Painful Red Spots on the Penis: Causes and Treatments - Dermatology

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The appearance of painful red spots on the penis, particularly near the glans (the head of the penis), can be concerning and may indicate a variety of conditions. Given your description of the spot being approximately 3mm x 2mm, not swollen, and painful to touch, there are several potential causes to consider.

1. Contact Dermatitis: This condition occurs when the skin reacts to irritants or allergens. If you've recently changed soaps, lotions, or laundry detergents, this could lead to a localized reaction. Symptoms typically include redness, itching, and pain upon contact.

2. Folliculitis: This is an inflammation of the hair follicles, which can occur in any area of the body where hair is present, including the genital region. It can be caused by bacterial infections, irritation, or even ingrown hairs. Folliculitis may present as small red bumps that can be painful.

3. Pearly Penile Papules: These are small, harmless bumps that can appear around the glans of the penis. They are normal anatomical variations and are not a cause for concern. However, they typically do not cause pain.

4. Genital Warts: Caused by the human papillomavirus (HPV), genital warts can appear as small, flesh-colored or red bumps. They can be painful and may require treatment if they persist.

5. Herpes Simplex Virus (HSV): If the red spot is accompanied by blisters or sores, it could indicate a herpes infection. This viral infection can cause painful lesions and is typically associated with other symptoms such as itching or burning.

6. Balanitis: This is an inflammation of the glans, often due to poor hygiene, infections, or irritants. Symptoms may include redness, swelling, and pain.

7. Other Skin Conditions: Conditions such as psoriasis or eczema can also affect the genital area, leading to red, painful spots.

Given that you have not engaged in sexual activity and have been using over-the-counter treatments without improvement for a week, it is crucial to seek medical attention. A healthcare provider, preferably a dermatologist or urologist, can perform a physical examination and may recommend tests to determine the exact cause of the red spot.
In the meantime, here are some general recommendations:
- Avoid Irritants: Refrain from using any new soaps, lotions, or other products on the affected area until you have a clearer understanding of the cause.

- Maintain Hygiene: Keep the area clean and dry. Avoid excessive moisture, which can exacerbate some conditions.

- Avoid Scratching: This can lead to further irritation or infection.

- Over-the-Counter Treatments: While you mentioned that topical treatments have not worked, you might consider trying a mild hydrocortisone cream to reduce inflammation, but only after consulting with a healthcare provider.

In summary, while there are several potential causes for the painful red spot on your penis, a definitive diagnosis can only be made by a healthcare professional. It is essential to seek medical advice to ensure appropriate treatment and to rule out any serious conditions.