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How can red spots on the head of my penis be treated?

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How can red spots on the head of my penis be treated?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. K. Shobana

Published At January 7, 2018
Reviewed AtFebruary 20, 2024

Patient's Query

Hello doctor,

The head of my penis is itchy and there are a few red spots in certain areas on the head. This has been happening for the past week or so. I have stopped applying soap to the area and I wash it with lukewarm water twice a day and apply Candid-B thereafter. The itchiness went away after three to four days but as I stopped doing that, the itching has been back. Initially, I had some pain while retracting my foreskin and my foreskin was kind of swollen but there was no pain or swelling. At times, I find a white substance around the foreskin when I try to retract it. Should I continue applying for Candid-B for a few more days? And what other precautions should I take so that it does not happen in the future?

Hello,

Welcome to icliniq.com.

With your description, I feel you are suffering from a fungal infection of your genitalia. Kindly stop Candid-B cream (Beclometasone Topical and Clotrimazole Topical). It has steroids in it. This gives you temporary relief from itching but promotes fungal growth. However, I cannot precisely diagnose your condition without having seen your clinical picture. I would suggest you attach a clinical picture along with your query. I would suggest you use:

  1. Seriva (Sertaconazole Topical) cream to the affected area. Apply a thin layer afterbath in the morning and at night before sleeping.
  2. Abzorb (Clotrimazole, Talc, and starch) dusting powder. Apply on top of the cream to the thigh folds.
  3. KZ (Ketoconazole) soap - use only in the genital area while taking a bath. Use your routine soap for the rest of the body.
  4. Tablet Teczine (Levocetirizine) 5 mg at night after food for 10 days for itching. Never scratch the area, use dry underwear all the time. Consult your specialist doctor, discuss with him or her and with their consent take the medicine.
  5. Keep the area dry as far as possible.

Patient's Query

Hello doctor,

I have attached a few photos so you would be able to assess the situation better.

Hello,

Welcome back to icliniq.com.

I have gone through the attachments (attachment removed to protect patient identity). You have candidal balanoposthitis, meaning fungal infection of the tip of the glans penis and foreskin of your penis. Here is the treatment suggested.

  1. Capsule Candiforce (Itraconazole) 200 mg take one tablet in the morning after breakfast and one tablet at night after dinner. Drink lots of water. You need to buy only two tablets and it is only one-day treatment.
  2. Seriva cream (Sertaconazole) apply this cream to the affected part, a thin layer afterbath. Use a clean dry towel each time to wipe the water over your genitalia. Then apply the Seriva cream two times a day, morning and night. Continue using this cream for two months even if you feel that you do not have to itch anymore because fungus needs a full course of treatment, otherwise, you will have a recurrence.
  3. Tablet Teczine (Levocetirizine) 5 mg. Take one tablet at night after dinner for 15 days. This is for itching. Consult your specialist doctor, discuss with him or her and with their consent take the above medicines.
  4. KZ soap (Ketoconazole). Use this soap to clean your genitals while taking a bath. Retract the foreskin completely every time you clean it.
  5. Abzorb dusting powder (Clotrimazole) apply to the groin area to keep it dry in the morning and night. This is for the groin (thigh folds) and not on your penis.

There are a few other things I would like to mention here,

  1. Avoid sexual contact for at least three weeks. Always use condoms.
  2. Ask your partner if she has a white discharge or itching in her genitalia. Because this is highly contagious, spreads sexually.
  3. Stop Candid-B (Beclometasone Topical and Clotrimazole Topical) Cream.
  4. Always wear cotton innerwear, change it daily, wash it with a good detergent, and make sure it is double rinsed so that there is no residual detergent. This can also cause irritation.
  5. Never scratch or rub your genitals. Take tablet Teczine (Levocetirizine) if you feel itchy.
  6. Check your blood sugar levels as a routine. High blood sugar level is one of the risk factors for fungal infections.
  7. You need to check your fasting blood sugar and postprandial blood sugar.

Skincare during fungal infection is very important. If you fail to follow, these medicines may not help to cure the infection completely. One more thing I want to mention here, in one of the pictures you have sent, I can see little violet discoloration, so I m keeping lichen planus-genital as the differential diagnosis. But it is very unlikely because you have had this problem only for a week. With dermoscopy examination, it can be precisely ruled out. But clinically it is a fungal infection. It is very very unlikely that it is lichen planus. You will be fine in three weeks, but continue the Seriva cream for two months.

Patient's Query

Thank you doctor,

I want to check if I need to upload the reports of the blood test.

Hello,

Welcome back to icliniq.com.

If the results are abnormal that is if they are high, then you need to meet a physician. Otherwise, nothing to worry. I am ruling out all possible risk factors here. You need not upload reports. You are required to consult a physician or endocrinologist only if the sugar levels are high. Follow the treatment I mentioned in the previous reply.

Thank you.

Patient's Query

Hello doctor,

My fungal infection seems to have healed however, recently I experience pain while retracting my foreskin in its erect state, and it tends to tighten up. I have no pain while retracting the foreskin in the flaccid state. Is it somehow related to the fungal infection or its different? Should I visit a dermatologist or urologist?

Hi,

Welcome back to icliniq.com.

Good to hear that a fungal infection has responded to anti-fungal medications.

  1. Is there any swelling of the tip of the penis or the foreskin?
  2. Do you see any redness or inflammation?
  3. Are you able to pass urine without any difficulty?
  4. How painful is it on a scale of 1 to 10?
  5. Any history of unprotected sexual contact while you were on medication?

If you see anything abnormal in that area, you can share the clinical pictures to assess the condition.

Patient's Query

Hello doctor,

I have attached a few photos. The pain seems to be more on the frenulum than the foreskin and the pain varies between 6 to 10. I do not have difficulty to pass urine. Yes, I observe some redness in the area also inflammation is on and off not constant.

Hello,

Welcome back to icliniq.com.

I saw the pictures, (attachment removed to protect the patient's identity). There is little redness, but no active infection. I suggest you continue Seriva cream for another week. You can switch to your normal mild soap like Dove, and clean the tip of the penis after retracting the foreskin at least two times a day. You need to wash off the collected material (smegma). This collected material can lead to inflammation and subsequent infection. I do not see any swelling of the foreskin, or inflammation of the glans. Sometimes if the frenulum is tight, you will feel pain when you attempt to retract the foreskin. Treatment includes releasing those tight bands by a surgeon or urologist. Try to wipe off the collected material with mild soap, if you still have pain, then you will have to see a urologist.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Ashwini. V. Swamy
Dr. Ashwini. V. Swamy

Venereology

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