Not all hand rashes are eczema. Some sexually transmitted diseases (STDs) can present on the hands. What should I do? Can I wash it away? Can I touch my face? Can I even shake another person's hand?
By understanding the potential STDs that can occur on the hands and the mode of transmission, hopefully, we can mitigate the risk of contracting hand STDs. In the unfortunate event of acquiring hand STDs, medical treatment should be sought without further delay.
What STDs can occur on the hand?
Herpes Infection (Herpetic Whitlow)
What is it?: when herpes simplex virus occurs on the finger, it is termed Herpetic Whitlow. It presents with an acute painful blister (water-bubbled) swelling, commonly with associated pus discharge. Both type 1 and type 2 of herpes simplex virus can cause herpetic whitlow. One may have associated fever, feeling under the weather, and present with painful lymph node glands over the affected site.
How can I get it?: this is commonly due to inoculation (transfer) of the active herpes virus from the mouth or genital region to the hand or finger via direct contact. The infection may be acquired from one's own self and/or partner's active herpes rash.
What can I do?: a course of antiviral medication, when given promptly, can alleviate symptoms and reduce the risk of further spreading of the virus to other sites of the affected person or sexual partner(s).
Should I be worried?: herpes viral infection is lifelong, and recurrence may occur. Speak to your doctor, as there is effective medication to manage the symptoms and address your concerns.
Those painful blisters on your hands and fingers could be herpetic whitlow.
Scabies
What is it?:scabies is a highly contagious mite disease due to infestation of Sarcoptes scabiei or Sarcoptes hominis mites. Scabies condition is commonly seen in overcrowded places, in those with poor sanitary hygiene and lower socioeconomic status, and in those who have a weak immune system. One can present with intense, itchy rashes that mimic eczema or fungus infection over the fingers and web spaces of the hands. Commonly, similar high-intensity itchy rashes can be spotted over the genital region. Occasionally, 'moving mites' or 'burrows of the mites' can be seen.
How can I get it?: scabies can be transmissible through prolonged close body contact; this includes during sexual contact with your sexual partner(s).
What can I do?: scabies can be treated with anti-mite lotion and cream. In more severe cases, one may receive oral medication from your doctor. The importance of successful treatment is to ensure all sexual partner(s) and all close contact family members are treated simultaneously. Home bedding/linen/clothing must be changed, washed at high temperatures, and bagged appropriately until the mites are eradicated.
Should I be worried?: scabies are treatable; however, the condition is highly infectious, and treatment can be a nuisance and time-consuming. Some patients may experience persistent itch after treatment of scabies. This is not an infectious state, but the symptoms can linger for weeks and eventually subside with time and symptomatic medications.
If you have a weak immune system, you could develop scabies more easily than others
Warts
What is it?:warts are due to HPV (human papillomavirus) infection. Warts are a viral infection that can affect anyone. Warts typically present as thick whitish patches/plaques on the skin surface that do not go away despite picking, poking or applying home remedies/creams. They can be itchy and sometimes bleed when you attempt to pick on them. Although hand warts may not necessarily be sexually transmitted, having sex with a person with HPV infection predisposes you to develop STD-related warts, and that, unfortunately, can occur on the hands as well.
How can I get it?: warts can be spread via contact, which includes sexual contact and can also be due to autoinoculation (an untreated wart elsewhere on the body and transferred to another surface such as the hands).
What can I do?: thankfully, this is treatable medically. Options, including topical cream, cryotherapy, and electrocautery, are effective in managing warts. HPV high-covalent vaccination has a positive protective role.
Should I be worried?: warts can come back. To make things worse, some people may have a latent period (meaning they have no symptoms) for months to years before developing warty symptoms. Again, HPV vaccination plays a role in preventing and managing latent HPV infections.
Warts can be very itchy.
Molluscum contagiosum
What is it?: molluscums are small, discrete, round, pimple-like raised lesions. Interestingly, the key characteristic of the condition is the presence of a signature 'indentation' on the lesion – medically termed 'umbilication'. Molluscum is due to a pox virus infection. Molluscum can be seen in babies or children and usually runs a limiting course. In adults, visible molluscum lesions can be due to an underlying immunocompromised state or associated with STDs. It can be itchy and spreads easily upon scratching.
How can I get it?: molluscum is usually passed on through direct contact. In adults, this occurs during sexual intercourse and injection of the virus onto the skin surface.
Should I be worried?: molluscum is infectious, though there is a possibility of spontaneous resolution of the viral infection; as long as it is present on the skin surface, there is always a chance of molluscum spreading to other parts of the body. It can be unsightly if seen on the hands, face, and eyelids!
Round lesions that resemble pimples may be molluscum contagiosum.
Syphilis
What is it?:syphilis is coined the 'great mimicry' as it can be commonly mistaken for various dermatological conditions, including eczema. Syphilis is sexually transmitted by Treponema pallidum. The presentation of syphilis ranges from subtle or no symptoms to rashes (including hand rash) on the body, ulcers (known as a chancre) over the genital/oral region, and cardiovascular and neurological symptoms. On the hands/palms, one can present with flaky (papulosquamous) palm rashes commonly confused with hand eczema.
How can I get it?: syphilis is transmitted through an infected sexual partner. Any form of sex, including oral, vaginal, and anal sexual intercourse, can potentially spread syphilis. Syphilis can also be passed on from untreated mother to foetus during pregnancy. Syphilis can also be transmitted through needle-sharing in drug users.
What can I do: syphilis can be treated. Treatment usually requires penicillin injections; a second-line option involving oral antibiotics may be offered in patients allergic to penicillin.
Should I be worried?: untreated syphilis can progress to secondary or even tertiary stage of the disease with irreversible involvement of the skin, heart valve disorders, and stroke. In an untreated pregnant mother, the disease can be passed on to the baby, leading to stillbirth and miscarriages. There is an association of syphilis infection with untreated underlying HIV disease or other sexually transmitted diseases.
You may mistake syphilis for dermatological conditions such as eczema.
The hand can be a source or medium to transfer STD
One will not acquire an STD by shaking the hand of another person with an STD. Nonetheless, fingers and hands can be mediums to transport viruses such as herpes, molluscum, and warts onto the face, eyelids, or even the eyes.
What are the symptoms on the hands that may suggest an STD infection?
If you have an unexplained itchy or painful rash in the form of a lump, swelling, or ulcer that does not resolve, you should consider seeing your doctor for a physical review. It is worth highlighting to your trusted physician your concern about STD-related infection so that your doctor has a wider net of differentials when evaluating and diagnosing your condition.
What should I do if I am worried about having an STD infection on my hands?
Please arrange a physical appointment with your doctor that you are comfortable with so that the doctor can evaluate your hand symptoms and, if needed, offer the relevant STD tests to diagnose or rule out STD infection. This is important as STD infections (including hand symptoms) do not resolve on their own and will require appropriate medical treatment for complete eradication.
If your symptoms persist, you should consider seeking medical attention.
What do I expect my doctor to do for my hand symptoms?
Your doctor will have to examine the hand presentation symptoms physically. Concurrently, during the physical review, your doctor will obtain a dermatological history and relevant social and sexual history. Your doctor may physically examine the body, including the mouth and the genital region. In the event of suspicion of underlying STDs, your doctor may offer skin tests (in the form of scrape/ swab) or even blood tests, urine tests and potentially urethral (in men) and vaginal (in female) swab tests.
Are STD hand rashes treatable?
Thankfully, most of the STD-related hand rash can be managed if appropriate medical care is given. Please do not hesitate to reach out to your physician if you have a concern about a hand symptom that may be due to an STD. It is a myth that STDs resolve on their own. Unless the right medications are offered, the STD infection may persist for months to years and risk spreading to people surrounding you.
How are STD hand rashes treated?
This will be dependent on the cause/type of STDs that lead to the symptoms on the hands. Treatment options can include oral medication (antibiotics, antivirals), topical creams, injections, or bedside procedures such as cryotherapy or electrosurgery.
Once the diagnosis is confirmed, your doctor will discuss and work with you to develop a practical medical solution to address your infection and symptoms.
Both you and your partner must seek medical attention should symptoms arise.
If the hand rash is due to an STD, can I pass it to my partner(s)?
Yes. As the name suggests, STD stands for sexually transmitted disease. If left untreated, the STD infection can be passed on to your sexual partners. It is imperative to seek medical treatment early to reduce or prevent the risk of passing STD infections to your partner(s) and avoid long-term complications (to yourself) if the STDs are left untreated.
Golden Rules to Reduce the Risk of STDs on the Hands
Practice good hand hygiene at all times, especially before and after intercourse
Know your sexual partner(s) well
Regular sexual health screening to pick up any infections early and treat them without delay
Aware of various hand symptoms that can be associated with STDs
Don’t take a chance and see your trusted doctor if needed
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Al-Mutairi N. Unusual presentations of molluscum contagiosum. J Cutan Med Surg. 2008 Nov-Dec;12(6):295-8.
Meza-Romero R, Navarrete-Dechent C, Downey C. Molluscum contagiosum: an update and review of new perspectives in etiology, diagnosis, and treatment. Clin Cosmet Investig Dermatol. 2019 May 30;12:373-381.
García-Montero P, Serrano-Pardo R, Ruiz-Rodríguez R, Sánchez-Carpintero I. Molluscum Contagiosum on the Palms: An Uncommon Location. Actas Dermosifiliogr (Engl Ed). 2019 Sep;110(7):615-617.
Al Aboud AM, Nigam PK. Wart. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK431047/
Post-Exposure Prophylaxis (PEP) is an antiretroviral medication (ART) option offer to people AFTER being possibly exposed to HIV to reduce the risk of becoming infected.
HIV infection will cause an infected person to produce antibodies as a response to fight the disease. HIV tests revolve mainly on detecting these antibodies to indicate whether HIV infection is present in the human body.
Sexually transmitted diseases (STD) or infections (STI) are serious conditions that can develop after having unprotected intercourse. At our clinic, we offer treatment for the following STDs:
Sexually Transmitted Diseases (STD), and alternatively known as sexually transmitted infections (STI) are spread via sexual contact, transmitted from a person to another through contact with body fluids such as blood, vaginal fluid or semen.
