Why is my penis still red for over a year despite treatment?

Question

Hello doctor,

I have been dealing with a red area on the head of my penis for almost a year now, and I am honestly starting to lose my mind over it. It does not itch or hurt at all, but the skin looks “off.” It stays red, and I have noticed small cracks starting to form in that spot. I have seen my GP, and they thought it was balanitis or maybe a fungal infection. They gave me Hydrocortisone cream, but that seemed to make the skin look even thinner and worse, and the redness did not improve.

I eventually tried Clotrimazole on my own. This actually helped quite a bit; it improved the redness, and the skin started to feel more “healed,” but it has not cleared it up completely. The red patch remains despite the improvement.

I am very careful with hygiene. I wash with water two or three times a day and apply the cream twice a day, but I am seeing zero progress lately. I am very stressed about this. Has anyone dealt with something like this that lasted this long?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Please share a clear picture of the affected area so I can guide you better. If there was unprotected sexual contact, we need to rule out sexually transmitted infections. Please do the following tests:

Treponema pallidum hemagglutination,
Herpes simplex virus 1 and 2-nucleic acid amplification test, or reverse transcription polymerase chain reaction.
Urine polymerase chain reaction for Chlamydia trachomatis and Neisseria gonorrhoeae.
Human immunodeficiency virus 4th-generation antigen or antibody screening.
Hepatitis B surface antigen.
Urine complete analysis with urine culture and sensitivity.
Complete blood count with erythrocyte sedimentation rate.

These tests will help us rule out common causes of genital ulcers, discharge, and irritation after exposure.

If there was no unprotected exposure, and it looks like a bacterial infection:

Apply Mupirocin ointment locally twice daily.
Take Doxycycline 100 milligrams twice daily for five days after food.

If there is significant itching suggestive of a fungal infection:

Apply Clotrimazole and Beclomethasone ointment locally twice daily.
Take Cetirizine one tablet at night for itching.

For general genital hygiene advice:

Wash the genital area twice daily (morning and night).
Use normal room-temperature water.
Avoid hot or cold water.
Do not use harsh or high-pH soaps.
Keep the area dry and avoid tight clothing.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.