HomeAnswersDermatologypost-inflammatory hyperpigmentationWhat can the big black spot on the foreskin be?

I have a big black spot on the foreskin, but no pain. Is it something dangerous?

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Medically reviewed by

Dr. Preetha. J

Published At September 17, 2020
Reviewed AtAugust 24, 2023

Patient's Query

Hi doctor,

I am a 27-year-old male with a height of 5.8 feet, and my weight is 136 pounds. I have a big black spot on the foreskin of the penis for the past four to five years. I do not know what it is. And I do not feel any pain.

Hello,

Welcome to icliniq.com.

Please answer my questions. Do you have any history of atopy or allergies? Did you contact with irritants or any chemical? Have any history of minor injury or trauma? Did you scratch or rub the lesion? Did you pop or prick it? Allergic reaction to irritant soap? Any chronic illness? Drug history? Any fixed drug eruption? Thank you.

Patient's Query

Hello doctor,

There are no allergies or any drug history. Sometimes in two to three months, I feel itching on the foreskin for one to two days. Nothing else apart from that. Regards.

Hello,

Welcome back to icliniq.com.

Online dermatologist prescription can be obtained from telemedicine portal or direct doctors consultation. I suggest trying Tablet Levocetirizine 5 mg twice daily for seven days (when itching is present). Avoid scratching of the lesion as it can cause secondary bacterial infection. Keep the penis clean and dry. Apply Candid (Beclomethasone with Clotrimazole) cream at night for seven days (when itching is present). Fucidin (Fusidic acid) cream at daytime for seven days to avoid secondary bacterial infection. Maintain proper genital hygiene. Any autoimmune disorder? History of fungal infection in the past? Are you diabetic? Are you hypertensive? Family history of melanoma? Are you sexually active? Do you have itching or burning? Do you have urethral discharge with any pain or irritation? Regards.

Patient's Query

Hello doctor,

Thank you for your response. This is the first time I have been consulting on this problem. Can you tell me what this problem is precisely called? Is it treatable? And how can I get this spot removed? Is it something dangerous? I am worried about this. Sometimes in two to three months, it feels itchy and smelly for one to two days maximum, like a bit of liquid on it. Do I have to start applying the Fucidin and other creams from today? And please tell me how it can be removed permanently. I masturbate three times a week. There is no family melanoma. But I have red spots on my chest. I have attached my reports. This creates itching, as I have a lot of dandruff on my scalp. Regards.

Hello,

Welcome back to icliniq.com.

It is seborrheic dermatitis (chest area) due to Malassezia globosa species (yeast). You can try Dersil AF (Ketoconazole) body wash or soap-like KZ (Ketoconazole) soap for bath. Salicia KT shampoo (Salicylic acid and Ketoconazole) twice weekly and keep it applied for 15 minutes and then wash off (for itchy scalp and dandruff). Apply Pacroma (Pimecrolimus) 1% ointment overnight over the chest area for seven days. Apply Ketoconazole cream in the morning over the affected area in the morning (chest region) for ten days. Tablet AF (Fluconazole) 400 mg once immediately. The penile lesion is a postinflammatory hyperpigmentation mark. Do not worry. Many penile lesions are usually benign. But some require intervention. A biopsy is recommended for confirmation of diagnosis. Laser therapy can be done for cosmetic issues after confirmation of diagnosis from histopathology reports. Avoid oil application as it acts as food for dandruff. Have a follow-up after ten days. Thank you.

Patient's Query

Hello doctor,

Thank you for your response. I have asked you about my dandruff and redness on the chest area. And I have used the creams, shampoo, and medicines as you have advised me. I am not using the shampoo now, and the dandruff is coming again. How to get rid of this problem. I am attaching photos again. I have got many red spots on the backside of my body. Should I continue to use the same cream and shampoo? I want to know when this will finish permanently. Or do I have to use this product forever? I want to get rid of these red spots and redness on my chest and back. I am attaching my reports below. Regards.

Hello,

Welcome to icliniq.com.

Apply Brevoxyl creamy wash on your back for 20 minutes before going to bath for one month. Nadibact (Nadifloxacin) cream twice daily or Clindamycin lotion twice daily for ten days on the inflammatory lesion. Ketoconazole soap for a bath for two months. Tablet Levocetirizine 5 mg at night after food for seven days. Avoid scratching and rubbing of lesions. Avoid activities that cause sweating. Avoid occlusion, friction, heat, and moisture. Wear loose, comfortable thin cotton wear. Scalp shampoo twice weekly for six weeks if dandruff issues. Discontinue previous medication. Has inflammation on the penis been reduced? Thank you.

Patient's Query

Hello doctor,

I have not used any cream on my penis, which you have advised me about last time. Because I do not feel any itching there. The big black spot is still there, but I keep washing my foreskin every day. Do I apply any cream to it? Is there any relation between my lesion on the penis with my chest region and backside? Red spots? What is the reason for these red spots? And this redness will finish forever or not? The shampoo you told me to use last time I was using that it stopped my dandruff, but now I am not operating for 1 week, so dandruff is coming back again. The scalpe shampoo is more effective than the previous shampoo? And for how long do I have to apply the scalp shampoo? Am I not advised to exercise? As it causes sweating? I am attaching my reports again of the black spot on my penis. It is so weird. Have no choice. I am really worried. Please give me your opinion on this. Thank you.

Hello,

Welcome back to icliniq.com.

In my opinion, it is penile Melanosis (attachments removed to protect the patient's identity) . Treatment is by Co2 laser. Also, Evaluation of lesions Is needed. Biopsy should be done to rule out malignant. Use scalp shampoo contact for 10 minutes. And then wash off. Improvement is seen in lesions. Previously It was Pityriasis versicolor a superficial fungal infection due to sweating and occlusion. Now there are acneiform eruptions seen. So use 1 percent Clindamycin lotion twice daily in the morning and evening for 20 days. Brevoxyl creamy wash 20 min before going to bath apply it on the trunk for 20 days—Ketoconazole soap for a bath for two months. Maintain proper genital hygiene. I can see the genital lesion has also improved. Regards.

Patient's Query

Hello doctor,

Thank you for your response. I have used clindamycin for ten days. There was a misunderstanding, but I think the genital lesion is reducing slightly. I am attaching the reports. The chest region is still the same, and the scalp shampoo is not affecting much as the dandruff is not reducing. The Levoxyl cream has been discontinued. It is not available anywhere. Is there any other alternative? I have used the soap for 20 days, but the chest region is still the same. My face sometimes looks or gets very dark and dull. After I use shampoo or I don’t know the reason, can you tell me? Is there any relation to the product I am using? Is there sweating a problem for me? Should I avoid it? Please give me your opinion on this. Thank you.

Hello,

Welcome back to icliniq.com.

I suggest you use Kevon to stay on lotion apply 20 minutes before bath for 20 days on chest or back. Use Ketoscalp shampoo alternate day for two weeks then thrice weekly for four weeks then twice weekly for next two weeks. Miconazole gel (Micogel) at night on the red area of the penis for three weeks. Avoid scratching and rubbing of lesions. Keep the genital area clean. Wash genitals with Episoft cleanser daily for two months. Wear loose, comfortable thin cotton clothes. Avoid occlusion/friction. Avoid activity which causes sweating. Stay in a cool, well-ventilated room or environment. Regards.

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

Dr. Dhepe Snehal Madhav
Dr. Dhepe Snehal Madhav

Venereology

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