What is the best treatment for genital herpes with reddish spots, itching skin, and a tighter penile foreskin?

Hello,

Welcome to icliniq.com.

I hope you are doing well.

Having gone through the history provided and the images (attachment removed to protect the patient's identity) provided from your end, it appears to be balanitis. Balanitis may be caused due to multiple reasons, including dryness as well as chapped skin, a condition termed eczema, fungal pathology, bacterial infections, psoriatic lesions, stress, changes in the climate, dietary factors, sweating, using any harsh chemicals and soaps or shampoos in cleaning the affected area, frequent trauma to the affected area and in case of other unknown causes which includes zoon's balanitis.

Multiple medications are available to reduce the dryness and inflammation associated with balanitis. Still, they may require consistency with the application and intake of the medication to reduce the inflammation, which may take months to show complete recovery.

My advice :

1. Terrasil (Clotrimazole) cream may be applied on the affected area in the morning daily for months together. They have antifungal and anti-drying properties, which help in hydration and prevent fungal infections in the affected area.

2. Fucidin H (Fusidic Acid and Hydrocortisone Acetate) cream may be applied in the smallest quantity as the thinnest layer on the affected area. This is a combination of corticosteroids and antibiotics, which are used to reduce inflammation and dryness formed on the affected area, along with preventing any secondary bacterial infections due to their antibacterial properties. Due to strong medication, the smallest quantity needs to be applied and may be continued for a maximum period of three weeks. Following this, they may be stopped for almost two weeks, after which they may be continued for two weeks, and so on.

3. Wick and Strom (L- Arginine) advanced penile moisturizing cream may be used to be applied on the affected area of the head of the penis once daily. They may be applied more than once daily because they have hydrating and moisturizing the area. In case of application more than once, it needs to be noted that the current creams, which are to be applied in the morning and at night, need to be applied first, and then following a waiting period of 30 minutes, this moisturizing cream may be applied on top of it.

4. Oilatum emollient (Liquid Paraffin) or bath formula, two caps full, which is available along with the bottle, may be mixed with one liter of normal temperature water, which can then be used for washing day affected area, which helps retain moisture as well as hydration. They may be used once daily.

5. Lukewarm salt water may also be used to soak and clean the area once daily. Lukewarm salt water, which is of sterile nature without any contaminants, may be applied to the affected area using cotton and kept for five to ten minutes before washing off daily. This is to reduce the itching or any symptoms along with anti-drying properties and in order to prevent any secondary bacterial infections.

6. Tablet Fluconazole 150 mg may be consumed orally as a single dose. They are to be taken as a single tablet after food today.

7. Since there are currently no signs of viral infection, the current medication, and creams, which are antivirals, may not be required.

8. Tablet Cetirizine 10 mg can be consumed in case of excess itching. This medication must be taken for a maximum period of two weeks and may also be continued later. This is to be taken after dinner one hour before going to sleep at night. This is helpful and reduces itching. Therefore, it is a sedative as well. Due to this reason, after consuming the tablet, it is not advised to go out or drive.

9. Capsule Omega 3 May also be consumed orally once daily after dinner in order to promote hydration of the affected area and may be continued for one month.

10. Avoid using harsh chemicals, soaps, or shampoos for washing the affected area, and make sure to clean and dry the area well after a bath and air the area well. Also, make sure to wear loose-fitting clothes in order to prevent further fungal infection.

11. Avoid oily and fried food, sweets, red meat, milk, dairy products, and spicy food, as they trigger the formation of infections. Instead, make sure to consume more fruits, vegetables, and proteins in the form of eggs and at least 13 glasses of water daily in a 250 ml glass size in order to provide hydration to your body.

Balanitis may be on and off depending upon the external as well as the internet triggers which have been mentioned above. Therefore, avoiding the external triggers and keeping the area moisturized, hydrated, and free of any secondary infections is key in order to manage the current inflammation. Also, make sure to have a balanced diet along with keeping the area clean and soft.

In case of any discharge or secretions, it is advised to undergo a swab test in which the secretions are tested by culture, and sensitivity testing wherein the presence of any bacteria or fungal elements may be found out, and any antibiotics or medications may also be provided within the report. To undergo the test, in-person consultation with the dermatologist may be required.

I hope the details provided above were informative and did provide clarity.

Hello,

Welcome back to icliniq.com.

Sure, I will provide the medication names alone below and the details of application of the medication may be got by referring to the previous answer. A single medication may not be enough to treat balanitis as they are most often caused due to multiple factors and may need treatment for preventing further infections as well.

The medications include:

1. Terrasil cream (Clotrimazole 1% cream ) to be applied in the morning for four weeks to 12 weeks.

2. Wick and Strom (L- Arginine) penile moisturizing cream to be applied in the afternoon and evening.

3. Fucidin H cream (Hydrocortisone and Fusidic acid) to be applied in a very thin layer only at night and left overnight.

4. Oilatum emollient (Liquid Paraffin) or bath formula for washing the area.

5. Tablet Fluconazole 150 mg one tablet to be taken after dinner today.

6. Tablet Cetirizine 10 mg to be taken at night one hour before going to sleep for two weeks.

7. Capsule Omega 3 to be taken after dinner for one month.

I hope it was helpful. Kindly revert back in case of further queries.

Stay happy, healthy and safe. Take care.