Small bump after protected encounter

[wdr432]

Hello,

I am posting as one of the "I did something stupid and am now panicking" group, of which there seems to be many amongst the males of the species.  For mostly idiotic reasons involving alcohol and depression, I had sex with a prostitute (in a place where it is legal, not that that reduces the stupidity) - two times, both protected with a condom.  However, at least the first time, I noticed the condom had slid up (not off - head still covered) as I pulled out.

I have otherwise been in a monogamous relationship for a number of years now, and this is the only time I have (or will, I hope) done something so stupid.

This was approximately three weeks ago.  Two days ago, I noticed a single, tiny flesh-colored bump on the shaft of my penis, about 2/3 of the way up.  It is soft to the touch, and under a magnified photo (yes, I'm a little freaked out), appears almost indistinguishable from the skin around it in color.  It is raised and flat lengthwise - so essentially perpendicular to the skin.  It is probably around a mm in width.

So - I guess my question is: how likely is it that I contracted something?  Is there something else that could look like that?  (I believe in the past I have had tiny "tags" that have gone away - I have them elsewhere on my body, and I believe that I recall having them on my penis before.)  I am concerned both about myself, and obviously that I could pass something to my partner.  It is mostly the timing of it (2.5-3 weeks after the event) that has me so panicked.

Thank you very much for your help.

[Edward W Hook, MD]

Welcome to the STD Forum.  I will give you my impressions and, I hope, reassurance but before I do, I need to caution you that while I will do my best to give you the best advice possible, there is no substitute for you being examined by a knowledgeable clinician who can actually directly exam the lesion you are concerned about.

Having said that, there really are not a lot of possibilities as to what might be going on.   Certainly a skin tag is a possibility.  The other major candidate is that this might be a very early genital wart due to HPV infection. The topic of HPV and genital warts is a complex one.  I will try to provide some facts.  For addition information on this most common of STDs, I would suggest search for other HPV- and wart-related Q&A on this site, as well seeking addition information on sites such as the American Social health Association web-site (disclosure, Dr. Handsfield and I are both on the Board of ASHA).

HPV is the most commonly acquired STD.  Over 85% of sexually active women and a similar number of men (there is less data on men) will have HPV infection at some time in their lives.  In some HPV will cause genital warts, in other women (but not men) the infection will not cause warts but may lead to changes in PAP smears.  In nearly everyone who gets HPV, warts or otherwise, the infections will resolve by themselves without therapy in between 8 months and two years months.  In a very small minority of women, HPV infection can persist and lead to the pre-cancerous lesions that PAP smears detect and which can then be treated.

I would suggest you get checked out by a knowledgeable clinician, either at your local STD Clinic or by a dermatologist.  In many cases, warts and HPV can be difficult to distinguish but can be treated similarly.  Because HPV infections are so very common, the issue of partner notification and therapy is often something that we do not insist upon although, if this is a wart, your could transmit it to a partner through unprotected sex prior to therapy,

Hope these comments are helpful. this is most unlikely to be something serious.  EWH

[Edward W Hook, MD]

Your encounter of concern was condom protected, dramatically reducing your risk for gonorrhea, chlamydia or other typical STDs. If this is a wart (and we don't know that it is), that is your major concern, not other STDs.

If it is a wart, it may take a while to clear on its own and might get bigger n the interim.  treatment is with any number of topical agents.   I think it best to be evaluated.  A dermatologist could do this, as could a trip to your local STD clinic where care tends to be good, cheap and highly confidential as well.  EWH

[wdr432]

Thank you very much Dr. Hook.  A couple of other questions:

1.  Given my description of the encounter, am I at significant risk for anything else?  (From reading the other forums, I am guessing the answer is no, but thought I would ask.)

2.  You mention that if it is a wart, it most likely will clear up on its own.  Is there anything I can or should do to make sure that happens?  What are the odds it will get larger if it is a wart, instead of clearing up?  If I see a clinician, what kind should I see?

Thanks again.