How can I manage a dark patch on my glans?

Question

Hello doctor,

I had my circumcision surgery seven to eight years ago, and after a few years, I noticed a small, dark, flat patch on the glans skin. It started growing very slowly over the course of a few years, and now almost 60 percent of the glans skin is dark with patches. However, it is not growing any further.

Also, I think the glans skin is dry. I hope it can be cured by any topical creams you can recommend, as I do not want to go for surgery or laser treatment.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and understand your concern.

I have gone through the details as well as the images that you have provided (attachment removed to protect the patient’s identity).

From the images, the concern that you are having, which is dryness and dark patches, seems to be a form of eczematous dermatitis of the glans penis and penile shaft.

Eczema is an allergic reaction that can occur due to external stimuli such as temperature changes, exposure to atmospheric pollutants, consumption of hot and spicy foods, dietary changes, changes in location, use of harsh soaps, excessive cleaning, and more. It can also be caused by internal factors like hormonal fluctuations, changes in temperature, stress, and sleeplessness.

The key to treating eczema is to keep the skin as moisturized as possible, for which I will be providing you with medication. Eczema often has a tendency to recur based on the factors I mentioned above, but there is nothing to worry about. Consistently keeping the skin moisturized can help prevent recurrences.

However, it is highly advisable to consult a doctor in person for an examination and skin testing by scraping. This procedure is not invasive and involves testing the flakes on the skin under a microscope to rule out any other possibilities. This is particularly important because it is a sensitive area that needs thorough examination.

For the time being, I will provide you with medications that will help alleviate the current issue.

Use a very thin layer of the Desonide 0.05 percent lotion/solution on the dry, flaky and pigmented areas only. Make sure to use it at night and for a maximum period of one week. In case of recurrence of the symptoms, the same lotion can be used for one week, and adequate breaks of at least two to three weeks in between each one-week application are advised.
Venusia Max cream (mango butter, cocoa butter, shea butter and aloe vera butter) moisturizing cream can be used once or twice daily on the affected area, which helps in keeping the skin moisturized and preventing any other infections that can happen due to dryness.
Use Luliconazole cream in the morning and afternoon daily for the next 8 to 12 weeks, which helps in preventing any fungal infection that can happen due to dryness and due to the fact that it is an unexposed area.
Consume one capsule Seacod (cod liver oil) at night after dinner for two months. This helps in hydration of the skin and prevents flakiness and pigmentation.
Consume one capsule of Evion 400 mg (vitamin E or Tocopheryl acetate) at night once daily after dinner for two months. This helps in eliminating the pigmentation as well as helps in hydrating the skin.
Lukewarm salt water with one tablespoon of coconut oil, which is mixed, can be applied to the affected area for five to ten minutes daily using a cotton ball.
Coconut oil can be used for massaging the affected area before taking a bath for two to three minutes, which can then be kept for around ten minutes and then washed off during bathing.
Do not use any harsh chemicals, disinfectants, hand washes, or harsh soaps on the affected area, as there is a possibility of dryness, which will worsen the condition.
Mild soap of any kind can be used and should not be applied directly. They have to be mixed in half a cup of water, and the solution that is formed with the mixture of soap and water can be used gently to wash the area for a maximum period of one minute.
Do not touch or pick the dry flakes, as they may spread.
Avoid stagnation of sweat and moisture on the affected area, and keep the affected area clean with a towel after a bath.

As I mentioned, it is mandatory to have the affected area checked directly as well in order to examine and take the scales on the skin for testing, which may or may not be needed after examination.

I hope this has helped you.

Please feel free to reach out to me again in case of further queries.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

Thank you for your kind words.

Penile melanosis also appears as dark patches on the glans penis. However, without a test or examination, it is not appropriate to provide a confirmative diagnosis.

As I mentioned earlier, a direct consultation for examination purposes is mandatory to rule out other possibilities. In the case of eczema, dry patches appear initially, which results in the formation of pigmentation.

The medications I have provided should be helpful in reducing the pigmentation and further recurrences of dryness. Despite this, I highly recommend consulting a doctor in person for examination, as I mentioned previously. This is important because the area is sensitive, and no delay should be made in having it examined thoroughly for a confirmatory diagnosis.

In the meantime, keeping the area moisturized will help reduce further recurrences of the condition.

I hope your query got resolved.

For further queries, you can consult me.

Thank you.