Is Your Rash Caused by an STD?
Sexual health is a stigmatized topic that has long been regarded as a taboo matter or something that is not often discussed in public conversations.
Although, understandably, specific bizarre imageries could prove to be unsuitable in a public setting, what is more concerning is the disregard for the importance of sexual health in resolving various aspects of a person’s holistic well-being when there is the possibility of triggering systemic infections from localized ones, progressive conditions that produce severe complications, and irreversible damage that could even risk the chance of conception later in life. Sexually transmitted diseases are ever so present in this society, and it is a must that everyone is aware of how to distinguish certain conditions from others through the simple examination of superficial symptoms – whether it is a rash, blisters, warts, or even something as severe as discharge or genital bleeding.
The manifestation of a rash is often misunderstood due to the possibility of various conditions to produce such a symptom – making it harder for other individuals, especially non-professionals, to provide an accurate understanding of how they should approach their situation. Of course, it is always advisable to consult your physician instead of resorting to self-diagnoses, but knowing whether a person has an STD or not could prevent the further transmission of the infection as soon as possible. In addition to that, having a rough idea could narrow down the options that you could take for diagnosis and rudimentary self-management while your doctor’s appointment is still a few days away.
To give you an idea of what STDs and STIs produce such manifestations, perhaps this guide would go a long way in providing a little more importance to your sexual health and preventing transmission at all costs when possible.
A rash is a symptom that is often associated with various other conditions due to the large surface area of the skin and its constant exposure to external factors. A genital rash is likewise subject to the same considerations – occurring in any part of the genitalia in both males and females and may be caused by various causes ranging from allergies and infections to autoimmune disorders. In the case of genital rash, these are often presented as reddish associated with some level of pain, itchiness, and the development of sores and bumps.
Apart from the sexually transmitted diseases and infections that have been outlined in this guide, a few other causes of genital rash could be:
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There are various ways to prevent the manifestation of a genital rash, and it ultimately depends on how the rash manifested in the first place. As previously mentioned, multiple conditions may cause a rash to display, and each one has a corresponding treatment regimen that you could follow to resolve the underlying cause instead of simply addressing the superficial symptoms.
In the case of an infection, apart from sexually transmitted ones, the best thing to do is consult your doctor for suitable antibacterial, antiviral, antifungal, or antiparasitic medications that could expel the causative microorganism from your body. In the case of an allergic reaction or an autoimmune disorder, the most common regimen is the use of either antihistamines or steroids to suppress your hyperactive immune system, but this is likewise subject to your physician’s recommendations, especially in cases where your disorder is associated with another chronic condition.
Syphilis is a systemic sexually transmitted infection caused by the microorganism known as Treponema pallidum or T. pallidum in various references. It is divided into three different stages. Each stage has its manifestations, dependent on whether the previous step was resolved entirely or left untreated by the patient. What makes Syphilis even more daunting is the risk of developing various complications that may result in irreversible damage to the genitalia – making it imperative that the condition is addressed at the soonest possible time to prevent such damage.
Reducing the risk of contracting Syphilis would mainly entail abstinence and protection as it requires sexual contact for the sores to transmit the T. pallidum cells to another individual. Suppose you are sexually active and are constantly participating in unprotected sex, especially when your partner has been recently diagnosed with Syphilis. In that case, you are highly at risk of likewise contracting the same condition.
Syphilis is often referred to as “The Great Pretender” due to the inherent ability of its symptoms to mimic the manifestations of other conditions – making it difficult to properly assess and diagnose the condition without subsequent laboratory testing and a proper examination from a physician.
Syphilis, as previously discussed, is divided into four different stages depending on the symptoms that the patient is currently manifesting. These are the primary, secondary, latent, and tertiary stages – all varying in their manifestations and the length that each stage occurs for. In the primary stage, the disease is characterized by the appearance of a single chancre which the appearance of multiple sores could then follow. These chancres are usually round, firm, and painless, but the circumstances may vary depending on the response of the infected individual. Following that, the secondary stage may proceed, which entails the formation of skin rashes and mucous membrane lesions in the mouth, vagina, or anus. These would not usually cause itching, and the rash would often appear reddish or brownish at the palms of your hands and the soles of your feet. Systemic manifestations like a fever could likewise be observed in this stage. Syphilis could also progress into a latent stage wherein it remains asymptomatic for a few months. When left untreated, it could then progress to the tertiary stage, wherein various complications now accompany the initial infection.
Neurosyphilis
Syphilis can invade nearby nervous structures throughout the infection period to produce a systemic infection within the nervous system – having sensory-related symptoms and a wide range of other manifestations that may include headache, altered behavior, loss of muscle coordination, paralysis, and dementia.
Ocular Syphilis
Much like neurosyphilis, ocular Syphilis could likewise occur in any stage. However, in this case, the microorganism targets most of the eye’s structure to cause symptoms such as vision changes, decreased visual acuity, and even permanent blindness. The most common conditions caused by ocular Syphilis are posterior uveitis and pan uveitis, but it could cause various other conditions depending on the structure that has been compromised.
Congenital Syphilis
Causing infant death in almost 40% of its cases, congenital Syphilis is a complication for pregnant women wherein the microorganism is transmitted from the mother to the baby – resulting in an increased risk of stillbirth or death immediately following delivery. Despite the lack of manifestations during birth, untreated congenital Syphilis in infants could cause fatal problems in a few weeks, including developmental problems and seizures.
Parenterally administered Benzathine Penicillin G is often used as the common antibiotic of choice for Syphilis in all its subsequent stages. However, its preparation, dosage form, dosage, and duration would all depend on the severity of the condition, the stage that the condition is currently at, and the manifestations currently present in the individual. In latent and tertiary Syphilis, the treatment would usually last for more than a year due to the difficulty in targeting slow-replicating cells, albeit its theoretical rationale has still not been thoroughly assessed by various studies.
Two types of tests are commonly used together in the conclusive diagnosis of Syphilis: treponemal and non-treponemal tests. Treponemal tests are a set of laboratory procedures including TP-PA, EIA, chemiluminescence immunoassays, immunoblots, and rapid treponemal assays used to assess the presence of treponemal antibodies in a patient initially. Treponemal antibodies appear earlier than non-treponemal ones, making it efficient to provide a pre-emptive diagnosis for an individual at risk. However, due to the existence of treponemal antibodies even after successful treatments, a non-treponemal test is required to conclude a positive treponemal test – indicating whether there is an existing infection or if the positive result is simply due to a previously resolved infection.
Genital Herpes is a sexually transmitted condition caused by the Herpes Simplex Virus, otherwise known as HSV. The causative agent of Herpes has two variations: HSV-1 and HSV-2. The infection is commonly transmitted upon contact with infected open wounds or lesions and contact with oral and genital secretions – making its transmission extremely easy and hard to notice for individuals without visible lesions or those not aware of their existing condition. HSV-1 and HSV-2 can be shed from the genitalia and skin of an infected individual whether they have visible lesions or a clear secretion, but genital transmission is only commonly associated with the HSV-2 variation. On the one hand, HSV-1 can be transmitted through oral sex with a person who has an existing HSV-1 oral infection.
According to the Centers for Disease Control and Prevention, there is an estimated 572,000 new genital herpes infections in the United States every year – highlighting the ease of transmission of the virus during sexual contact. It was also found that genital HSV-2 infections are more common in women than in men due to the increased risk of infection when the transmission is man to woman instead of woman to man through penetrative vaginal sex.
The manifestation of genital Herpes is not a rash in the strictest sense as it resembles ulcerations and blisters more than it does a rash. Most HSV infections, both HSV-1 and 2, would often go unnoticed due to the lack of apparent symptoms (asymptomatic). It may also be possible to be mistaken with another condition as its symptoms, although scarce, represent a wide array of conditions that could have similar manifestations as an HSV infection. In the case of symptomatic manifestations, the symptoms often seen are blisters that would develop around the genitals, in the rectal area, or the mouth depending on the point of contact with the ulcerations during sexual intercourse. After its incubation period of 2 to 12 days, the blisters would appear in the infected areas and then break off to produce painful ulcerations that could take two to four weeks to heal completely. This is known as herpes “outbreak” or episode by various references.
The first outbreak’s (following initial) manifestations could be different from the subsequent episodes throughout the infection. The first outbreak will be mainly associated with longer-lasting lesions and an increased viral shedding – subsequently resulting in a period of increased contagiousness and accompanying systemic symptoms such as fever, body pains, swollen lymph glands, and headaches. On the one hand, subsequent outbreaks could be recognized by prodromal symptoms that patients usually recognize days or hours before the lesions appear. These may include localized genital pain, a tingling sensation, or shooting pain in the legs, hips, or buttocks.
Genital Herpes is a sexually transmitted condition that has no specific cure. However, it can be aptly managed to non-contagious levels for each infected individual to return to their previous life and habits.
With the persistence of the infection throughout, it is apparent that one of the complications associated with contracting an HSV infection is the persistence of painful ulcers. It is also possible with both HSV-1 and HSV-2 infections to progress into a condition known as aseptic meningitis, wherein the brain's lining is inflamed. The development of extragenital lesions is likewise a possible complication in the later stages of genital herpes infections.
Currently, there is no available medication that can serve as the cure for genital Herpes. However, the infection can be effectively managed with antiviral therapy to minimize the outbreaks while the individual is taking the medication. Suppressive antiviral therapy is likewise effective in reducing the likelihood of transmission during intercourse.
HSV Nucleic Acid Amplification Tests (NAAT) are the most sensitive option in diagnosing genital Herpes. However, culture testing can likewise be employed in certain conditions, albeit with low sensitivity to low viral loads. Type-specific tests may sometimes be used if recurrent lesions and symptoms are observed, but confirmatory tests may likewise be necessary before a conclusive diagnosis is provided due to the limitations of its performance.
HIV or Human Immunodeficiency Virus is a condition wherein a virus attacks the body’s immune system – compromising it to the point where the body’s CD4 cell levels are less than capable of protecting the body from even simple pathogens. When left untreated, the disease could progress into a condition known as AIDS or Acquired Immunodeficiency Syndrome – the stage wherein various comorbidities are common and, most often than not, severe and fatal.
As of this writing, there is no known cure for HIV, but the condition can be effectively managed to reduce the viral load to undetectable levels – making it possible for the individual to partake in sexual intercourse without transmitting the pathogen.
HIV was initially found in a chimpanzee in Central Africa, but it was later passed to humans when infected animals were hunted for food, and the infected blood came into contact with the person’s systemic circulation. Similarly, the virus can likewise be transmitted through bodily fluids such as blood, semen, and genital secretions. However, contrary to the common misconception, HIV is not transmitted through saliva.
The manifestations of HIV may differ between each person, but flu-like symptoms are the most common among infected individuals within the first 2 to 4 weeks following exposure. The symptoms could persist for up to a few days and weeks, and it may include the following:
If the condition is not addressed, HIV progresses through three different stages that have their respective manifestations.
Acute Infection
The viral load is immense at this stage, and transmission is nearly guaranteed upon contact with infected bodily fluids. A flu-like manifestation may be evident as this is the body’s natural mechanism when its immune system is attacked. However, there are likewise cases wherein no indications are observed, and the condition remains asymptomatic.
Chronic Infection
In this stage, the condition undergoes “clinical latency,” wherein the disease becomes asymptomatic. However, it is essential to note that the virus remains active in this stage, but its reproduction is glacial enough not to produce any evident manifestations. The condition remains to progress without proper therapy, and by the end of this stage, the viral load will suddenly rocket as the CD4 levels drop – progressing into a condition known as AIDS.
Acquired Immunodeficiency Syndrome
Also known as the most severe phase of an HIV infection, AIDS is the stage wherein the immune system is now severely compromised to the point where various opportunistic infections are now very persistent and common. Without proper treatment, a person with a diagnosed AIDS condition has an estimated lifespan of approximately three years due to the massive viral load and an overwhelming number of subsequent infections.
There is no determined cure for HIV, but the viral load can be managed to undetectable levels using an antiretroviral therapy composed of various antiretrovirals taken for a certain period. In most cases, the viral load is contained within the first six months of medication, but the resolution of an individual’s “contagious” status can only be determined by measuring the person’s viral load.
It is also important to note that a pre-emptive routine of antiretroviral medications may be prescribed when an individual is exposed to an infected patient’s bodily fluids, such as in cases where sexual contact occurred, blood transfusion from an infected person happened, or you were pricked with a needle used in an infected individual.
The standard diagnostic process for HIV is using bodily samples such as blood or fluids and examining them through various laboratory processes depending on what is available within your country. In most cases, this is used as the diagnostic procedure to provide a conclusive assessment of a patient’s condition, albeit this is likewise subject to various factors like time passed since exposure, risk factors, and history.
Home testing kits are likewise present, but this could again be subject to inconsistencies due to the risk of contaminating the sample when handled carelessly. Consult your physician if you believe that you are at risk to be tested and treated at the soonest possible time.
According to some researchers, rapid treatment following exposure could make an infected patient “functionally cured” in about 10% of early diagnosed patients. More research, however, is still necessary to conclusively establish this hypothesis.
No. Although it is commonly misunderstood that the term “bodily fluids” encompasses saliva, it is not true that HIV can be transmitted through this process.
No. Contact with bodily fluids and sexual intercourse is the only way to transmit Herpes.
Yes. Herpes can perform viral shedding even from normal-looking genitalia – making it infectious even if there are no apparent symptoms in an infected individual.
Yes, with the use of the appropriate antibiotics.
According to various studies, Syphilis is considered contagious for up to 2 years or longer following initial exposure.
It depends on the appearance of the symptoms and how fast the disease progresses in your body. If the damage is already done, although the pathogen can be addressed, the impact on your body could no longer be reversed.
According to the Centers for Disease Control and Prevention, there were a total of 129,813 cases of Syphilis in the United States diagnosed in 2019.
Centers for Disease Control and Prevention
National Institute of Allergy and Infectious Diseases
Eunice Kennedy Shriver National Institute of Child Health and Human Development
Written by Mark Riegel, MD
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