We at Bustle love giving you tips for how to tap into your sexual potential and troubleshoot when things aren’t going your way in the bedroom. But what about finding solutions to those stressful sexual health situations that inevitably crop up when you’re getting down? Emma Kaywin, a Brooklyn-based sexual health writer and activist, is here to calm your nerves and answer your questions. No gender, sexual orientation, or question is off limits, and all questions remain anonymous. This week’s topic: sexually transmitted skin conditions you should know about.
Q: My friend says that she checks out the private parts of anyone she’s going to sleep with to make sure they don’t have any diseases. Is that something you can do to tell if someone has anything? Does it actually work? And which STDs can you see — all of them, or are some invisible? I'm also nervous about all the STDs you can catch just from skin-to-skin contact, even if you use a condom.
A: This is a bit of a complex question. There are a number of sexually transmitted diseases (STDs) out there, and only some of them are actually visible on the body. And of these, most aren’t visible all the time. So the short answer is no, you can’t look at someone to know if they have a STD. However, some STDs do present on the skin. Let’s learn about the main ones, because it’s important to know what they look like in case you are confronted with one of these diseases (whether on your partner or on your own body) as well as to know what’s actually like to live with them — because (spoiler alert) it’s really not the end of the world.
1. Herpes
Of the STDs that you can see with your naked eyes on your partner’s naked body, none comes with more stigma than herpes simplex, or HSV. Most of the stigma comes with the fact that once you have this virus in your system, you can’t get rid of it. But at its core, herpes is a manageable skin condition that affects your nerves. The virus is in the same family as the chicken pox, shingles, and mononucleosis (mono). Not so scary now, right?
How Can You Tell If Someone Has It?
Herpes blisters look like this. They can show up in two general areas — HSV-1 is most likely to present around your mouth, and HSV-2 around your genitals. But you can actually get herpes sores on a bunch of places on your body, including your lips, tongue, gums, labia (vaginal lips), cervix, penis, scrotum, urethra (pee hole), anal opening, thighs, butt, and even your fingers, eyes, and brain.
If you see a blister on someone’s mouth or netherparts, that’s a good indication that they have herpes. But that’s not the whole story — because not everyone who has HSV knows it. These asymptomatic people can still transmit the virus — basically, the research has found that if you get symptoms, you can pass along the virus 20 percent of days, but if you don’t know you have it because you’ve never had any symptoms, you can still pass it along 10 percent of days. So basically, just because you don’t see it doesn’t mean it’s not there.
What’s It Like To Have?
If you have the HSV virus inside you, you won’t experience symptoms most of the time. When you do, you’ll get a bunch of tiny, fluid-filled blisters, which can be accompanied by flu-like symptoms such as achy muscles, headache, and fever. After a couple of days, these blisters will burst, leaving behind painful ulcers that take up to three weeks to heal, but your skin can take over a month to stop hurting.
The good news is that the first outbreak is generally the worst in terms of both pain and frequency, and will occur in most people anywhere from three days to two weeks after when you got exposed. You can tell you’re about to get an outbreak because you’ll feel tingling, burning, itching, or painful feelings in the affected areas. Between outbreaks, you’ll feel like every other human in the world.
How Can You Protect Yourself From Getting It?
Herpes is transmitted through skin-to-skin contact. That means the only way to definitely not get HSV is to not let your parts touch the parts of someone who has it. Since that’s not how most adults live their lives (and as we’ve learned, you can get it from someone who doesn’t even know they have it), we’re in luck that there are some things people with HSV can do to minimize the risk of transmission (note that I didn’t say 100 percent prevent). These include: using condoms, having your partner take medication that suppresses symptoms, and not having sex when your partner is having an outbreak.
2. Human Papillomavirus
Human Papillomavirus is also called HPV, or genital warts (which, as we’ll learn, is only part of the story). There are more than 200 different strains of HPV, the vast majority of which are not sexually transmitted and therefore have no place in this conversation. But around 40 strains can be shared through knocking boots, and that’s because they live in your genital and anal regions. Of these, some cause genital warts and others can lead to cancer.
How Can You Tell If Someone Has It?
The strains of HPV that cause genital warts and those that can end up being cancerous are different. If you encounter someone who has one of the wart strains, and they’re having an outbreak, they will have small fleshy bumps in their special parts that look like this and are often referred to as “cauliflower-like”. Your previously favorite vegetable. But if your sexual partner has a strain that can cause cancer, you won’t be able to see it.
And it gets more complicated. If you have female reproductive organs, you’re tested routinely for HPV during your pap smear, so if you have HPV, you’ll know about it. But what about if you don’t have those parts? Research has found that if you have a vagina and you test positive for HPV, your sexual partner has around a 70 percent chance of also having it. But there’s no approved routine HPV test for humans with male reproductive organs. So if you’re sporting a penis and want to know if it’s infected, or you practice anal sex and are worried that you may have HPV in there (which can happen), talk to your doctor. For everyone worried about maybe having HPV in your butt, ask for an anal pap. Which exists.
What’s It Like To Have?
If you are exposed to a wart strain of HPV, you can develop symptoms in the form of warts. While these warts don’t hurt, they can get itchy or even bleed if they’re irritated. Unfortunately, I can’t tell you how long an outbreak will last, and that’s because it really differs from person to person. You can get warts easily removed when they pop up. Most of the time you can use a topical medication, but you can also get them frozen or burned off by your doctor (just like any other wart). If you get them removed, the symptoms usually go away anywhere from one to nine months — which, let’s face it, is a ridiculously long range to be working with.
Luckily, the frequency of the wart outbreaks diminish over time. And even more good news is that in a majority of cases, your body will clear the HPV infection all on its own. In fact, the average life of an HPV infection is between four and 20 months, and most people get rid of it within two years. So basically, just because you test positive for HPV or get warts doesn’t mean you’ll have it forever.
How Can You Protect Yourself From Getting It?
The bad news is that HPV is pretty easy to contract. That’s because it’s transmitted through skin-to-skin contact and sexual bodily fluids. So basically, you can get it through unprotected vaginal, anal, and oral sex (and sharing sex toys), but also just through touching the infected area of someone who has it.
There are two ways to protect yourself against HPV. You can lessen your risk by using condoms, and you can also ask your doctor about Gardasil, the HPV vaccine. This three-shot vaccine protects against only the highest-risk strains for both cancer and warts, so you could still get HPV after you’ve been vaccinated — but it won’t be with the most intense strains.
3. Crabs, aka Pubic Lice
No, these aren’t actually crabs, in the "under the sea” sense. They are tiny insects that like to live in your pubic hair, although they can actually live in any part of your body that has hair. And they survive off of your blood. Yikes!
How Can You Tell If Someone Has Them?
Pubic lice are small (about the size of the head of a pin), but they’re not too small to see. Here are some photos if you want to know what they look like. You can also see the white egg sacs, called nits — getting any memories from lice epidemics in kindergarten? Same thing, only on your pubes.
What’s It Like To Have Them?
If you get crabs, you probably won’t notice for the first five or so days, while they’re settling in. Then, if you get symptoms, you’ll get itching and burning down there, which is usually worse at night. You can also get a mild fever and feel irritable.
Luckily, this pest is easy to treat. You can get over-the-counter pubic lice treatment, and if that doesn’t work, your doctor can prescribe you the stronger stuff. It’s important to know that shaving doesn’t solve the problem (because the lice can just relocate to other areas of your body), so seriously — get the medication. You have to also wash all your bedding, clothing, anything that could have gotten exposed to the lice. It’s also important that you and your partner (if you’re both infected) get treated at the same time so you don’t just pass these little dudes back and forth.
How Can You Protect Yourself From Getting It?
Crabs can migrate between hosts (that’s us) extremely easily during sex, when pubic areas are in contact. But they can also hop on over during other types of contact, like snuggling or sleeping next to someone. The good news is that they don’t fly or jump, so you actually need to touch someone who has them to get them yourself. The bad news is that they can be transmitted on vehicles between people such as bedding or towels.
4. Scabies
Scabies is an itchy skin disease that is caused by an itch mite. That’s right, a tiny bug. These mites are super small, just one third of a millimeter long, and have eight legs. They burrow into your skin like your worst nightmare and it’s this burrowing that makes you itch.
How Can You Tell If Someone Has Them
Scabies mites are too small to see without a magnifying glass or microscope, so you won’t be able to see the actual mites to diagnose yourself or someone else. But you will be able to see the skin rash that they cause — it’s characterized by small red bumps and blisters (often described as looking like pimples, click here to see) with thin lines that can be red, brown, or gray. This rash shows up in the webbing between your fingers, your wrists, the back of your elbows and knees, around your waist and nipples, around your feet, and around your genitals and butt. Just a few mites can cause a big rash, with only around 15 mites being the culprit of a rash that has hundreds of bumps.
What’s It Like To Have Them?
If you have scabies, you’ll be itchy. I mean super itchy, relentlessly itchy, itchy for days. And you’ll have a pimple-y rash.
If this is happening to you, don’t worry. There are drugs. You can take them orally or put them on topically, and they’ll fix you right on up.
How Can You Protect Yourself From Getting It?
Scabies mites are spread by skin-to-skin contact (they can’t jump from person to person), so you need to touch someone who has them. And it’s actually a bit hard to get — you need prolonged contact, which means not just a brush-by but a real long touch. Like with sex, which is why scabies is characterized as a STD, but also with long hugs.
5. Molluscum Contagiosum
Molluscum contagiosum sounds like a Harry Potter spell, but it's not. It's a skin disease that's caused by a virus, and it can show up anywhere where you have skin.
How Can You Tell If Someone Has It?
You can tell if someone has molluscum contagiosum because they'll have little pink waxy bumps on their skin. These bumps usually have a super small indent in the middle. They look like this like this. Usually people just get around 10 or 20 of these little bumps, but if you have a compromised immune system (such as if you are living with HIV) you can get over 100 of them.
If you think you have this virus, go talk to your doctor. She'll be able to diagnose you — often just by checking out the bumps, but in some cases she may scrape off a piece to look at under a microscope.
What’s It Like To Have?
If you have molluscum contagiosum, you may just have bumps, and no more symptoms (as if that's not enough). But sometimes the bumps can itch or feel tender.
Fortunately, the bumps can be removed by your doctor, either by using chemicals, by freezing, or by electrocution. And even better, these little dudes can go away on their own. The issue with waiting for them to leave on their own time, however, is that it can take a while — an average of two years, in fact. So if that sounds like a long time, go to the doctor to get your lumps zapped.
How Can You Protect Yourself From Getting It?
Molluscum contagiosum is, as its name would suggest, super contagious. As in, it's really easy to get. It's sometimes categorized as an STD because you can get it during sexual contact, but it's more often spread during non-sexual skin-to-skin contact. You can also get it by touching infected towels and clothing. And yes, yoga mats. Condoms can help protect you from getting it sexually, but if the condom doesn't physically cover the bumps, you can still get them. If you want to canoodle with someone who is struggling with molluscum contagiosum growths, they can also cover the areas with the sores with a bandage or clothing. While this won't 100 percent protect you, it does reduce your risk of getting it.
The Bottom Line
The harsh reality is that if you’re sexually active, or really if you touch the bodies of other people (so, like, most of us), there’s a big chance you’re gonna catch at least one of these STDs in your life. What you do with that knowledge is up to you. You can curl into a ball inside a carefully titrated bubble just your size to make 100 percent sure no germs ever touch you, ever. You can say F%$K IT, these skin conditions aren’t that bad, and have sex with whoever you want. Or, you can do anything in between. The full range is available to you, and you’re empowered to change how you deal with it throughout your life.
Regardless of how you want to live your life, remember that if someone comes across your path who has one of these STDs, they’re just like you. They didn’t do anything reckless to become infected. They just lived their lives the way they wanted and caught a very enterprising virus or bug that’s doing its absolute best to survive. So treat them kindly, because it probably wasn’t easy for them to tell you about their condition in the first place.
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Images: Reed Fish/Flickr; Giphy
