Itchy Symptoms After Sexual Encounter: Is It an STD?

Is it a sexually transmitted infection (STI)?

Hello Dr.
Lee: My penis has been itching at the base since the day after I had protected sexual intercourse with a stranger.
The itching is more pronounced when I walk and less severe when sitting.
When I examine the itchy area, it appears slightly red, but there is no pain, only itching.
I have visited the dermatology department at Taichung Veterans General Hospital twice, and the doctors said that my skin looks normal and they could not determine the cause (the doctors also confirmed it is not pubic lice, and I have not noticed any parasites).
I initially thought it was pubic lice, and shaving the hair did provide some relief, but the itching returned once the hair grew back.
This symptom has persisted for nearly five months, and I have not scratched it.

1.
Based on the symptoms described, what could be the possible cause?
2.
Is it possible that this could be a symptom of syphilis or another sexually transmitted infection?

Xiao Zhang, 10~19 year old female. Ask Date: 2008/04/17

Dr. Li Yilun reply Urology

Sexually transmitted infections (STIs) are commonly referred to as sexually transmitted diseases (STDs).
Your symptoms, primarily characterized by itching or redness of the skin, do not resemble those of warts or gonorrhea.
While syphilis and gonorrhea can sometimes present with skin symptoms, they typically do not manifest the day after sexual intercourse.
Therefore, a diagnosis cannot be made based solely on the described symptoms.
It is recommended to visit a healthcare facility for screening for syphilis and AIDS.
Engaging in sexual activities with strangers increases the risk of contracting infections, so please take care of yourself.

Reply Date: 2008/04/17

More Info

It sounds like you are experiencing a concerning situation following a sexual encounter, and it's understandable to feel anxious about potential sexually transmitted infections (STIs) or other health issues. Based on your description, you have been experiencing itching at the base of your penis, which has persisted for nearly five months. You have also consulted with dermatologists who found no visible signs of infection or infestation.

1. Possible Causes of Itching: The symptoms you describe could be due to several factors. Common causes of itching in the genital area include:
- Irritation: This can occur from friction during sexual activity, especially if there is a lack of lubrication or if the condom used was not suitable for your skin.

- Allergic Reactions: Sometimes, personal care products, lubricants, or even latex from condoms can cause allergic reactions leading to itching.

- Fungal Infections: Conditions like jock itch (tinea cruris) can cause itching and redness in the groin area. This is more common in warm, moist environments.

- Bacterial Infections: Certain bacterial infections can also lead to itching and discomfort.

- Dermatological Conditions: Skin conditions such as eczema or psoriasis can manifest in the genital area and cause itching.

2. STI Considerations: While some STIs can cause itching, the absence of other symptoms (such as discharge, pain during urination, or sores) makes it less likely that your symptoms are due to an STI like syphilis or gonorrhea. However, some STIs can be asymptomatic, especially in the early stages. For example, chlamydia and herpes can sometimes present with mild symptoms or none at all.

- Syphilis: Typically presents with sores or rashes, but early stages can be asymptomatic.

- Gonorrhea: Often presents with discharge and painful urination.

- Chlamydia: Can be asymptomatic but may cause discomfort or discharge.

Given that you have already consulted with dermatologists and they found no signs of infection, it may be beneficial to see a urologist or an infectious disease specialist for further evaluation. They can conduct specific tests for STIs, including blood tests and swabs, to rule out any infections that may not have been detected previously.

Recommendations:
- Follow-Up Testing: Since you are experiencing persistent symptoms, it is advisable to undergo STI testing, even if you do not have typical symptoms. Testing can provide peace of mind and help identify any underlying issues.

- Avoid Irritants: In the meantime, avoid any potential irritants, such as scented soaps or lotions in the genital area, and consider using hypoallergenic products.

- Monitor Symptoms: Keep track of any changes in your symptoms, including the appearance of new symptoms or changes in the itching.

In conclusion, while your symptoms may not immediately suggest an STI, it is essential to rule out any infections through proper testing. Persistent itching should not be ignored, and further medical evaluation is warranted to determine the underlying cause and appropriate treatment. Remember, early detection and treatment of STIs can significantly improve outcomes and reduce the risk of complications.

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