Persistent Discomfort and Redness on the Glans: Seeking Solutions

The skin on the glans is red and uncomfortable?

Hello, Doctor.
Previously, I had a skin tear on my glans and went to see a doctor.
I applied a topical ointment, specifically Weikang'en cream, and took oral antibiotics.
However, my condition worsened, so I consulted a different doctor who prescribed Xinghui Meikang cream and Xinghui Ziqinsuan cream, but it got even worse.
The wound started to ooze and showed signs of ulceration.
Later, when I returned to the southern part of Taiwan, I visited a dermatologist who prescribed medication.
I noticed that the name of the ointment on his prescription was the same as Weikang'en cream, but after applying it, my wound healed quickly.
Now, the surface of the wound has improved, but I still feel discomfort on my glans.
It’s not pain, but more like a sensation of having a wound, similar to a tingling feeling or nerve pain.
I can’t distinguish it clearly because it’s quite uncomfortable, especially when I’m trying to sleep.
I went to see another doctor, and he prescribed Naxinjing cream and Washington zinc oxide ointment, which provided some relief.
However, continuously applying medication hasn’t resolved the issue, and it’s frustrating.
Today, I went to see a doctor again, but the doctor who had previously helped me was on leave, so I visited another clinic.
This time, the doctor prescribed Kangyan cream.
My concern is that I noticed Kangyan cream contains Ziqinsuan, which is also in the Xinghui Ziqinsuan cream that worsened my condition before.
I’m hesitant to use the Kangyan cream prescribed by the doctor for fear that it might cause further redness, swelling, and pus.
What should I do? Should I apply the Kangyan cream that the doctor just prescribed? I’m really troubled; it has been over six months since the inflammation started.
What should I do to improve my condition? Thank you, Director.

Bai Bai, 20~29 year old female. Ask Date: 2016/08/31

Dr. Wu Yuxin reply Dermatology

Without actually seeing the lesion, it is impossible to make a definitive diagnosis.
If it is causing significant distress, please seek medical attention promptly.

Reply Date: 2016/08/31

More Info

It sounds like you are experiencing a challenging and frustrating situation with persistent discomfort and redness on the glans, which has been exacerbated by various treatments. I understand your concerns, especially given the duration of your symptoms and the varying responses to different medications.
First, it’s important to recognize that the glans can be sensitive, and any irritation or injury can lead to discomfort that may feel like nerve pain or a burning sensation. The fact that you have tried multiple treatments, including topical creams and oral antibiotics, suggests that this may be a more complex issue than a simple infection or irritation.

Given that you mentioned the use of medications containing clotrimazole (the active ingredient in the creams you've used), it’s possible that the initial treatments may have led to a temporary improvement but did not address the underlying cause of your symptoms. The presence of pus and signs of ulceration indicate that there may have been a secondary infection or an inflammatory response that needs to be managed appropriately.

Here are some steps you can consider moving forward:
1. Consult a Specialist: If you haven't already, it may be beneficial to see a urologist or a dermatologist who specializes in genital skin conditions. They can provide a more focused examination and may suggest additional diagnostic tests, such as a culture of any discharge, to identify the specific pathogens involved.

2. Avoid Irritants: While you are treating the area, it’s crucial to avoid any potential irritants, including harsh soaps, fragrances, or other topical products that could exacerbate the condition. Stick to gentle, hypoallergenic cleansers and avoid excessive moisture or friction in the area.

3. Consider a Patch Test: If you are hesitant to use the new medication (康炎乳膏) due to concerns about its ingredients being similar to those that previously caused a reaction, you might consider doing a patch test. Apply a small amount to a less sensitive area of skin to see if there is any adverse reaction before applying it to the affected area.

4. Monitor Symptoms: Keep a detailed record of your symptoms, including when they worsen or improve, and any new products you use. This information can be invaluable for your healthcare provider in determining the best course of action.

5. Follow-Up Care: If you start using the new cream and do not see improvement within a week or if symptoms worsen, return to your healthcare provider for further evaluation. Persistent symptoms may require a different treatment approach, such as a stronger topical steroid or an antifungal that targets specific organisms.

6. Consider Psychological Impact: Chronic discomfort can take a toll on mental health. If you find that anxiety about your condition is affecting your quality of life, consider discussing this with your healthcare provider. They may recommend counseling or support groups for individuals dealing with similar issues.

7. Lifestyle Adjustments: Ensure that you are practicing good hygiene and consider wearing breathable, loose-fitting underwear to reduce irritation. Staying hydrated and maintaining a healthy diet can also support your overall skin health.

In conclusion, while it’s understandable to feel frustrated and anxious about your symptoms, it’s essential to approach this situation with a clear plan. Consulting with a specialist, avoiding irritants, and carefully monitoring your symptoms will help you find a resolution. Remember, healing can take time, and it’s important to be patient with yourself during this process.

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