Is the scab on my penis a pustule or a friction injury?

Question

Hello doctor,

I recently had a small scab on my penis that became itchy. I accidentally rubbed it one night, and the area became inflamed and had a white dot under the skin. I have been putting Bactrim on it and keeping a band-aid because if it rubs against my pants, it gets inflamed.

What do I do?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand this is uncomfortable and concerning, and I appreciate you sharing the details.

Based on your description, this appears to be a localized inflamed lesion, most likely due to friction, minor trauma, a small infected hair follicle (folliculitis), or a superficial bacterial infection. The white dot you noticed suggests a small collection of pus (a pustule), which can develop after irritation or rubbing. At this stage, the main focus should be on gentle care and preventing further irritation.

Avoid covering the area with a tight bandage unless necessary, as constant occlusion and friction can worsen inflammation and trap moisture. Instead, keep the area clean and dry. Wash gently once daily with lukewarm water and a mild cleanser, then pat dry; do not rub.

Regarding Bactrim, it is actually an oral antibiotic (Trimethoprim-Sulfamethoxazole) and should not be used topically. If you are using a topical antibacterial ointment, that is acceptable in a thin layer for a few days. A topical antibiotic such as Mupirocin or Fusidic acid would be more appropriate if there are signs of infection.

For better clarity, I would strongly encourage you to share a clear photo of the affected area (maintaining your privacy) along with the image of the cream you are using. This will help determine whether it is a simple infection, irritant reaction, or another condition and guide precise treatment. Also, please let me know

Is the lesion painful or just itchy?
Is there any fluid or pus discharge?
Have you had any recent sexual contact?
Have you had similar lesions in the past?

Since the lesion is in the genital area, other conditions should also be kept in mind, including genital herpes (a common, chronic sexually transmitted infection (STI) caused by the herpes simplex virus), which typically presents with painful blisters or ulcers, and syphilis (a curable, bacterial sexually transmitted infection (STI) caused by Treponema pallidum), which more commonly presents as a painless ulcer. These need to be ruled out if the lesion changes, persists, or new symptoms appear.

In the meantime, avoid rubbing, scratching, or squeezing the area. Wear loose, soft cotton underwear to reduce friction, and keep the area dry by avoiding prolonged moisture from sweat or occlusion. Most minor lesions improve within a few days with these measures.

Once you share the photo and answer the questions, I will be able to guide you more precisely on whether only topical treatment is enough or if further medication is needed.

I hope this answers your query.

Please let me know if I can assist you further.

Thank you.