Post-Intimacy Rash: Causes and Solutions for Men

After having unprotected intercourse with my wife, I developed a rash on my penis, and it appears to be a candidal infection of the glans and foreskin?

Hello Dr.
Tsai! I once contracted molluscum contagiosum while playing around and transmitted it to my wife.
We both received treatment, applying the ointment prescribed by the doctor daily until we were cured, and there have been no recurrences since.
We have maintained a monogamous relationship, but after our recovery, when we have unprotected intercourse, I notice that my penis develops a rash and itches.
After a day or two, when I retract the foreskin, I start to see red rashes, followed by symptoms of candidiasis.
In severe cases, it can lead to ulceration and pus discharge, and the foreskin becomes swollen and difficult to retract.
However, if I wash the affected area with clean water daily, it usually heals on its own in about a week.
My wife's genital area appears normal, with no itching or swelling.
We both clean ourselves before intercourse, yet I still experience rashes and inflammation, which is very distressing.
I have become reluctant to have sex and prefer to masturbate instead.
I consulted a urologist, but he said there were no subcutaneous signs and advised me to return for a check-up after the inflammation occurs.
However, my work does not allow me to return immediately...
I initially suspected an allergy to my wife's secretions, but is it possible to develop an allergy after three years? Moreover, I am the only one experiencing candidiasis, while my wife shows no symptoms.
I would like to seek your help, Dr.
Tsai.
Thank you.

Xiao Yang, 30~39 year old female. Ask Date: 2022/08/06

Dr. Cai Zhuorong reply Urology

It is common for women to be asymptomatic or to have mild symptoms.
If there are any concerns, it is advisable to visit a gynecologist together with your wife.

Reply Date: 2022/08/06

More Info

Understanding post-intimacy rashes and their causes can be quite complex, especially when considering the various factors that can contribute to skin reactions in men. Based on your description, it seems you are experiencing recurrent rashes and inflammation after sexual intercourse, which can be frustrating and concerning.

Firstly, it is important to consider the possibility of contact dermatitis, which is a skin reaction that can occur due to an allergic reaction or irritation from substances that come into contact with the skin. In your case, since you mentioned that your wife does not exhibit any symptoms, it is less likely that her bodily secretions are the cause of your reactions. However, it is possible that you may have developed an allergy to something else, such as a lubricant, soap, or even the material of condoms if you were using them at any point.
Another potential cause of your symptoms could be a fungal infection, such as candidiasis (yeast infection), which is known to affect men and can lead to symptoms like itching, redness, and discharge. This is particularly relevant given your history of recurrent symptoms that resolve with cleaning and may suggest a fungal component. The fact that your wife remains asymptomatic could indicate that the infection is localized to you, which can happen if there is a disruption in the normal flora of your skin or mucous membranes.

Additionally, the history of molluscum contagiosum you mentioned could also play a role. While you have been treated and have not had a recurrence, the skin can sometimes remain sensitive or reactive even after the virus is cleared. This could lead to a predisposition to other skin issues, including dermatitis or fungal infections.

To address your concerns, here are some recommendations:
1. Hygiene Practices: Continue to maintain good hygiene before and after sexual activity. Use mild, unscented soaps and avoid any harsh chemicals or irritants.
2. Avoid Irritants: If you suspect that a product (like a lubricant or soap) could be causing irritation, try eliminating it from your routine to see if your symptoms improve.

3. Topical Treatments: Over-the-counter antifungal creams may help if you suspect a yeast infection. However, it is essential to consult with a healthcare provider for a proper diagnosis and treatment plan.

4. Consult a Dermatologist: Since your symptoms are recurrent and bothersome, it may be beneficial to see a dermatologist who can examine your skin and possibly perform allergy testing to identify any specific triggers.

5. Consider a Urologist Follow-Up: If your symptoms persist, it might be worthwhile to revisit a urologist, especially if you notice any changes in your urinary habits or if the inflammation worsens.

6. Communication with Your Partner: Since your wife is asymptomatic, it might be helpful to discuss your concerns with her and ensure that both of you are on the same page regarding hygiene practices and any potential treatments.

In conclusion, while the exact cause of your post-intimacy rash may require further investigation, considering factors such as contact dermatitis, fungal infections, and previous skin conditions can help guide your approach to treatment. It is crucial to seek professional medical advice for a tailored solution that addresses your specific symptoms and concerns.

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