Q. I have a small fleshy lump on my penis for the past one year with no changes in it. Please help.

Answered by
Dr. Prathish Kumar
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on May 23, 2020

Hi doctor,

On my penis I have a small fleshy lump and I have had it for around 12 months. My girlfriend has had an STD check within these 12 months, and the tests have come back clear so I do not think it is warts.

I think it may be a skin tag. I have been applying tea tree oil to it the past week, which has dried it up and made it feel a bit looser. The reason I am getting in touch is because I have started to develop black marks on my penis, they are very small but I want to make sure it is not connected to the lump.

Dr. Prathish Kumar

General Medicine Internal Medicine
#

Hi,

Welcome to icliniq.com.

I get to see you ate worried about the lump in your penis. I have gone through your pictures (attachment removed to protect patient identity), not clear though, it looks very small.

Considering your statement to be present for the past 12 months with such a small size without any growth or difficulty in skin retraction, it is not a significant problem.

Still, I need a bit more information for a better understanding. As I have mentioned, had it been the same size for the past 12 months? Is there any color change over the lump or redness or pain over the lump? Do not mistake me for this, how many sexual contacts you had, only your girlfriend or beyond her? Was there any watery or pus discharge anytime from the lump? Do you have any burning sensation while passing urine or cloudy colored urine?

And regarding the black marks, do you have any itching sensation over the black marks? Are the black marks increasing in number and size? Do you have a fever?

It will be helpful to guide you better if you can upload the investigations you have done for STD check and more clear picture of your lesions. Review back with the investigations advised below if not previously done and upload your previous investigations.


Investigations to be done:

CBC (complete blood sugar), RBS (random blood sugar), Urine routine.

Treatment plan:

Tablet Amoxicillin and Clavulanic acid 625 mg twice daily for five days, Fexofenadine twice daily for five days.


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Thank you doctor,

I have not noticed any size increase at all, nor any difficulty pulling my foreskin back. There is no color change on the lump, but yesterday, I did notice a section of it has turned black. I think this maybe since I have been applying tea tree oil onto it, it seems dry and feels a lot more looser.

I have had a sexual partner before my current partner, but since she had an STD check I have not had any partners like I said I have not had a test myself, but hers came back clear and I have not slept with anyone else since she had her test.

To pain or redness on the lump, no sort of discharge from the lump either, no pain what so ever. No cloudy urine nor pain whilst urinating. There is no symptoms of anything, apart from the lump and black marks everything has been fine.

Regarding the black marks, they are not increasing in size, nor numbers as far as I am aware. I only noticed them just over a week ago because I was checking my penis for other lumps. I have no itching sensation or pain, the black marks are flat, almost look like an ink smudge.

I have attached a few more images to this message.

Dr. Prathish Kumar

General Medicine Internal Medicine
#

Hi,

Welcome back to icliniq.com.

I have gone through your answers and pictures uploaded (attachment removed to protect patient identity).

All in total, this appears to be a simple skin tag only and the black spots may be a temporary appearance. So you can be absolutely sure this is nothing to worry about.

Skin tags in the penile areas are not so common but can occur. It frequently occurs in people who wear tight trousers, when your penis is in continuous friction and pressure. And sometimes this may occur as an early marker for people who are prone to develop diabetes.

So I would advise you to wear loose trousers, apply some talc powder to reduce sweating and friction there. And I would also suggest you to investigate yourself for the basic investigations including sugars as I have already mentioned particularly if you have a family history of diabetes and also an STD (sexually transmitted disease) check just to build up your own confidence.

Tea tree oil and apple cedar vinegar oil are some alternative remedial options which might help a bit as you said it makes the stalk loose and shrink the size to some extent, but not scientifically approved. But, caution to be made as it might irritate the skin for some people. And your black spots may be due to this oil also, which we cannot prove unless you stop applying the oil and check for regression of the spots.

And if you are still feeling uneasy with that skin tag, you can get it removed by the cauterization method from a dermatologist. It is just a simple OPD procedure.


Probable diagnosis:

Penile skin tags.

Treatment plan:

Finish the medicine course as I have already given.

Regarding follow up:

Review with investigations.


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