease

Is your penis bent during an erection? At the point where it is bent, can you feel a painful lump?
If it is yes to both questions, you may have Peyronie’s Disease. This happens when a spot along the penis shaft becomes inflamed and as it heals, it leads to contraction of one side of the penis causing it to bend. The pain may arise from the area of inflammation or in certain cases when the curvature is so severe, it causes pain during sexual intercourse.
Please see a doctor if you think you have Peyronie’s disease, and once the diagnosis is established the doctor may suggest several treatment options ranging from shock wave therapy to surgery.

9) Paraphimosis

This is a condition where the foreskin is completely retracted to expose the head of the penis and cannot be pulled forward to cover the head of the penis again. When the foreskin get inflamed and forms a band around the penis, it may affect the blood flow to the tip of the penis and usually causes severe pain.
This is a medical emergency and patients with this issue should see a doctor immediately. Most of the time, the doctor can use special techniques to pull the foreskin back into place.
Learn more about Paraphimosis.

10) Chronic Pelvic Pain Syndrome

This is a condition where there are non-specific symptoms in the groin area including pain in the penis, testicles or even lower back pain. This is due to inflammation either in the prostate or any of the organs in the groin area.
Read more about CPPS here.
Next time you feel pain or discomfort, do consider the possible.
If you wish to speak to our doctor about penile pain, please visit our DTAP Clinics or you can call us, or email us for an appointment at hello@dtapclinic.com.sg.
Take Care!

Also, Read:

  1. Things to do to maintain your penis health
  2. 11 Causes of Penile Itching & Pubic Itch
  3. 10 Ways to Improve Sexual Performance for Men
  4. An Overview of STD by an STD Doctor
  5. Anal Warts! What You Need To Know
  6. Weak Erection: Does Size Matters?
  7. Sexual Health Advice for Travellers 
  8. What you need to Know about Erectile Dysfunction 
  9. What You Need to Know about Premature Ejaculation Treatment
  10. What you need to know about Testosterone Deficiency Syndrome
  11. What is HIV / AIDS Signs and Symptoms

 

STD Risk from Receptive Unprotected Anal Sex in Men

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Anal sex, not only consists of penile insertion into the anus (bottom) but also allowing your partner to use his mouth on the anus (analingus) or insertion of fingers and sex toys into the anus.
It is highly recommended to use condoms and lube during anal sex to reduce the risk of contracting a sexually transmitted disease (STD).

What is the STD that you can potentially get from anal sex for Men-Who-Have-Sex-With-Men (MSM)?

1. Chlamydia and Gonorrhea

The reason why we clumped them together in this article is that chlamydia gonorrhoea can present with similar symptoms and may present together in certain patients. These bacteria’s can present in a few ways:

Anal Discharge

Discharge is a term used when liquid is seen coming out of the anus. This is usually very minimal and patients usually notice a small number of stains on their underwear. In very rare situations, the volume may be high and appear yellow in colour. see more of Rectal Gonorrhea

Anal Discomfort

Patients usually present with mild discomfort in the anal region and some of them describe it as a feeling of constant urge to poo. It is never painful, and if patients present with severe pain, it is usually due to haemorrhoids or a tear at the opening of the anus.

Anal Bleeding

This is very rare. If patients present with bleeding, it is usually due to piles or a tear at the opening of the anus.

Lower Urinary Tract Symptoms

The insertive partner (or top) may present with a burning sensation when passing urine, urethral discharge, an increase in urinary frequency, waking up in the middle of the night to pass urine and the feeling of incomplete bladder emptying. However, keep in mind a large proportion of men may not show these symptoms.
It is best to get tested via anal swab or urine test for these bacteria if you have had an exposure as it can be easily treated with antibiotics.
Prostate infection and inflammation can be due to non-Sexually Transmitted infections & Sexually Transmitted Infections.
We provide Rapid Chlamydia & Gonorrhea PCR Screening (Next Day Results).

2. Human papillomavirus (HPV)

HPV is, in fact, one of the most common STD’s out there but is less well known. It is usually transmitted through skin to skin contact, through contact with infected mucous membranes or bodily fluids. In other words, condoms will not protect you from this virus. There are many different strains and can cause anal cancer and cauliflower-like growths in the anus and surrounding skin. It is recommended to see a doctor screen for anal warts, or other genital warts because some warts may be inside the anus and may not be visualised externally.
Warts can be treated and you should see a men’s health doctor if you have any suspicious lumps. It is highly recommended for men who engage in anal sex to get the HPV vaccine.
Rapid HPV Testing (Next Day Results) is available in our clinics.
Check out: How to Get Rid of Warts

Read: Is HPV Vaccine Necessary for Males?

3. Herpes

There are 2 kinds of herpes virus, HSV type 1 and HSV type 2. These viruses can be easily passed through skin to skin contact, which means condoms have a very limited to a negligible role in reducing the transmission. They usually present in the area of contact with multiple, small and painful ulcers or blisters within a week or sometime months after exposure. If there is any suspicion, the doctor will perform a dry swab to diagnose the lesion. Unfortunately, there is no cure but there is treatment available for flares.

4. Molluscum Contagiosum

Molluscum Contagiosum is caused by a virus call Poxvirus and presented with lesions that may appear anywhere on the body. The lesions are small, raised and usually white or flesh-coloured with a dimple or pit in the centre. The size can range from 2 to 5 mm in diameter and may be itchy or sore. This virus can be passed through skin to skin contact or thru contaminated materials such as clothing, towels, pool equipment or even toys. The good news is that these lesions usually do not cause long-term medical problems and can be easily treated. Water Wart Removal is available in our clinics.

5. Syphilis

Syphilis an STD which is transmitted thru any form of sexual contact. It is caused by a bacteria known as Treponema pallidum. This disease can present in many ways, from a single, big and painless ulcer in the area of sexual contact, to rashes around the body and palms. In certain cases, they can cause an infection in the brain and spinal cord. This symptom can present any time between 9 to 90 days after being infected. The good thing is this disease is usually curable with antibiotics.

6. HIV

The riskiest sexual behaviour for getting and transmitting HIV in men is anal sex. The receptive anal sex is much riskier as the bottom partner’s risk is 13 folds higher than the insertive partner. This virus can pass through blood, semen, pre-seminal fluid (Pre-cum) or rectal fluids.
This risk is higher when recreational drugs are used.
Condoms and HIV pre-exposure prophylaxis (PrEP), if used consistently can reduce the risk of getting HIV significantly. The condom reduces the risk of getting HIV by 63% for the insertive partner and 72% for the receptive partner if they engaged in anal sex with an HIV infected partner.
Yes. it is not 100%!!. PrEP can reduce the risk of getting HIV by more than 90%. If you think you have been potentially exposed to the virus and did not use a condom, you can see a doctor within 72 hours of the exposure to start the HIV post-exposure prophylaxis (PEP) treatment.
Also, a regular HIV Test is recommended if you are sexually active with unknown HIV status partners.
If you think you have had an exposure to HIV or any form of STD thru risky sexual activity, it is recommended you get tested and seek treatment early to reduce any untoward complications and risk of passing it to your partner.
Take Care!

Other Reads:

  1. The HIV Pro-Virus DNA Test can be done 10 days post exposure.
  2. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  3. What are the Causes of Abnormal Penile Discharge?
  4. HPV Infection & HPV Vaccination for Men who have sex with Men
  5. Low HIV Risk Doesn’t Mean No HIV Risk
  6. 7 FAQs HIV Preexposure prophylaxis (HIV PrEP)
  7. HIV PrEP for Travel – How You Need to Know
  8. An Overview on STD from an STD Doctor
  9. Everything You Need to Know about Herpes Simplex Virus
  10. How Do I Treat Oral Herpes (Cold Sores)
  11. Syphilis Symptoms – Painless Sore & Ulcers
  12. HIV Symptoms – What You Need to Know
  13. 10 Common HIV related Opportunistic Infections

 

Genital Blisters, Genital Warts and Genital Ulcers – Causes & Treatments

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Genital blisters, genital warts, genital ulcers – more common than you think but invariably exceedingly distressing for the person suffering from them. Today we talk a little about the various causes for the above genital skin conditions.
Genital lumps, bumps and sores can be an alarming phenomenon for anyone. One day you notice a tiny little bump, or perhaps several bumps.
Now you’re not sure when they appeared – was your skin normal last week, or did you just never notice the bumps for a good duration? Or perhaps you notice what you thought was a little pimple or an ingrown hair follicle which happens from time to time because you shave. But now it’s burst, leaving a painful raw ulcer.

What are the Causes of Genital Blisters, Genital Warts and Genital Ulcers?

1) What are the Causes of Genital Blisters?

Genital blisters are small, fluid-filled bumps and can occur anywhere over the genital region.

a) Genital Herpes

One of the classic causes of genital blisters is genital Herpes, caused by the Herpes Simplex Virus.
Here’s a video about Herpes

Genital herpes has Several Stages:
Stage 1: Prodrome – the skin appears normal but you may feel an unusual sensation like a tingling or itching. This indicates that the virus is active and heralds an impending outbreak
Stage 2: Redness – you may notice some nonspecific red spots which may be uncomfortable or slightly painful.
Stage 3: Blisters – this is usually when people realise something is not right, Initially, these may resemble tiny pimples. They then grow in size and become fluid-filled and painful.
Stage 4: Ulcers – the blisters burst, leaving shallow, painful ulcers
Stage 5: Scabbing or crusting – a scab or crust forms over the ulcer, which eventually heals
Also, check out What is Oral Herpes & Cold Sore

b) Balanitis

In males, balanitis may sometimes present with tiny blisters. The term “balanitis” is a descriptive term which means inflammation of the head of the penis and foreskin. This usually manifests as skin redness, with some tiny blisters or whitish bumps, as well as possible itching/pain or discomfort.
There can be multiple causes of balanitis. The skin on the penis is no different from skin elsewhere on your body and redness, discomfort and irritation can be caused by many factors:

  • Infections such as fungal skin infections
  • Skin irritation caused by external factors like soaps (irritant or contact dermatitis)
  • Mechanical trauma in the form of excessive friction e.g. masturbation or sexual intercourse with insufficient lubrication
  • Poor hygiene
  • Sensitive skin e.g. in people prone to eczema or dry skin

Depending on the possible underlying trigger or cause, various topical creams may be useful. In some cases, skin swab tests or urine tests may be useful in checking for underlying infections.
Read more about What is a Penile Infection?

2) What are the Causes of Genital Warts?

a) Human Papilloma Virus

This is THE cause of genital warts. Genital warts are skin coloured, fleshy bumps which may occur singly or in clusters around the genital and anal region. They can range from tiny firm bumps to larger, irregular shaped bumps which are classically described as “cauliflower-like” in appearance.
The Human Papilloma Virus (HPV) is a sexually transmitted viral infection. There are many strains of HPV and they are transmitted through sexual contact. Some strains are responsible for genital warts, while other “high risk” strains can lead to an increased risk of cancers such as cervical, oral and anal cancers.
If you have warts, it effectively means you have been infected by at least one strain of HPV. If you are female and you are not already doing your regular PAP smear for cervical cancer, you should do a PAP smear with high risk HPV testing because an individual may have not just one but several strains of HPV. You can read more about PAP smears and cervical cancer screening.
There are various methods available for the treatment of genital warts, ranging from topical medications to freezing or cryosurgery electrosurgery. But one must be prepared that warts can unfortunately recur as the treatment for warts addresses the effects of a HPV infection but does not clear the virus from your body.
The best defence we have against genital warts is the HPV vaccine – Gardasil 9, which provides immunity against certain wart causing strains of HPV.

3) What are the Causes of Genital Ulcers?

When people think of genital ulcers, often the first few causes that spring to mind may be herpes or syphilis. However, genital ulcers can be due to other infections as well as rarer, non-infective causes such as autoimmune diseases.
This is why various tests are useful in differentiating the causes of genital ulcers. The treatment of choice varies drastically depending on what the underlying cause is.
Caused by Sexually transmitted infections (STIs)

  • Herpes Simplex Virus (Common)
  • Syphilis (Common)
  • Chancroid (Rare)
  • LGV (Rare)
  • Donovanosis (Rare)

Non-infective causes

  • Behcet’s (Autoimmune)
  • Crohn’s disease (Autoimmune)
  • Fixed drug eruption (rare causes)
  • Skin Cancer (rare causes)

a) Herpes Simplex Virus

(Painful shallow ulcers and blisters)

As mentioned earlier, both genital blisters and ulcers are different stages of a herpetic flare. A genital skin swab test for the presence of HSV DNA is helpful in confirming HSV as the cause of genital ulcers.

b) Syphilis

(Painless ulcers)

Syphilis can cause ulcers both during its primary and secondary stages.  A chancre, a painless round ulcer, occurs in primary syphilis, while in secondary syphilis, multiple painless ulcers may occur as well. One of the defining traits of a syphilitic ulcer is its painlessness.
These ulcers may be accompanied by other symptoms such as a rash elsewhere on the body.

C) Chancroid

(Multiple painful deep ulcers and swollen groin lymph nodes)
Chancroid is a painful ulcer which is frequently associated with enlarged and painful inguinal (groin) lymph nodes. These are located along your underwear line and may be felt as tender swollen lumps. There are usually several or multiple deep and painful ulcers.
This is caused by a bacterium called Hemophilus ducreyi, which is transmitted through sexual contact. Painful lymph nodes and negative test results for both Herpes and syphilis support this diagnosis. The good news is that antibiotic treatment can clear this up.

Lymphogranuloma venereum (LGV)

Small ulcer, swollen groin lymph nodes, possible rectal pain

Lymphogranuloma venereum (LGV) is an uncommon cause of genital ulcers. It is caused by the bacterium called Chlamydia trachomatis (serovars L1-3). This Chlamydia is different from the “subtype” of Chlamydia trachomat is that causes the common STD you are thinking about. A Rapid Chlamydia & Gonorrhoea PCR test will be about to detect the infection.
The ulcer it causes tends to be small and often goes unnoticed. The lymph node swelling is dramatic and painful and may even discharge pus.
If this was acquired through anal intercourse, inflammation of the anal and rectal canal (known as “proctitis”) can occur, causing rectal pain, bleeding and discharge and diarrhoea.

Donovanosis

Shallow beefy looking ulcers

This is again a rare cause of genital ulcers in the developed world. It is caused by a bacterium called Klebsiella granulomatis and causes shallow ulcers which may bleed easily. This is usually diagnosed with a punch biopsy, which is when a sample of skin tissue is removed for evaluation in the lab.

Other rare causes:

Autoimmune or inflammatory causes, skin cancers, drug reactions

“Autoimmune” diseases occur when your body’s immune system has a tendency to attack itself and one of the many manifestations can be genital ulcers. These are rare and treatment is by a specialist doctor. These ulcers will go away only with good control of the underlying disease.
Sometimes, a bad reaction to a certain medication may cause a persistent, painful ulcer.
Very rarely, genital ulcers may be due to cancer.

All in All

The good news is that most of the above mentioned causes for genital blisters, warts and ulcers can be treated. But an even better step would be to protect yourself from even developing these – safe sexual practices (using barrier protection, doing your regular sexual health screening, and getting the HPV vaccine) are your best bet against these.
Take Care!

  1. HPV Infection & HPV Vaccination for Men who have sex with Men
  2. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  3. How Late Can a Period Be (Delayed Menstrual Cycle)
  4. What are the Causes of Abnormal Penile Discharge?
  5. STD Risk for Receptive Unprotected Anal Sex in Men
  6. Low HIV Risk Doesn’t Mean No HIV Risk
  7. HIV PrEP for Travel – How You Need to Know
  8. An Overview on STD from an STD Doctor
  9. Everything You Need to Know About Herpes Simplex Virus
  10. How Do I Treat Oral Herpes (Cold Sores)
  11. Syphilis Symptoms – Painless Sore & Ulcers
  12. HIV Symptoms – What You Need to Know
  13. 10 Common HIV related to Opportunistic Infections