Should I worry about a brown spot on the glans?

Question

Hello doctor,

I am 18 years old. About 1.5 to 2 years ago, I noticed a small brown spot on the glans. It has gradually enlarged and has now reached the meatus. It is flat, painless, and currently not associated with any other symptoms. Sometimes I also experience a split urinary stream.

Approximately two to three years ago, I had hard smegma on the glans because I had not retracted my foreskin at that time. I removed it using my nails. Could this be the cause, and is this a serious condition? Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com

I am very thankful to you for your concern. I know it is a matter of your worry, as the affected area has been increasing gradually and now covers the meatus.

A flat brown patch on the glans that has slowly increased in size over approximately one and a half to two years, is painless, and is not associated with other symptoms, is most commonly due to a benign condition known as penile melanosis (also called genital lentiginosis).

This condition represents an increase in melanin pigment in the skin and is not cancerous. Such patches may slowly enlarge over time and can sometimes extend toward the meatus while remaining completely harmless.

As for the history of smegma and your use of your fingernails to remove it, this might have irritated the area back then. Sometimes, trauma or inflammation of an area can cause post-inflammatory hyperpigmentation, which can sometimes result in a dark spot on the skin. This means that irritation may have contributed to the pigmentation, but it does not cause cancer.

But then again, when there is a pigment on the head of the penis that grows larger, especially on the opening area, you should get this checked up. Though rare, other conditions need to be excluded. There are some positive points about your story.

The lesion is flat, painless, and has enlarged very slowly over a long period without sudden changes. You have not reported bleeding, ulceration, crusting, itching, or irregular surface changes. A stable, uniformly pigmented, flat patch without alarming features is much more suggestive of a benign condition such as penile melanosis or post-inflammatory hyperpigmentation rather than a malignant process.

Concerning the split urinary stream, this is typically unrelated to pigmentation. More frequent causes might include mild irritation of the urethral meatus, slight meatal stricture, inflammation, or meatal stickiness. In case there is no pain, burning, or difficulty in urination, it is not usually a severe problem.

Nevertheless, if your urine stream is divided or shooting frequently, a urologist will examine the meatus to rule out meatal stricture.

In case of 18 years of age, more severe reasons are uncommon, although enlarging lesions must be taken into consideration. The main reason could be benign pigmentation, though consulting a dermatologist in person is highly advised. It would be helpful to take a photo, if possible.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.