Medical & Surgical Dermatology

Sexually Transmitted Diseases (STDs)

What are sexually transmitted diseases?

Sexually transmitted diseases (STDs) or sexually transmitted infections spread from one person to another by sharing needles, or by having genital, anal, or oral sex. STDs are very common. The United States has the highest rate of STDs in the world. Two thirds of all STDs occur in teenagers and young adults under the age of 25. One out of four sexually active teenagers will get an STD before he or she turn 21. There are more than 20 different types of STDs; the most common are herpes simplex (HSV), genital warts (HPV), molluscum contagiosum, pubic lice (crabs), scabies, chlamydia, gonorrhea, syphilis, hepatitis B and C, and HIV/AIDS.

Can you tell if someone has an STD?

Since infections are often spread when the infected person has no symptoms, most of the time you cannot tell if someone has an STD. People may not be aware that they are infected and do not discuss it if they are. If you have sex even once with an infected person, you can become infected. No one is too young, too old, too rich, or too poor to get an STD.

Types of STDs

Herpes Simplex Virus (HSV)

Herpes simplex of the tongueHerpes simplex produces painful sores in the genital and/or oral areas of the body that may recur for years. The disease is spread from one person to another, and to non-genital areas through close physical contact. The virus may be transmitted during asymptomatic shedding (when the virus is passed without visible sores or symptoms). A newborn may become infected during childbirth and appropriate precautions must be taken at the time of delivery.

There are two types of herpes simplex, HSV I and HSV II. About 30% of first-time genital herpes infections are caused by HSV I, the most likely source is oral sex. HSV II is more often the culprit that causes genital herpes. Outbreaks are treated and therapy may also be given to decrease the possibility of transmission (suppression) when there are no symptoms.

Venereal Warts [Condylomata Acuminata, Human Papilloma Virus (HPV)]
HPV causes cauliflower-shaped lesions that grow in size and number and are spread by contact from one person to another. Certain HPV types, those that produce flat, dark, or skin colored bumps, may be associated as a cause of cancer of the cervix. HPV can be detected with a physical examination. A Pap smear test may be done. In pregnant women, the baby can become infected during delivery, and precautions to avoid this must be taken. Warts are treated by surgical or chemical methods. Since warts are often stubborn, multiple visits may be required.

Molluscum Contagiosum

Molluscum contagiosum produces small shiny bumps that are spread by skin-to-skin contact. They may be passed with non-sexual exposure in children. Molluscum can usually resolve within a year in healthy individuals, but they are annoying, unsightly, and may spread. There are several effective treatments including curettage (scraping), cryosurgery (freezing), and topical medications. As with all STDs, contacts and sources of the infection should be checked.

Pubic Lice (Crabs)

Pubic lice are tiny crab-like insects that infest the pubic hair and cause itching. Lice lay eggs on the hairs and the infestation continues until treated with medications to kill the lice. A hygiene program is necessary to eliminate the problem as well as to prevent re-infection. The source of the infestation must be found.


Scabies is caused by microscopic mites that burrow under the skin and cause severe itching. It is spread by close physical contact, not necessarily sexual contact, and treated with medications that kill the mites. Proper cleansing and hygiene are also necessary to eliminate the source of infestation as well as to prevent re-infection. This usually involves treatment of all individuals living in a household.


Chlamydia is an infection that can cause a whitish discharge from the vagina or penis or that can have no symptoms at all making it undetectable. Without symptoms, the infection may lead to pelvic inflammatory disease in a woman which can prevent her from having children. If a woman with chlamydia becomes pregnant, her newborn can become infected during childbirth. After a culture, chlamydia can be cured with antibiotics; therefore, early diagnosis and treatment are important.


Gonorrhea may have no symptoms or produce a discharge from the vagina or penis, or a burning sensation with urination. It can cause pelvic inflammatory disease and sterility in women. If a woman with gonorrhea becomes pregnant, her newborn can become infected during childbirth. Proper diagnosis allows for treatment with antibiotics. Partners must be treated.


Syphilis causes non-painful sores on the body, most frequently the genitals and mouth. A rash can develop if untreated. Syphilis can damage the heart, blood vessels, brain, and nervous system. A baby can become infected during pregnancy. A blood test is used to diagnose and monitor the disease. Syphilis can be cured with antibiotics and partners must be treated.

Hepatitis B and C

Both hepatitis B and C can be transmitted sexually. Hepatitis B can cause fever, achy muscles, vomiting, diarrhea, and liver damage. It is the only STD that can be prevented with a vaccine. The hallmark of Hepatitis C is a yellow discoloration of the skin called jaundice. Hepatitis C is the most common cause of chronic liver disease which may require a liver transplant. Currently, no vaccine exists to prevent Hepatitis C.


The human immunodeficiency virus cripples the immune system, which can result in long-lasting infections, diarrhea, fever, weight loss, and can be fatal. It can be transmitted to the fetus during childbirth or during breastfeeding. Treatments are available, but currently, there is no cure or vaccine to prevent it.

How do I protect myself from STDs?

The only method that works 100% of the time is to abstain from oral, anal, or genital sex, or to have one mutually monogamous lifetime partner who is not infected. Condoms can lessen the risk of infection by STDs that are spread by body fluids found in the semen, blood, or vagina, but they must be used properly. Since they cannot cover all body areas, condoms do not offer complete protection against STDs such as herpes, venereal warts, syphilis, molluscum contagiosum, pubic lice, and scabies, that are spread by touching or other non-genital skin-to-skin contact. Remember, more than one type of STD can be transmitted at a time.
Birth control pills protect against pregnancy, but do not protect against STDs. Alcohol and drugs make it harder for you to protect yourself because they can cloud your judgement.

It is not who you are, but what you do, that puts you at risk for STDs. You cannot tell by looking at a person if he or she has an STD, or if he or she does not. For further information, early diagnosis, and treatment, contact your Water’s Edge Dermatology practitioner.

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