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

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

10 Common HIV-related Opportunistic Infections

In late-stage HIV infection, the virus would have spread through the body and attacked the immune system for many years without treatment. On blood tests, the number of viral copies, or viral load (VL), will be very high, while the CD4 cells of the immune system would be very low.
When the immune system is in this weakened state, it is much easier for certain pathogens (bacterial, viral, fungal etc.) to invade and cause an infection – these types of infections are called Opportunistic Infections (OI’s). Sometimes, these infections can cause certain types of cells to become cancerous, and these are also classified as Opportunistic Infections.

HIV-infection

What is an Opportunistic Infection?

In a healthy and normal functioning immune system, these pathogens do not usually cause infection, or they may cause very mild disease. Apart from advanced HIV infection, Opportunistic Infections may affect people who are on chemotherapy for cancer, immunosuppression for autoimmune diseases or post-organ transplant, among other conditions.
In HIV, many of these Opportunistic Infections are what we also term as “AIDS-defining illnesses” – that is, if these infections are found in someone who has HIV, we would classify them as having AIDS (Acquired Immunodeficiency Syndrome). Many of the symptoms and signs of late-stage HIV infection are due to these Opportunistic Infections rather than directly from the virus itself.

What is HIV Treatment?

HIV treatment and management consists of taking a set of correct HIV medicines to delay the control HIV, monitoring for and treating any opportunistic infections, and taking care of the patient’s general health and well being.

What are the most common Opportunistic Infections?

This is a list of some of the most common HIV-related opportunistic infections:

1) Candidiasis (Esophageal, Tracheal, Bronchial)

Also known as thrush, candida is a very common fungal organism that is found almost everywhere in the environment and can be isolated from around 30-50% of healthy people. Most of the time, it does not cause any symptoms of infection; however, in people with HIV, there can be invasive candida overgrowth in the esophagus and airways. It is often the first sign of a weakened immune system in previously undiagnosed individuals.

2) Cryptococcosis

Caused by the fungus cryptococcus neoformans, this can infect any part of the body, but most commonly will invade the lungs (pneumonia) or the brain (abscesses).

3) Cytomegalovirus (CMV)

Caused by an intracellular virus, this infection can cause inflammation of the brain, lungs, intestines, and eyes. CMV retinitis of the eye is sight-threatening and should be treated as a medical emergency.

4) Herpes Simplex Virus (HSV)

Another common virus, Herpes Simplex Virus (HSV) can cause symptoms in people with a normal immune system as well – usually cold sores or blisters around the mouth, genital region or anus.
However, in people with a weak immune system, outbreaks tend to be more frequent, severe, and prolonged in duration, and can also invade the lungs and esophagus.

5) Mycobacterium Tuberculosis (TB) & other Mycobacterial infection

Tuberculosis (TB) would most commonly affect the lungs, but may also spread to lymph nodes, brain, kidneys, or bones. Symptoms of TB include recurrent fever, night sweats, chronic cough, and weight loss. Other mycobacteria are very commonly found in soil and around the environment, and very rarely would cause problems in healthy individuals; as Opportunistic Infections, they will usually affect the lungs but can spread throughout the body.

6) Pneumocystis Carinii Pneumonia (PCP)

Caused by a fungus pneumocystis carinii, now renamed as pneumocystis jirovecii, this infection is commonly one of the first signs of a late-stage HIV infection. Symptoms would include shortness of breath on exertion, dry cough, and high fever, and if left untreated can be deadly.

7) Salmonella septicemia

Salmonella is a common bacteria that is usually found in contaminated food or water. In healthy individuals, this may cause an acute ‘food poisoning’ with vomiting, diarrhoea, and sometimes fever. However, salmonella as an Opportunistic Infection can spread throughout the body and cause septicemia, or blood poisoning, leading to multi-organ failure and death.

8) Toxoplasmosis

This is caused by a parasite called toxoplasma gondii, which is found in the faeces of certain animals (normally cats, rodents, and birds), and can be found in undercooked red meat such as pork. It can cause infection of the lungs, eyes, liver, and brain.

9) Kaposi’s Sarcoma (KS)

This is a type of abnormal growth/tumor of connective tissue – more specifically, of the capillaries (small blood vessels). It can occur anywhere in the body, but if it arises on the skin or mucous membranes, KS will usually appear as firm reddish or purplish lumps. The cancerous changes in the cells are a result of infection by human herpesvirus 8 (HHV8),

10) Invasive cervical cancer

This is a cancer of the cervix, which is the neck of the womb, or uterus. Malignant changes can occur after infection with certain types of human papillomavirus (HPV), and all women (HIV or not) should be screened regularly with pap smears and HPV testing. It is also recommended to get the HPV vaccine (Gardasil 9), to prevent HPV infection, cervical cancer, and genital warts.

How can Opportunistic Infections be prevented?

As these infections only occur in people with a weakened immune system, the most important way to prevent them would be to treat the underlying HIV infection. Highly Active Antiretroviral Treatment (HAART) is very effective at treating HIV and ensuring the virus is adequately suppressed. With a low or undetectable viral load, the body’s immune system has time to recover – and when the CD4 cells have returned to sufficient numbers, the risk of Opportunistic Infections is lowered drastically. The earlier an HIV infection is diagnosed, the earlier treatment can be started and the better the chances of avoiding Opportunistic Infections.
For patients who are diagnosed with HIV later and have low CD4 counts at diagnosis (<500), it is important to consider Opportunistic Infections prophylaxis while we are waiting for HAART to work. This means starting patients on certain medications (e.g. antibiotics, antifungals, and/or antivirals) to prevent some of these specific infections. It may take 6-12 months for the CD4 counts to recover once HAART has been initiated; once the CD4 counts are improved, these prophylactic medications may be stopped.
Other general advice for people living with HIV would include:

  • Reducing or preventing exposure to other sexually transmitted infections
  • Getting vaccinated (e.g. HPV vaccine, annual flu vaccine, pneumococcal vaccine, etc.)
  • Avoiding undercooked or raw foods (including eggs, meat, unpasteurized milks and cheeses, etc.)
  • Avoid drinking untreated water
  • Speak to your doctor about any other changes that may need to be made at home, work, or when on vacation to reduce exposure to OI’s

Take Care!

Other Interesting Reads:

  1. An Overview of STD – From an STD Doctor
  2. The HIV Provirus DNA Test can be done 10 days post exposure.
  3. What are the Symptoms of HIV Infection and AIDS?
  4. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  5. What are the Causes of Abnormal Penile Discharge?
  6. Low HIV Risk Doesn’t Mean No HIV Risk
  7. What You Need To Know about HPV, Cervical Cancer, Pap Smear & HPV Vaccination
  8. 11 Causes of Dyspareunia (Pain During Intercourse)
  9. What is HPV Vaccination (Gardasil 9)
  10. 10 Causes of abnormal Vaginal Lumps and Bumps
  11. An Overview of Gonorrhoea
  12. Genital Warts: The Cauliflower-Like Lumps on the Genitals
  13. Syphilis Symptoms (Painless STD Sores & STD Rashes) 

 

How to Quit Smoking – Smoking Cessation in Singapore

“Tobacco is the legal product which, used in moderation and exactly as the manufacturer intended, causes harm to the consumer.” – Federation of European Cancer Societies

Smoking is bad for you. I think that fact has been scientifically proven beyond the shadow of a doubt. Even people who continue to smoke realize this. Smoking damages the lungs. In fact, it can damage the lungs permanently. This is called emphysema. Once a person develops emphysema he will have it forever even if he stops smoking. Smoking greatly increases the risk of developing strokes and heart attacks. Smoking greatly increases the risk of developing not only lung cancer but also a variety of other cancers like stomach cancer, colon cancer, pancreatic cancer and prostate cancer.
Smoking not only harms the smoker. It has also been proven beyond a doubt that second-hand smoke damages health as much as actual smoking. According to the World Health Organisation every year almost 1 million people die as a result of exposure to secondhand smoke.
But to quit smoking is hard. This is due to the highly addictive nature of nicotine and also the fact that smokers get used to the ritual and social aspects of smoking. So while it is easy for non-smokers to say “Why is it so hard? It harms you and your family. It is expensive. It stinks! Why don’t you just stop?!” They, unfortunately, do not take into account the addictive nature of smoking. It is also difficult for non-smokers to empathize with smokers partly contributed by our health authorities’ extremely effective campaign to denormalize smoking in Singapore.
Also Read: Why Can’t Singapore Just Ban Cigarettes?
Also Read: Tobacco Past & Present

 

How to Quit Smoking (Smoking Cessation)?

It is difficult to get a smoker to quit smoking. In fact, most of them do not even think about it. So when a smoker is contemplating quitting smoking or better yet, has made the decision to want to quit, it is imperative to provide them with as much support as we can. Here in Singapore, there are multiple avenues to access such support.

If you are a friend or family of someone who is trying to quit smoking, learn more about what you can do for them by downloading this easy to read e-guide published by Singapore’s Health Promotion Board.

If you are a smoker reading this and have decided you want to quit, there are many ways you can reach out for support.

1) Join the I Quit Program

I Quit is Singapore’s National Smoking Cessation Program. It provides support for smokers who have the intention to quit smoking. There are many ways to sign up for the I Quit program. The easiest way is probably filling up an online form. I Quit is currently running a program that aims to get smokers to stop smoking in 28 days.
Smokers intending to quit have access to free counselling from trained and certified smoking cessation counsellors just by picking up the phone and calling the I Quit hotline known as Quitline. In fact, while signing up for the program, smokers can opt to have counsellors from Quitline call them instead.
Also, smokers on this program will receive daily SMS to keep them motivated to refrain from smoking. Smokers can also go online to the Health Promotion Board’s website and download self-help material like the Quit Fix Booklet and the I Quit Calendar. There is also community support that smokers intending to quit can reach out to via a Facebook Group known as the I Quit Club.
Just to add a little cherry on top of the Sundae, smokers who manage to remain smoke-free for 28 days will receive a $50 voucher from HPB. If he can remain smoke-free for 3 months, he will receive an additional $30 voucher. If he can make it to 6 months smoke-free there is yet another $20 voucher to be had.

Go down to I Quit Roadshow

Singapore’s Health Promotion Board holds regular smoking cessation roadshows. Go down to any of these road shows to see what they have to offer. You can sign up for a smoking cessation program on the spot.
Details on upcoming roadshows can be found in the I Quit Club page on Facebook.

2) Speak to a Pharmacist

Go to any retail pharmacy like Guardian or Watsons or Unity. Pharmacists are trained to provide smoking cessation counselling. They can also counsel you on the use of Nicotine Replacement Therapy. If the pharmacist feels that you require more intensive behavioural therapy or counselling or that you need to see a Doctor, they can point you in the right direction.

3) See a Doctor

See your friendly neighbourhood GP. Or visit your nearest polyclinic. Or if you are already seeing a Doctor for some other unrelated medical issues, you can always mention to him during your next follow up visit that you wish to get some help to quit smoking. Believe me, your Doctor will be thrilled and will be most eager to help you.
This is arguably the easiest way to go about it. Most Doctors are knowledgeable in smoking cessation and can counsel you on what you need. Be it accessing the national smoking cessation program known as I Quit, or referring you to a trained and certified smoking cessation counsellor or even prescribing you medicines or nicotine replacement therapy to help you quit smoking.
There are 3 so-called “pharmaceutical aids” to help you quit smoking.
The most well known is probably NRT (Nicotine Replacement Therapy). This helps smokers reduce their cravings and side effects of quitting by supplying their bodies with nicotine. It usually comes in the form of chewing gum or lozenge. They are usually taken for a duration of 2 to 3 months.
The 2 other pharmaceutical aids are tablets. One is Bupropion (Zyban) and the other is Varenicline (Champix). Both of these are tablets and can have potential side effects. They are usually taken for 3 months. They help to reduce cravings by activating certain chemicals in the brain. Please discuss with your Doctor if you can benefit from these.

The MOST important thing to remember is that these pharmaceutical aids work much better with behavioural intervention. In other words, do not just take the medicines. You still have to have a quit plan in place. You still have to keep yourself motivated. You still have to receive daily reminders and support to quit. You will still benefit from talking to a smoking cessation counsellor.

Be Strong. Take Care.


 

What are the Sign​s & Symptoms of HIV / AIDS

Human Immunodeficiency Virus (HIV) is a virus that can be spread through sexual contact, contaminated needles, blood transfusions, and other infected body fluids. It targets the immune system, specifically CD4 cells, and if left undiagnosed and untreated, can overwhelm the immune system and cause life-threatening complications.
HIV symptoms can appear at different times for different people, and some may not recall having any symptoms at all until diagnosis (which can be many years after the initial infection).

 

What are the Different Stages of HIV Infection?

HIV infection occurs in three main stages:

  1. Acute HIV Infection,
  2. Chronic HIV Infection (Clinical Latency Stage),
  3. and Late-Stage HIV or AIDS (Acquired Immunodeficiency Syndrome).

HIV symptoms may vary depending on the individual and the stage of infection, and some people may not have any HIV symptoms at all.

1) Acute HIV Infection

Within the first 2-4 weeks after initial infection, the virus replicates very quickly and HIV viral load will reach a high level. People may experience flu-like symptoms, which they may describe as ‘the worst flu ever’.
This is known as Acute Retroviral Syndrome or ARS. These acute HIV symptoms may occur in about 70-80% of people.
Acute Retroviral Syndrome ARS / HIV Symptoms may include:

  • Fever
  • Night sweats
  • Swollen glands
  • Sore throat
  • Body rash
  • Fatigue
  • Body aches
  • Headache
  • Nausea and vomiting
  • Diarrhea

Acute HIV symptoms can last between several days to several weeks, until the body can develop HIV antibodies to fight the virus. This is also the stage of the greatest infectious risk to others as the HIV viral load is very high. However, do remember that these symptoms are seen in other common conditions as well, and you shouldn’t assume you have HIV just because you experienced them.
If you are concerned about any symptoms or potential exposure, it is best to see a doctor to have them evaluated and consider HIV testing.
HIV Symptoms in a Nutshell

Different HIV tests are able to detect the infection at different times

The earliest you may be able to detect the virus is with HIV DNA/RNA PCR testing, which can be accurate from 10-12 days post-exposure. Other more common tests would be the 4th Generation HIV p24 Antigen/Antibody test, which is considered conclusive from 28 days post-exposure.
If you have had a potentially risky exposure within the last 72 hours, you can consider a course of medication called HIV Post-Exposure Prophylaxis (HIV PEP). This works to prevent the virus from replicating and taking hold in the body, and can reduce risk of transmission by more than 90%. It is only effective if started within 72 hours.

2) Chronic HIV Infection

After the early stage of acute HIV infection, the disease enters into a clinical latency stage, where the virus is developing in the body, but no symptoms are seen. During this time, the virus is still active but will replicate slowly inside the cells – it can still be transmitted to others, but the risks of transmission are lower than during the acute phase.
If you have been diagnosed with HIV and are on HIV antiretroviral treatment (HAART), the virus is often kept under control and you may experience a symptom-free period that can last decades. If the virus can be suppressed to undetectable viral load levels, we would deem the risk of transmission extremely low. This stage of HIV infection can last for 5-10 years.
If you have HIV but are not on treatment, then it will eventually progress to late stage infection, known as AIDS.

3) AIDS (Acquired Immunodeficiency Syndrome)

Late Stage HIV / AIDS (Acquired Immunodeficiency Syndrome)
If you have HIV but are not on antiretroviral treatment, it will eventually weaken your immune system and progress to AIDS, or Acquired Immunodeficiency Syndrome.
Symptoms or signs of late stage HIV / AIDS may include:

  • Rapid weight loss
  • Recurring fever
  • Profuse night sweats
  • Extreme tiredness
  • Swollen glands
  • Persistent diarrhea
  • Mouth or genital sores and ulcers
  • Fungal infections, especially oral thrush
  • Shortness of breath, lung infections (e.g. PCP)
  • Memory loss, limb weakness and other neurological disorders
  • Mucous membrane and skin rashes and lesions (patches of reddish-purplish lesions may be characteristic of Kaposi sarcoma)

Many of these signs and symptoms in AIDS are due to Opportunistic Infections (OI’s), which are organisms that usually only cause infections in people with a weak immune system. People with normal functioning immune systems will typically be able to fight these types of infections off, or suppress them so they do not manifest with significant symptoms.
Common types of OI’s include candidiasis (thrush), pneumocystis carinii pneumonia (PCP), tuberculosis (TB), and salmonella colitis infection, among many others.
In someone who is diagnosed with late-stage HIV and whose CD4 cell count is found to be very low, doctors will usually start on certain medications such as antifungals or antibiotics to prevent these OI’s; they will be kept on these medications as prophylaxis, while they are taking their regular HIV medications, until their CD4 count is high enough (indicating their immune system is strong enough to fight off these infections by itself).
Even if you experience the previously mentioned symptoms, it is impossible to confirm HIV infection unless you get tested. If you are concerned about a possible exposure, please visit our clinics for a consultation and evaluation.
Take Care!


Other Interesting Reads:

  1. Weak Erection? Erectile Dysfunction? How to Improve Erection with Pills
  2. The HIV Provirus DNA Test can be done 10 days post exposure.
  3. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  4. What are the Causes of Abnormal Penile Discharge?
  5. An Overview of STD – From an STD Doctor
  6. What You Need To Know about HPV, Cervical Cancer, Pap Smear & HPV Vaccination
  7. Anonymous HIV Testing – What You Need to Know
  8. Low HIV Risk Doesn’t Mean No HIV Risk
  9. What is HPV Vaccination (Gardasil 9)
  10. 10 Causes of abnormal Vaginal Lumps and Bumps
  11. An Overview of Gonorrhoea
  12. What is the Treatment for Cold Sores? What causes Cold Sores?
  13. Genital Warts: The Cauliflower-Like Lumps on the Genitals
  14. Syphilis Symptoms (Painless STD Sores & STD Rashes)

Psoriasis: Inflammatory Skin Condition Series

Welcome, come to our first series of what you need to know about Inflammatory Skin Disease. In this series, we will write about Psoriasis.

What is Psoriasis?

Psoriasis is an inflammatory skin disease caused by an increased rate of skin cell turnover, resulting in thick scales appearing on the skin.
The skin usually becomes inflamed leaving a red hue. The affected skin results in being dry and unsightly.
Apart from its appearance, patients might experience itch as one of the most distressing symptoms.

Do You Have Psoriasis?

This condition usually presents with a rash that looks like salmon pink patches with silvery scales. It can appear anywhere on the scalp, body, back and limbs.
The scaly patches on the scalp are usually thicker and commonly it affects the elbows, the knees and the back.
This condition can affect the nails leading to a “pitting” appearance.
Patient with severe psoriasis might experience joint pain, swelling or tenderness.

Why Does Psoriasis Happen?

Studies show that patients with this condition can run in the family and it might be started by factors such as infection, or certain medications.
Studies have also shown that the imbalance in the immune system has a correlation with psoriasis.

What you shouldn’t do that might worsen Psoriasis?

Physical and emotional stress are well known to aggravate psoriasis.

Do try to lead a healthy lifestyle like eating healthily and exercising regularly. Exercise is strongly recommended as apart from keeping healthy it helps to alleviate stress. In addition, exercising outdoors with sun exposure will benefit your condition.
Throat infections or flu may also aggravate the disease as well thus it is important to strengthen your Immune system through a good balance diet.
Some medications may provoke the appearance of psoriasis.
Patients with falls causing skin injury might trigger a flare of psoriasis.
It is also important to use the medications as prescribed by your physician. It is also recommended to keep hydrated and employ the use of emollients to prevent your skin from drying out and itching.
Most importantly, do not scratch your skin as this may worsen your condition. There are anti-itch menthol cream or medications which might alleviate from the itch.

What are the Different Treatments for Psoriasis?

1) Topical medications
Most people with this condition have mild disease and get considerable relief with topical applications. These include topical steroids, coal tar and vitamin D cream.
However, your physician will advise you on the uses of the different medication.

2) Oral medications
If your condition is not responsive to the above medications, there are third line treatment such as oral medications.
Unfortunately, these drugs may suppress your immune system and cause severe side effects.
There are also risks involved and these include damage to the liver, kidney, causing you to have reduced red blood cells or even causing harm to your foetus if you are pregnant.

Is Psoriasis a Rare Skin Disease?

No, psoriasis is not an uncommon skin disease and it is not infectious. It cannot be passed on to other patients through contact.

Is there a cure for Psoriasis?

Unfortunately, there is no cure for psoriasis. However, most patients are able to achieve a good control over their condition and able to lead normal healthy life just like everyone else.

What else?

There are multiple studies that show that psoriasis has strong associations with other diseases. Obesity, Diabetes, Liver problems and high cholesterol are some of the examples.
Thus, apart from keeping psoriasis at bay, it is also extremely important to have your routine health check. Some blood tests that might be done include a check of your sugar and cholesterol levels.

If you wish to visit us for skin related concern, please visit us at our VITILIGO, PSORIASIS & SKIN CLINIC by DTAP at Scotts Medical Cente. We accept walk-ins and appointments.

Take Care!

Syphilis Symptoms & Treatment (Painless STD Sores and Rashes)

What is syphilis?

Syphilis is a sexually transmitted infection (STD) with many different manifestations and potentially serious complications. It is caused by a bacteria called “Treponema pallidum”.
In the past, before the advent of antibiotics, syphilis was considered a dangerous illness with long-term, devastating consequences which could even affect the brain and nerves.
Thankfully, with the development of penicillin antibiotics and lab tests to detect syphilis infection early, modern medicine is now well equipped to diagnose, treat and cure syphilis well before complications can set in.

Syphilis – Still a Real and Relevant Infection Today

As of recent years though, there has been a rise in syphilis cases amongst both heterosexuals as well as homosexual couples, as reported by the Centers for Diseases Control (CDC), a reminder that syphilis remains a very real infection concern that any sexually active individual should be aware of.
Syphilis is transmitted by direct contact with a syphilis sore, which is a painless ulcer known as a “chancre”. These chancres can occur both in the mouth/oral cavity or in the genital region and the rectum. Sexual contact in the form or oral, vaginal or anal intercourse can all spread syphilis. If a pregnant mother has syphilis, she can also transmit it to her unborn child.

What are the symptoms and different stages of syphilis?

Reading about syphilis can be confusing because it is an infection with different stages and a multitude of varied symptoms.
But to simplify things, there are three stages of syphilis: primary, secondary and tertiary.

Primary Syphilis Symptoms

(usually begins a few weeks up to 3 months from infection)

a.) Syphilis Symptoms: Chancres
  • Painless, round ulcer
  • usually single – occurring at the site where the infection enters the body which is usually in the genital, anal or oral region
  • lasts between 3 – 8 weeks

Note that chancres will heal by themselves and disappearance of the chancre does not mean the infection is gone!

Secondary syphilis

(months or more after initial infection)

b.) Syphilis Symptoms: Rashes
  • Syphilis is known in the medical world as “the Great Mimicker” – so keep in mind that the rash it causes may look very different from what you see in photos!
  • The classic rash is a brownish rash over the palms and soles but syphilis can also cause a rash anywhere over the body
  • May range from very faint rashes to obvious reddish patches
  • Generally not itchy
  • Can occur anytime from when the initial chancre is healing to weeks after
  • May come and go
c.) Snail track ulcers
  • Raw reddish ulcers in the mouth and genital region
d.) Condylomata Lata
  • Raised, greyish patches that occur in moist regions of the body like the groin, armpits
e.) Nonspecific symptoms
  • Fever
  • Enlarged lymph nodes
  • A sore throat

Tertiary syphilis

(occurs decades after initial infection)

  • Tertiary syphilis is now fairly rare as most cases are detected and treated before they progress to this. Symptoms depend on the organs affected by syphilis

NOTES:
Someone with syphilis can also feel entirely well and not have any symptoms- this is known as latent syphilis. If the infection was acquired within the last year, it is considered early latent syphilis, but if it occurred more than a year ago, then it is considered late latent syphilis.
Syphilis can affect the eyes and nerves during any stage of infection. This can result in a variety of symptoms including vision problems, abnormal body movements and even early dementia or memory problems.

What Does a Syphilis Test Do

Who should test for syphilis and what tests are done to diagnose syphilis?

You should test for syphilis…

  • If you have had sexual contact with someone with known syphilis
  • If you have symptoms suspicious for syphilis
  • As part of your regular STD screening if you have an active sex life and have had partners whose infection status you are unsure of

Diagnosis of a syphilis infection is done through a blood test which looks for antibodies to syphilis. Syphilis blood tests can be a little complex and your doctor will be able to explain more to you about the interpretation of results and what to look out for.

What Treatment is Available for Syphilis?

Syphilis infections are treated with penicillin which is administered as an injection. The dosage or number of injections required depends on the stage of the infection.
In unfortunate cases where the infection fails to clear up with initial treatment (which is known as treatment failure), then additional antibiotics may be required for a longer duration of time.
In order to determine if treatment is successful, as well as to monitor for recurrence of the syphilis infection, regular blood tests at intervals of a few months may be required. Until one is clear of syphilis, it is best to abstain from the sexual activity so as to minimise the risk of transmitting the infection to others.
Syphilis remains a problem in the present day, but while it is a potentially serious infection, the good news is that with early diagnosis, the frightening complications that occur with untreated syphilis can very easily be prevented.

Take Care!

Other Interesting Reads:

  1. An Overview of STD – From an STD Doctor
  2. Weak Erection? Erectile Dysfunction? How to Improve Erection with Pills
  3. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  4. What are the Causes of Abnormal Penile Discharge?
  5. What are the Symptoms of HIV Infection and AIDS?
  6. What You Need To Know about HPV, Cervical Cancer, Pap Smear & HPV Vaccination
  7. 11 Causes of Dyspareunia (Pain During Intercourse)
  8. What is HPV Vaccination (Gardasil 9)
  9. 10 Causes of abnormal Vaginal Lumps and Bumps
  10. An Overview of Gonorrhoea
  11. Genital Warts: The Cauliflower-Like Lumps on the Genitals
  12. Syphilis Symptoms (Painless STD Sores & STD Rashes) 

What is the Treatment for Cold Sores? What Causes Cold Sores?

What exactly is a cold sore?
You have probably heard of cold sores or even have had one at some point in your life. But perhaps you’re not entirely sure of what it is caused by and what else you may need to be concerned about.
A cold sore is a small, painful, fluid-filled blister that most commonly occurs near the mouth or on the face, although it may infrequently appear elsewhere on the body. Cold sores tend to occur in clusters.  The appearance of a cold sore is sometimes preceded by an unusual tingling or itching sensation over the same area.
The blisters then form and eventually burst, leaving shallow ulcers/open sores which scab over, forming a crusty lesion. They may come and go, with each flare lasting up to a few weeks.

What Causes Cold Sores?


Cold sores are caused by the Herpes Simplex Virus

There are two types of Herpes Simplex Viruses (HSV) – Type 1 and Type 2.
Cold sores are caused by the Herpes Simplex Virus (Type 1), and genital sores are caused by the Herpes Simplex Virus (Type 2).

genital-herpes

Herpes Simplex Viruses (Type 1)

HSV-1 usually causes cold sores, while HSV-2 tends to be responsible for genital sores. HSV-1 is extremely common in the general population, with the World Health Organisation (WHO) estimating 3.7 billion people under the age of 50 have HSV-1 globally.
Herpes Simplex Viruses (HSV) is transmitted through body secretions.
HSV-1 can be transmitted through saliva via kissing, or sharing of utensils (oral-to-oral transmission), but oral-to-genital secretion can also occur through oral intercourse. This means that someone with cold sores can transmit HSV-1 to their partner’s genitals, resulting in genital sores. An STD Screening can screen for both herpes simplex viruses.
Individuals with HSV are most contagious when they have cold sores, but can still be infectious even when they have no sores or blisters.
Here’s a video about Herpes

Unfortunately, HSV infections are lifelong – meaning there is no cure for HSV and once infected a person carries the virus for life.
This is the reason why cold sores can flare up from time to time. There are certain triggers that can set off an outbreak of cold sores- for instance, environmental factors such as sunlight and cold temperatures, or anything which weakens your immune system, such as an illness, or medications which suppress your immunity.

cause-of-cold-sore

What is the Treatment for Cold Sores?

Antivirals can help clear up and keep cold sores away.
While there is no cure for HSV, the good news is that anti-viral medications (treatment for cold sores) are extremely effective in suppressing the virus and can be used to treat an outbreak of cold sores, and even prevent or minimise future outbreaks.
Some people may not be significantly bothered by their cold sores, which flare up only occasionally and go away by themselves. However, if you are troubled by your symptoms and worried about transmission of the virus to people around you during a flare, anti-virals such as acyclovir or valacyclovir are available as both oral tablets and topical creams.
Sometimes, just the topical cream (treatment for cold sores) may be enough to address your cold sores but if they fail to respond or if your flare is particularly bad, your doctor may prescribe a short course of tablets on top of the cream.
If you are someone who experiences frequent and painful outbreaks of cold sores, or if you are concerned about transmitting the virus to your loved ones, then suppressive anti-viral therapy may be a good option for you. This is when you take the anti-viral medication on a daily basis in order to achieve continued suppression of the virus just like HIV treatment. This not only stops flares from occurring but also reduces your infectivity and the risk of transmitting HSV to others.
Now that you know a little more about, the cause of and, the treatment for cold sores, hopefully, this has helped you realise that you do not need to live with intermittent painful outbreaks. There are treatment options available in our clinics, so if this is an issue which has been troubling you, then it’s time to make that a thing of the past.
Take Care!

Other Interesting Reads:

  1. An Overview of STD – From an STD Doctor
  2. What are the Symptoms of HIV Infection and AIDS?
  3. Weak Erection? Erectile Dysfunction? How to Improve Erection with Pills
  4. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  5. What are the Causes of Abnormal Penile Discharge?
  6. What You Need To Know about HPV, Cervical Cancer, Pap Smear & HPV Vaccination
  7. 11 Causes of Dyspareunia (Pain During Intercourse)
  8. 10 Common HIV-related Opportunistic Infections
  9. What is HPV Vaccination (Gardasil 9)
  10. 10 Causes of abnormal Vaginal Lumps and Bumps
  11. An Overview of Gonorrhoea
  12. Genital Warts: The Cauliflower-Like Lumps on the Genitals
  13. How Do I Get an Anonymous HIV Testing?
  14. Syphilis Symptoms (Painless STD Sores & STD Rashes) 

 

10 Ways to Improve Sexual Performance for Men

Sex has always been a very important thing to men and sexual performance is strongly linked to one’s manliness. However, as we age, just as other bodily functions, sexual performance may also not be as great as before.

So here are 10 ways you can do to improve sexual performance for men.

#1 Work it!

Exercise helps to boost blood circulation, improve stamina and endurance. It is also proven to improve libido and with better strength and flexibility, sex will be so much more enjoyable for both you and your partner.

#2 Smoke-out – Stop smoking

One of a way to improve sexual performance is by cutting down your cigarette. If you’re smoking, try to quit.
Smoking will impair blood circulation and may cause erectile dysfunction or weaker erections.
Smoking also reduces endurance, stamina and may affect sex drive.

#3 Be Zen

Manage your stress. With our current hectic lifestyle, constant deadlines, constantly rushing from one place to another, stress has become one of the top causes of many medical conditions.
One of the man that it can cause, a weaker erection, lower testosterone levels, drop in sex drive, fatigue. We may not be able to eliminate stress totally from our lives, but we need to learn how to manage them positively.
Find time for your hobbies, for socialising, for personal time etc. Manage your stress before it manages you.

#4 Sober up

A glass of wine may be good for you, but drinking bottles and bottles of beer is too much. Try to cut down on alcohol consumption.
It will reduce blood flow to the penis hence causing weaker erections. It also impairs your sense of judgment so you won’t be able to be as good in bed as you’d like to be.

#5 Eat clean

One of the ways to increase sexual performance is nutrition and diet.
Healthy eating is not just about looking slim and fit. A proper diet also affects a lot of your bodily functions including sexual health.
Eating certain foods like pomegranates, salmon and avocado are good for blood circulation and libido.
You also got to admit, when you’re slim, fit and sexy, sex is definitely more enjoyable for both parties.

#6 Let’s foreplay

Sexual performance is not just about the deed.
For most men, that may be the case, but for women, the foreplay is as important if not, more than the penetration.
It sets them up to work towards achieving orgasms and ultimately climaxing towards sexual euphoria.
This is what bring you closer to Sex God status.

# 7 Have a cuppa

A recent study by the University of Texas showed that men who drink 2-3 cups of Coffee a day are less likely to complain of erectile issues.
Caffeine has properties similar to Erectile Dysfunction drugs like Viagra, says study coauthor Run Wang, M.D.
The stimulant triggers a series of effects that cause the arteries in your penis to relax and your blood flow to increase, both are important for a strong erection (and improve your sexual performance).

#8 Snooze more

A good night’s sleep is so important for overall health. It is also important for sexual health.
In fact it works both ways. Lack of sleep may affect sexual performance and lack of sex may affect sleep.
A good night sleep does improve libido and sex drive while regular sex helps give you a good night sleep.
So make sure you get at least 6-8 hours of quality sleep.

#9 Practice makes perfect

One of the ways to improve sexual performance is by practising it.
Just like any sport, you will only get better with practice.
Do it regularly. Explore more ways to make your partner excited and satisfied. And enjoy it.

#10 Zap it

Recent studies have shown that applying shockwave therapy to the penis (penile rejuvenation) can improve erectile function and improve sexual performance.
Shockwave therapy uses energy from acoustic waves to trigger a process called neovascularisation. This is the formation of new blood vessels. This helps to improve blood flow to the region.
Clinical trials of shockwave therapy have had encouraging results. The process is painless and has no side effects or downtime whatsoever.
Many men have found that their erections have improved. We also found that even if you don’t have erectile dysfunction, this therapy may further enhance the hardness, girth and strength of your erection. This service is available at our Somerset branch. If you like to know more about this drop us an email at hello@dtapclinic.com.sg

That’s All Folks!


Also, Read:

  1. Weak Erection? Erectile Dysfunction? How to Improve Erection with Pills
  2. Things to do to maintain your penis health
  3. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  4. Does Penis Size Matters?
  5. What are the Causes of Abnormal Penile Discharge?

Why Do I Have Abnormal Vaginal Discharge?

Let’s talk a little about normal vaginal discharge first.

The vagina is a muscular passage which leads from the vaginal opening to the cervix, which is the entrance to the womb. There are naturally occurring “good” lactobacillus and other bacteria which are part of the normal vaginal flora. The walls of the vagina have glands which produce secretions for the cleansing of the vaginal canal. Normal vaginal discharge is a result of these secretions. It is usually clear or whitish and largely odourless and may change slightly throughout your menstrual cycle.
 

via GIPHY
 

How to identify abnormal vaginal discharge and what you should be worried about?

However, when you notice a major change from your usual vaginal discharge, this abnormal vaginal discharge may indicate that something is wrong.
Signs that your vaginal discharge may be abnormal include different coloured discharge – greenish, yellowish, greyish or even brownish discharge, the presence of a bad vaginal odour, changes in discharge consistency such as thicker, clumpy discharge or large amounts of watery discharge.
If this discharge is accompanied by abdominal pain, fever, or spotting/bleeding after sexual intercourse or bleeding when your period is not due yet, then these are all alarming features that should Fprompt you to consult a doctor.
Abnormal vaginal discharge is one of the most common female health problems and it should not be something you feel you have to suffer in silence about. Most ladies will experience this at some point in their life and while it can be an extremely distressing and uncomfortable problem, it is very treatable.
 
 

You probably have a vaginal infection.

The top cause of abnormal vaginal discharge is a vaginal infection, also known as vaginitis. Other rare causes of abnormal vaginal discharge include cervical abnormalities such as cervical cancer.
The next question, then, would be what sort of infections you have to worry about if you are experiencing abnormal vaginal discharge. These can broadly be divided into Sexually Transmitted Infections (STIs) and non-Sexually Transmitted Infections (STIs).
The most common causes of abnormal vaginal discharge are non-sexually transmitted infections- Bacterial Vaginosis and yeast infections. These all occur when there is disruption to the delicate balance of your healthy vaginal flora and can be triggered by a multitude of factors.
However, if you have had unprotected sexual intercourse, particularly if you are unsure of your partner’s infection status (whether this be a casual partner or a long-term partner), then your abnormal vaginal discharge may very well be due to a Sexually Transmitted Disease (STD) such as Chlamydia, Gonorrhoea, Trichomonas, and various types of Mycoplasma and Ureaplasma bacteria.
Regardless of the underlying cause of your abnormal vaginal discharge, proper evaluation is crucial as it allows you to receive the appropriate treatment, which is important not just in relieving your discomfort but also in preventing more serious, long-term complications (like Pelvic Inflammatory Disease) that can occur with certain infections.
 
 

Why does the abnormal vaginal discharge keep coming back?

This is a very common question and recurrent abnormal vaginal discharge can be an extremely frustrating and distressing issue.
Recurrent yeast infections and bacterial vaginosis tend to be responsible for the above phenomenon and can be triggered by a variety of factors which upset the balance of your vaginal flora.
 

1) Hormonal Fluctuations

  • For some ladies, they may find that the hormonal fluctuations during their peri-menstrual period (before or after menses), may cause them to be prone to recurrent yeast infections.
  • Pregnancy

 

2) Weakened Immune System

  • If you have diabetes or are undergoing any other sort of medical treatment that affects your immunity, you may be more prone to recurrent yeast infections.

 

3) Sexual Lifestyle

  • Sexual intercourse can trigger off bacterial vaginosis – in fact, the number of sexual partners which one has had is actually a risk factor for bacterial vaginosis, with every new partner that a lady has increased the risk of Bacterial Vaginosis infections.
  • Other habits like using spermicide may also kill off the good lactobacilli in the vagina and lead to increased susceptibility to infection

 

4) Medications

  • Being on the combined oral contraceptive pill does increase your risk of recurrent yeast infections
  • Antibiotic usage (for instance, taking something for a bacterial throat infection) can also (ironically) upset the delicate balance down there

 

5) Hygiene Habits

  • Use of vaginal douche washes or feminine washes with harsh chemicals can disrupt your natural vaginal balance and lead to increased yeast and BV infections
  • Tight underwear, pantyliners or menstrual pads which trap humidity and moisture may also place you at increased risk for a yeast infection

 
As can be seen, not all triggers may be entirely avoidable but good habits- like avoiding feminine douche washes, wearing breathable cotton underwear, minimising antibiotic use unless medically indicated, and using condoms- do play a part in helping you maintain a healthy vagina.
If you keep having abnormal vaginal discharge that comes back with a vengeance after the initial episode, do speak to your doctor about additional treatment that may be suitable for you.
 
Remember that you are not alone – abnormal vaginal discharge is common – and treatable!
Don’t let your discomfort about the topic keep you from treatment.
 
Take Care!

Other Interesting Reads:

    1. What You Need To Know about HPV, Cervical Cancer, Pap Smear & HPV Vaccination
    2. 11 Causes of Dyspareunia (Pain During Intercourse)
    3. How Do I Get an Anonymous HIV Testing?
    4. What is HPV Vaccination (Gardasil 9)
    5. 10 Causes of abnormal Vaginal Lumps and Bumps
    6. An Overview of Gonorrhoea
    7. What is the Treatment for Cold Sores? What causes Cold Sores?

 
 

An overview of STD’s from an STD Doctor

Sexually transmitted infections or diseases (STI’s/STD’s) are infections which are commonly spread through sexual contact, including vaginal, anal, and oral sex.

Some can even be spread just through direct skin-to-skin contact!

No one really talks about it, but sexually transmitted infections are very common, especially among young people – or rather, anyone who is sexually active is at risk!

Common Sexually Transmitted Diseases (STDs)

Chlamydia, Gonorrhea, Herpes Simplex Virus (HSV) and Human Papilloma Virus (HPV) are some of the most common STI’s we encounter in the clinic.
Syphilis and HIV are less commonly seen, but of course, pose a risk of serious and even potentially life-threatening complications if left undiagnosed or untreated.

Here are just some of the signs and symptoms that may appear if you have a sexually transmitted infection:

Chlamydia and Gonorrhea

Did you know that up to 8% of sexually active females between the age of 16-40 will be carrying a chlamydia infection at any one time, and most will not have any symptoms at all!

Herpes Simplex Virus (HSV)

  • Fever and flu-like symptoms before the outbreak
  • Tingling, itching, or burning sensation where the blisters would appear
  • Swollen lymph nodes
  • Cold Sores
  • Crops of painful blisters/ulcers – these can vary in appearance and severity, and can be transmitted to any site of the body depending on exposure (e.g. mouth, hands, buttocks, eyes!)

It is estimated that 1 in 5 people in the US have genital herpes!

There is no way to fully eradicate the herpes virus once it has been contracted – it usually causes recurrent outbreaks of blisters, and can be transmitted even without visible ulcers.

Human Papilloma Virus (HPV)

  • Certain types of HPV can cause genital warts – may appear as a small bump, or cluster of bumps, flat lesions, or ‘cauliflower-like’ protrusions with a small stem; sometimes these may be itchy or bleed if scratched
  • Most types of HPV are actually asymptomatic (no signs or symptoms), but can instead increase the risk of oral and genital cancers – these can be detected on screening (especially recommended for women > 30 years old, to be done together with a pap smear)

The newest HPV vaccine is now available, and will protect against 9 strains of the virus!

The US FDA has also recently extended the recommended coverage to males and females from ages 9 to 45 years old.

Syphilis

Known as ‘The Great Pretender’ as symptoms can mimic other conditions, and can vary greatly between individuals and depending on the stage of infection

  • Primary stage: usually presents with a solitary ulcer known as a chancre at site of initial infection, which is often painless and can be easily missed; may have associated swelling of lymph nodes as well
  • Secondary stage: can happen weeks after primary chancre has appeared and even healed, and presents with skin rashes and/or lesions over mucous membranes – the STD rash can occur on any part of the body, but typically also appears with reddish-brown spots over the palms and soles of feet
  • Tertiary stage: can occur many years (even decades) after infection was first acquired, and can affect multiple organ systems including the brain, nerves, heart, eyes, blood vessels, bones and joints

Learn More about Syphilis Symptoms (Painless Sore & Rashes) 

Frequently Asked Questions (FAQs)

When should I see a doctor?

If you have any worrying symptoms or exposure risk, see a doctor immediately. However, it is important to remember that many people may not have any noticeable symptoms for any of these infections, or that symptoms may take a long time to develop (weeks to months), thereby increasing the risk of complications and also the risk of transmission to others. As such, it is recommended to perform regular STI screening at least once or twice a year for anyone who is sexually active even if there are no obvious symptoms. STD Testing may be done more frequently if there has been any potentially risky exposure. Risky exposures would include sex with someone who has had multiple sex partners, sex with commercial sex workers (CSW), or unprotected sex with a person of unknown status.

What is the ‘window period’ for testing?

The window period refers to the time period following exposure where it may be still too early to detect infection with full accuracy. Different infections will have different window periods for detection. For bacterial infections such as chlamydia and gonorrhoea, this period is fairly short, and most cases can be accurately detected 1-2 weeks post-exposure. However, for blood tests (e.g. HIV, syphilis) we usually recommend at least one-month post-exposure for accurate results. For concerns on specific infections, it is best to speak to the doctor who can advise you most clearly in person.

What will happen when I see the doctor?

Screening is a simple procedure and will include a thorough consultation with a doctor, physical examination if necessary, and either blood and/or urine or swab tests. You will need to find a doctor you can be comfortable speaking with about your risk and symptoms, as it will guide us to determine the most appropriate tests for you.

How soon can I get my results?

Most tests that we send to the lab will have a turnaround time of 3-5 working days. We also have Rapid STD Testing available in all our clinics for the “Big Four”: HIV and syphilis (results in 20 minutes), and chlamydia and gonorrhoea (next day results).
Earlier diagnosis means earlier and more effective treatment, reducing the risk of late-stage complications and also minimizing the risk of further transmission. 

Learn More: What are the symptoms of HIV and AIDS?

Will my medical information be revealed to anyone else?

Your medical information is strictly private and confidential, and will not be shared with any other individual or organization. Only HIV infection is notifiable by law in Singapore – this means that if you did a lab-based HIV test and it came back positive for HIV, this result would have to be notified to the Ministry of Health.

However, our Robertson Walk Branch has been mandated to perform rapid HIV testing anonymously – this means that no matter the result, it will not be notified to the Ministry of Health. The Robertson Walk clinic is the only DTAP branch that can do HIV testing anonymously.

Can these infections be cured?

Many of these infections are treatable and can be fully cured/eradicated. Certain infections require longer courses of treatment and/or clearance testing to ensure they are cleared.
However, there are a few infections which can be treated with medications but may not be fully curable, such as herpes, hepatitis B, and HIV. Your doctor will advise you in more detail should your tests show any abnormal results. (see HIV Treatment)

If you or your partner are experiencing any possible signs or symptoms of infection, or have had any potential risk exposures, please see a doctor today.

Take Care. Be Safe!


Other Interesting Reads:

  1. What You Need To Know About HPV, Cervical Cancer, Pap Smear & HPV Vaccination
  2. World AIDS Day (2018) #KnowYourStatus
  3. Weak Erection? Erectile Dysfunction? How to Improve Erection with Pills
  4. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  5. What are the Causes of Abnormal Penile Discharge?
  6. 4 Things You Need to Know About Penile Health
  7. Sexual Health Advice For Travellers 
  8. Mycoplasma Genitalium Testing & Treatment
  9. What are the Symptoms of HIV Infection and AIDS?
  10. Things You Need to Know about Travelling & HIV PrEP
  11. 11 Causes of Dyspareunia (Pain During Intercourse)
  12. What is HPV Vaccination (Gardasil 9)
  13. 10 Causes of abnormal Vaginal Lumps and Bumps
  14. An Overview of Gonorrhoea
  15. What is the Treatment for Cold Sores? What Causes Cold Sores?
  16. Herpes: Everything You Need to Know!

We provide a discreet, comfortable and private environment for you to discuss your STD/HIV related medical matters.