Painful Bumps Under the Foreskin: Is It Herpes? - Urology

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When it comes to painful bumps under the foreskin, particularly in the area where the glans meets the shaft, there are several potential causes to consider. Given your description of the bumps being painful, white, and somewhat raised, it is important to differentiate between various conditions, including herpes, folliculitis, pearly penile papules, or even a sexually transmitted infection (STI).

1. Herpes Simplex Virus (HSV): Herpes typically presents as painful blisters or sores that can appear on the genital area. These lesions often start as small red bumps that can progress to fluid-filled blisters, which eventually crust over. If the bumps you are experiencing are painful and have not changed significantly over the past month, it is less likely to be herpes, especially if you have not experienced any flu-like symptoms, such as fever or swollen lymph nodes, which often accompany an initial herpes outbreak.

2. Folliculitis: This condition occurs when hair follicles become inflamed, often due to infection. It can present as small, red, or white bumps that may be painful to touch. Folliculitis can be caused by bacteria, fungi, or irritation from shaving or friction. If the bumps are located near hair follicles, this could be a likely cause.

3. Pearly Penile Papules: These are small, harmless bumps that can appear around the corona of the glans. They are typically white or skin-colored and are not painful. They are a normal anatomical variation and do not require treatment.

4. Other STIs: Conditions such as genital warts (caused by the human papillomavirus) or molluscum contagiosum can also present as bumps in the genital area. These may vary in appearance and can be painful or itchy.

Given that you mentioned the bumps are painful and have remained unchanged for a month, it is advisable to seek a medical evaluation from a healthcare provider. They can perform a physical examination and may recommend tests, such as a swab of the lesions, to determine the exact cause.
In the meantime, here are some general recommendations:
- Avoid Irritation: Refrain from touching or manipulating the bumps to prevent further irritation or potential infection.

- Maintain Hygiene: Keep the area clean and dry. Use mild soap and water, and avoid harsh chemicals or fragrances that could exacerbate irritation.

- Avoid Sexual Activity: Until you have a clear diagnosis, it is wise to avoid sexual activity to prevent potential transmission of an STI and to avoid further irritation.

In terms of treatment, if the bumps are determined to be caused by an infection, your healthcare provider may prescribe topical or oral medications. If they are benign, reassurance and monitoring may be all that is necessary.

In conclusion, while it is understandable to be concerned about the nature of these bumps, a proper diagnosis from a healthcare professional is crucial. They will provide the most accurate information and appropriate treatment options based on your specific condition.