Well, Mr. Bloomberg does not have a 311 for this one. We all know the old dermatology adage — “If it’s wet, dry it. If it’s dry, wet it. And, if you don’t want it, don’t touch it!” So it goes that abstinence is the best policy for avoiding sexually transmitted diseases. But, what if you hooked up with that person in the club last night? I offer some definitions and some need-to-know facts:
Genital warts — These are growths, caused by human papillomavirus (HPV), often on the genitals or in the area above the genitals or in the groin. HPV, when it occurs on the vaginal cervix, can cause cervical cancer (hence sexually active women are encouraged to get regular Pap smears). HPV is spread to others by direct rubbing, such as unprotected sex. You can spread one lesion to yourself by shaving — HPV is introduced into the skin by the microtrauma of the blade, causing many warts. “But I wore a condom!” you say. Well, condoms definitely prevent the spread of HPV, but a condom does not cover the base of the penis, so you are still exposed.
Herpes — this condition results in small blisters on a red base that come out in roughly the same place each time. It is caused by the herpes simplex virus (HSV) 1 or 2. They can occur on the lip (known as oral herpes, cold sores, fever blisters) or on the buttocks, vagina, or penis (known as genital herpes). Spread is most often by direct contact with an open sore — genital to genital (sex), oral to genital (going down), or oral to oral (kissing). “But I didn’t see a sore!” you say. Well, people with HSV can have asymptomatic viral shedding — no sore, but they are still contagious. The condom does prevent the spread of HSV, but like HPV, it does not cover everything. Also, sometimes the HSV lesion can be camoflouged in redundant genital skin, especially very early or very late in an outbreak, and in the dark.
Scabies — This is a condition caused by very small mites that burrow into the skin, resulting in itching. It is highly contagious by rubbing. Often there are red bumps of the fingerwebs and wrists that itch intensely.
You may ask: “How long do I have after I’ve slept with someone before I can declare myself clean?” Good question. If you didn’t have an outbreak of genital warts, herpes, or scabies by six weeks out, it’s likely you’re in the clear.
Is there a cure for these things? Can I prevent them? Will they ever go away on their own?
Indeed, these are the questions we all face when taking the risk of sex. And, I have good news and bad news.
Bad news first — herpes is the gift that keeps on giving. There is no vaccine and no way to clear it from your system permanently. But (and don’t we all like buts), valacyclovir is a medication that can be taken to shorten the outbreak once it pops up. Also, if you get many outbreaks a year, you can take valacyclovir daily to prevent the outbreak and reduce the amount of asymptomatic viral shedding to your partner.
For genital warts, there is a vaccine on the market against four of the most common types of warts. The vaccine works for men and women, and some medical groups recommend that all young boys and girls get the vaccine. There are creams to make the warts resolve, and you can see a dermatologist to cut them off. There is a chance your body will fight them off for good after some months, but they come back periodically, in some people for life.
Scabies is easily treated with permethrin cream, but all direct contacts — especially sexual partners — should be treated simultaneously.
Jacob O. Levitt M.D.,
Associate Professor and Vice Chair, Dermatology
Director, Dermatology Residency Program
Mount Sinai School of Medicine
Dermatology Faculty Practice Associates
Mount Sinai Medical Center
5 East 98th Street, 5th floor
New York, NY 10029-6189
Tel: (212) 241-9728