Concerns About Upper Lip Changes After Recent Sexual Encounter

Upper lip inquiry?

Dear Doctor,
My last sexual encounter was on May 22.
After reading some information online, I started to worry about AIDS and learned about the window period.
I gathered a lot of information and contacted the AIDS testing center at Taipei Veterans General Hospital.
I was informed that the ELISA test requires a three-month window period.
However, due to my anxiety, I opted for a self-paid RT-PCR test, which I took on June 9, approximately 16 days after the encounter.
The test results came back negative, but I still have some concerns, possibly because I haven't been attentive to my body in the past.
Recently, I have been particularly aware of changes in my body, possibly due to psychological factors.
I noticed a small flesh-colored spot on my upper lip that is not palpable but can be seen upon close inspection.
My lips are often dry, and my throat feels dry as well, but I am unsure which specialist to see.
I first consulted a general internist who also specializes in ENT and gastroenterology.
He told me it was herpes due to my lowered immunity.

To seek further confirmation, I visited a dermatologist who said it was definitely not herpes.
After that, I went to another ENT specialist who just applied medication to my throat and nose, stating that it was not herpes either.
I saw three doctors in one day, and I am still questioning what the underlying issue is.
Could it be related to AIDS? Which specialist should I consult, or what could be the cause of my symptoms? Please help clarify my concerns!
Thanks!

we, 20~29 year old female. Ask Date: 2004/06/27

Dr. Lai Ronghao reply Urology

I think you might be experiencing "sexually transmitted infection (STI) anxiety" after a risky sexual encounter.
Many doctors have said that there is no problem, so what is there to worry about? If you are still concerned, you can follow up in three months and, in the meantime, avoid risky sexual behaviors.

Reply Date: 2004/06/27

More Info

Concerns about changes in the body after a sexual encounter, especially regarding potential HIV infection, are quite common and understandable. It’s important to address both the physical symptoms you are experiencing and the psychological impact of your concerns.

Firstly, regarding your sexual encounter on May 22 and the subsequent testing you underwent, it’s reassuring that your RT-PCR test on June 9 returned negative. This test is highly sensitive and can detect HIV earlier than standard antibody tests, which typically require a longer window period. The fact that you tested negative at 16 days post-exposure is a good sign, but it’s essential to remember that the window period for HIV testing can vary. The ELISA test, which you mentioned, is indeed most reliable at three months post-exposure, and it’s recommended to follow up with this test for conclusive results.

Now, concerning the changes in your upper lip, such as the small, flesh-colored spot and the dryness you are experiencing, it’s important to consider several factors. The symptoms you describe could be due to various causes, including:
1. Herpes Simplex Virus (HSV): While you mentioned that one doctor suggested it might be herpes, the other specialists disagreed. Oral herpes can manifest as small blisters or lesions on the lips, but it can also present as subtle changes in the skin. If you have a history of cold sores, this could be a possibility.

2. Allergic Reaction or Irritation: The dryness and changes in your lips could be due to an allergic reaction to a product you are using (like lip balm or toothpaste) or irritation from environmental factors (like dry weather).

3. Psychological Factors: Anxiety and stress can manifest physically, leading to heightened awareness of bodily changes. This can sometimes cause benign conditions to feel more concerning than they are.

4. Other Dermatological Conditions: Conditions like angular cheilitis or other skin disorders can cause changes in the lips and surrounding areas. A dermatologist would be the best specialist to evaluate these symptoms.

Given that you have already seen multiple specialists, it may be beneficial to consult with a dermatologist who can provide a focused examination of your lip changes. They can assess whether there is a dermatological issue that needs treatment or if it’s something benign.

In terms of your anxiety about HIV, it’s crucial to manage your mental health alongside your physical health. Consider speaking with a mental health professional who can help you navigate your fears and anxieties regarding your health. They can provide coping strategies and support as you await further testing and results.

In summary, while your negative HIV test is a positive indicator, it’s essential to follow up with the recommended ELISA test at three months for conclusive results. For your lip changes, a visit to a dermatologist is advisable to determine the cause and appropriate treatment. Lastly, addressing your mental health concerns is equally important, as anxiety can significantly impact your overall well-being.

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