What causes foreskin itching with white dots?

Hi,

Welcome to icliniq.com.

I understand how concerning and uncomfortable this situation must feel, especially with the itching and your recent history of infections. I appreciate the detailed information you provided, as it really helps.

As per your description and the image that you have uploaded (the attachment has been deleted for confidentiality), the white patches under the foreskin may be attributed to non-cancerous disorders such as pearly penile papules and Fordyce spots.

These are very common, harmless, and not sexually transmitted. The fact that you have noticed them for a long time without any pain, bleeding, or changes suggests they are likely a normal anatomical variant.

However, the intense itching you are currently experiencing, especially when the area rubs against your underwear, indicates there may be superimposed irritation or mild inflammation of the foreskin (irritant balanitis).

Given your recent treatment for chlamydia and trichomoniasis, it is also possible that changes in local flora, moisture retention under the foreskin, friction, sweating, or even detergent residue in your underwear could be triggering this irritation.

In some cases, a mild overgrowth of Candida (yeast) can cause itching without significant redness or discharge.

At this stage, I recommend gentle care. Wash the area once daily with lukewarm water only (avoid using soap inside the foreskin). Gently retract and dry the area thoroughly before replacing the foreskin, and wear loose cotton underwear to minimize friction.

Avoid scented products, harsh soaps, and excessive washing. If the itching persists, you can apply Daktacort cream (2 % Miconazole Nitrate for antifungal treatment and 1 % Hydrocortisone Acetate) once a day to the affected area for only seven days. This will help address contact eczema and any potential fungal infection present under the foreskin.

Importantly, this does not appear to be an active STI (sexually transmitted disease) based on the image and your description, especially since there is no pain, ulceration, discharge, or bleeding.

However, if your symptoms worsen, if redness spreads, swelling develops, discharge appears, or if the itching does not improve within a week, you should consult a clinician for examination and possibly a swab.

I hope this information helps with your situation. Please share your valuable feedback to improve patient care, and let me know if you have any further questions.

Thank you.