Dr. Subhash Kashyap
Dermatology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I have a rash on my penis head, it does not hurt much and it does not look severe, but it is uncomfortable and I feel very sensitive now and also it stings when I urinate but not always. Because of Covid-19 I do not want to visit a doctor, so I browsed the internet and I am afraid it is not getting better as it is. It has been a month now and it comes and goes. I took Zithromax for three days and Locoid lipocream but nothing happened. After one week, I am taking Zithromax and I took Augmentin 1 g every 12 hours for one week and Fucicort cream, it got better but the skin felt very sensitive and stinginess inside shaft started. I stopped Fucicort now and using Elica-M at night and just vaseline in the morning for three days now as I am afraid to get worse. It does not hurt much but I still have slight redness and stinginess on the outside.
Hi,
Welcome to icliniq.com.
You have used steroid creams and a lot of antibiotics. But I do not know how it started at all? Was it itchy to start? Urine burning or after you urinate, because steroids change every morphology and just cover symptoms and signs. I want to know if there was any discharge from the urethra to start with? Any history of unprotected high risk sex? Fever, or itchy red rash in partner? If none of the above then follow this. Take tablet Fluconazole 150 mg of for seven days, Sertaconazole cream twice daily for seven days and coconut oil. Review after seven days. Single dose Fluconazole for your partner. If you are diabetic control it and keep dry.
Patient's Query
Hi doctor,
Yes, it started with little itchiness for one or two days. Burning is mainly during urinating and not every time. No discharge happened. No fever as well for both of us. For my partner, only itchiness and redness are present.
Hi,
Welcome back to icliniq.com.
Then it is fungal infection only. Candida is present in all of us but sometimes it causes infection and itchiness in wet and moist conditions. Keep dry and continue the treatment. If Fluconazole is not available, you can also use capsule Itraconazole 100 mg twice a day with meals, it is a newer and safer drug. Your partner shall take a single dose of 200 mg of Itraconazole. Avoid intercourse for some days. If itching, take tablet Loratadine 10 mg once a day. Review after seven days or earlier if needed.
Thank you.
Patient's Query
Hi doctor,
Just one thing, I had a sexual encounter with a woman, only oral from both sides 10 days before and I started getting these symptoms. Is it possible to be STD? There are no signs on my mouth or any other parts of my body, also as I said before no discharge from me and only clear discharge from my partner.
Hi,
Welcome back to icliniq.com.
You have taken Azithromycin and Augmentin. That is fine for most STDs. But we are left with only one STD not covered, trichomoniasis. But it does not spread by oral route. Please continue the earlier treatment I advised.
Thank you.
Patient's Query
Hello doctor,
Me and my wife took one dose of Secnidazole, last week. The next day, we started the Fluconazole, I took one tablet daily for seven days and my wife took it for just one day. I also applied Sertaconazole cream twice daily and coconut oil between the two times. My wife is good now, and I am better, but still, I feel stinginess every now and then, the head and the top skin are very sensitive. I stopped the cream seven days later as I could not find another tube in the Pharmacy and used only coconut for two days. I woke up yesterday with my skin red and swollen. I got the cream again yesterday and I feel better now but still not perfect. Should I continue another week or try a different thing? The head is no longer red just stings, only for the two days I stopped using the cream. Also, I had a very slight stinging during peeing but not every time.
Hello,
Welcome back to icliniq.com.
It is pleasing to know that you are showing recovery. response to Sertaconazole suggests that it is a fungal infection. As this is active against fungus only no other antiinflammatory action like steroids are there. Your wife also responded that is good. Continue Sertaconazole for 10 days. If it is not available Clotrimazole or Miconazole are equally effective. Candida is normally present in our body so you actually cannot eradicate it. Somehow you have become susceptible to it so it is causing symptoms. Antibiotics and invasive strain from other person is sometimes the culprit. Dryness is the key, avoid sex for 10 days till your skin heals and forms a protective barrier of its own and flora adjusts to normal. Get your sugar level tested if you have not ruled out diabetes ever. Diabetics are more prone to such infections.
Thank you.
Investigations to be done
Preventive measures
Patient's Query
Hello doctor,
Even though I feel better, I feel that the progress has stopped. The top skin and part of the head are still a bit itchy and very sensitive. Shall I take another dose of Fluconazole or maybe any other medication besides the Sertaconazole cream? When I feel the sensitivity or itchiness there is no redness at all just the feeling but nothing is showing.
Hi,
Welcome back to icliniq.com.
No need to take more drugs now. Stop everything. Clean and keep dry. Use only coconut oil after drying. Sensitivity will gradually subside. You may take Loratadine 10 mg once a day.
Thank you.
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