What causes white coating and red spots on the penis?

Question

Hi doctor,

I am a 64-year-old male. I have been getting a white coating on my penis under the foreskin for a few months now, probably after having unprotected sex with a known female. It goes away by washing with water, but recurs every day.

If I am unable to clean the area at least two to three times a day, the penis can smell a bit with a very minor itch, and becomes sensitive with a few small red spots while washing the next day. There is no other symptom or pain otherwise.

I am currently taking these medications.

Perindopril 8 mg.
Metoprolol 50 mg.
Amlodipine 5 mg.
Atorvas 10 mg.
Ecosporin 75 mg.
In addition, I have a B-complex tablet daily to avoid cramps in the calf.

Please guide.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and understand your concerns.

I am deeply concerned about your worries. The most likely causes for your condition are the following.

Candida (yeast) infection – The most common cause of recurrent white coating, mild odor, and itching.
Mixed bacterial infection – May accompany yeast or follow exposure to partner’s vaginal infection.
Poor foreskin hygiene or trapped smegma - It can worsen or maintain inflammation.
Sexually transmitted infections (STIs) - Infections such as trichomonas, chlamydia, or herpes (though you have no ulcers, pain, or discharge).
Diabetes – Elevated blood sugar encourages yeast growth and recurrent balanitis.

I suggest the following for you:

Get your penis examined by a doctor (preferably a urologist or dermatologist). They wi’ll likely do a penile swab or urine test to confirm yeast/bacterial cause and rule out STIs.
Blood sugar test (fasting glucose) to rule out diabetes or prediabetes.
You can use a topical antifungal Clotrimazole cream once at night for eight days.
It is sometimes combined with a mild steroid (Hydrocortisone 1 %) for short-term relief if inflamed.
A topical antibiotic (Fusidic acid or Mupirocin) may be added if bacterial infection is suspected.
Take the tablet Fluconazole 150 mg. Take the first dose, then the second dose after three days, and the last dose after 72 hours.

I hope this answers your query. Feel free to reach out anytime.

Thank you.