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After going through the history and images provided (attachments removed to protect the patiemt's identity) from your end, it appears as balanitis, an inflammatory condition affecting the glans, penis, and foreskin. It may be due to multiple factors, including fungal and bacterial infections, eczema, psoriasis, autoimmune conditions, and idiopathic causes. They may also appear due to the use of harsh and strong chemicals, soaps, or shampoos to clean sensitive and private areas due to hygiene issues or other underlying medical conditions and in case of other skin disorders. Currently, they appear as eczematous lesions leading to balanitis. They usually appear as red to white spots and white scaly, dry flakes and may also appear to have secretion or oozing. They may present with no symptoms, but some may also experience itching, pain, discomfort, burning sensation, and burning during urination. They may appear on and off but may be managed.
Consult your specialist doctor, talk with them, and take medications with their consent.
My advice:
1. Clotrimazole cream is to be applied on the affected area in the morning and afternoon for eight weeks or till the rashes reduce. Terrasil cream is the brand available with the content.
2. Fucidin H cream (Fusidic acid and Hydrocortisone cream) is to be applied at night in a very thin layer in a minimal quantity on the affected area for four weeks. Do not apply in deep cuts or wounds. Make sure to apply on areas that are scaly and dry.
3. Lukewarm salt water to be used to wash the affected area in the morning daily for 2 to 3 minutes.
4. Liquid paraffin and white soft paraffin emollient may be added in the amount of two caps full (cap of the bottled medication ) to be mixed in 1 liter of water (normal temperature) and may be used to wash the affected area daily in the morning.
5. Capsule Omega-3 once should be taken daily at night after food for two months. It helps reduce dryness.
6. Make sure to keep the affected area moisturized and avoid using harsh chemicals, soaps, or shampoos to wash the area.
7. Apply a moisturizing shampoo twice daily on the affected areas, in the morning and evening. You can use it after half an hour of applying the medications mentioned above. They help in keeping the area moisturized.
8. Ensure using more fruits and vegetables and consume at least 15 glasses of water (250 ml standard glass size) daily. Avoid milk, dairy products, red meat, sweets, and fried and oily food.
9. In case of severe balanitis, they may require surgical intervention. Therefore in such a situation, I advise you to consult a surgeon in person for an assessment of severity and to provide management options for the same.
10. The secretions might be investigated with a swab test done at a dermatologist's office or laboratory and taken for culture and sensitivity tests. This might help in ruling out the presence of bacteria or fungal elements and may provide an antibiotic or antifungal to which the organism is most sensitive.
It may take a few weeks to months for the lesions to fade; therefore, it is advised to continue the medication consistently. Fucidin H cream is a strong cream that is not recommended for more than four weeks. In case of continued usage, it needs to be discontinued for three weeks following the first four weeks of application and then continued again for four weeks following a break of three weeks.
Hope the details are informative and provide clarity.
Kindly follow up in case of further queries.
Thank you.