Why do I have tightness and dryness under my foreskin?

Question

Hello doctor,

I have been experiencing persistent dryness of the penis beneath the foreskin, along with visible lines and some discoloration. After washing, I also find it difficult to fully reposition the foreskin over the head.This issue began following treatment for chlamydia. I have tested negative for all sexually transmitted diseases; however, the symptoms have continued despite treatment.

Previous medications:

Lotriderm.
Doxycycline.
Ofloxacin.

Laboratory tests conducted:

Swab test.
STD panel.

Despite these treatments and tests, the condition has not improved. I would appreciate further evaluation and guidance.

Kindly help.

Thank you very much for your guidance and support.

Answer 1

Hello,

Welcome to icliniq.com.

Thank you for reaching out.

Since your STI (sexually transmitted infection) tests came back negative and treatments like antibiotics or combination creams have not worked, it is unlikely you have an ongoing infection. Instead, the problem may be non-infectious and affecting your foreskin or glans. Some possible causes are irritation, contact dermatitis (skin inflammation caused by contact with irritants or allergens), recurrent balanitis (inflammation of the penis head, often due to infection, irritation, or poor hygiene), or early scarring of the foreskin.

These issues can be caused by inflammation, such as eczema or skin irritation, or by early changes that could worsen over time. Infections like candida can also show up if there is an underlying skin problem, rather than being the main cause.

Based on what you have told me, like dryness, visible lines, changes in color, and difficulty moving the foreskin after washing, simple irritation could be the cause. However, these symptoms can also happen with a condition called lichen sclerosus (also known as BXO is a chronic skin condition that causes thin, white, patchy skin, commonly affecting the genital and anal areas). This is an inflammatory problem that can lead to scarring of the foreskin and glans. Symptoms may include tightness, small tears, discomfort, changes in skin color, painful erections, or urinary problems.

The photo you sent was too unclear for me to assess properly, so I do not want to make any guesses based on it. To help me understand your situation better, could you please answer the following questions?

Have you noticed any white patches, a white ring, or scar-like areas on the foreskin or near the tip?
Are there any cracks, peeling, itching, soreness, or bleeding?
When erect, can the foreskin move back and return to its normal position easily, or does it feel tight?
Have you experienced any urinary changes, such as spraying, burning, a weak stream, or ballooning of the foreskin?
Do you have a history of eczema, psoriasis, diabetes, or recurrent thrush?
Is there any persistent red patch, ulcer, lump, or area that appears unusual and is not improving?

While we figure this out, here are some care tips you can try:

Avoid forcing the foreskin backward or forward.
Wash gently with warm water or use a mild, non-irritating moisturizer instead of soap or shower gel.
Dry the area carefully after washing.
After washing, make sure the foreskin goes back to its normal position, but don’t use any force.
If masturbation makes your symptoms worse, try to reduce friction and consider using a plain, non-irritating lubricant.

Because this problem has continued even after treatment, I strongly recommend seeing a general practitioner, urologist, or sexual health specialist in person. If the diagnosis is still unclear, seeing a dermatologist might also help.

Please seek urgent medical help if your foreskin gets stuck behind the glans, if you have a lot of swelling or pain, or if you have trouble passing urine.

I hope this clarifies your concerns.

Please feel free to reach out anytime if you need further assistance.

Thank you.