Recurring Small Lesions on the Penis: Causes and Solutions - Urology

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Recurring small lesions on the penis can be a concerning issue, especially when they cause discomfort and have a tendency to recur. Based on your description, it seems that you have experienced a cycle of symptoms that includes tightness in the scrotum, a burning sensation during urination, the appearance of small red spots, and eventual ulceration of these spots. The fact that these lesions heal on their own but recur suggests an underlying issue that may need further investigation.

From the symptoms you've described, there are several potential causes for these lesions. While the previous doctors you consulted ruled out herpes, it is essential to consider other possibilities. Here are some potential causes:
1. Bacterial Infection: As suggested by your doctors, a bacterial infection could be responsible for the lesions. If the lesions are indeed caused by bacteria, it may be worth exploring whether a different antibiotic or a longer course of treatment is necessary, especially since the lesions have recurred multiple times.

2. Folliculitis: This is an inflammation of the hair follicles that can occur in the genital area. It can present as small red bumps that may become painful and can sometimes lead to ulceration.

3. Contact Dermatitis: Irritation from soaps, lotions, or other products can lead to dermatitis, which may cause similar symptoms. If you've changed any products recently, consider reverting to what you were using before.

4. Sexually Transmitted Infections (STIs): While your tests for common STIs came back negative, it may be worth considering other infections that may not have been tested for. Conditions like molluscum contagiosum, which is a viral infection, can cause small bumps and may require specific treatment.

5. Immune System Issues: You mentioned that the doctor suggested a decrease in immune function could be a factor. If your immune system is compromised, it may lead to recurrent infections or skin lesions. A thorough evaluation of your immune status may be warranted.

6. Dermatological Conditions: Conditions such as psoriasis or lichen planus can also cause lesions in the genital area. A dermatologist may be able to provide insights into these possibilities.

Given the recurring nature of your symptoms and the discomfort they cause, it is advisable to seek further evaluation. Here are some steps you can take:
- Consult a Dermatologist: A dermatologist specializes in skin conditions and may be able to provide a more accurate diagnosis and treatment plan. They may also perform a biopsy of the lesions if necessary.

- Consider Allergy Testing: If contact dermatitis is suspected, allergy testing may help identify any irritants or allergens that could be causing your symptoms.

- Review Your Hygiene Products: Ensure that any soaps, lotions, or other products used in the genital area are gentle and free from irritants.

- Maintain Good Hygiene: Keeping the area clean and dry can help prevent infections. Avoid tight clothing that may cause friction.

- Monitor Your Immune Health: If you suspect that your immune system may be compromised, consider discussing this with your primary care physician. They may recommend blood tests to assess your immune function.

- Document Symptoms: Keep a diary of your symptoms, including when they occur, any potential triggers, and the treatments you have tried. This information can be valuable for your healthcare provider.

In conclusion, while the lesions you are experiencing may not be herpes, they are still a cause for concern, especially given their recurrent nature. A thorough evaluation by a specialist, along with appropriate testing, is essential to determine the underlying cause and develop an effective treatment plan. Don't hesitate to advocate for your health and seek further opinions if necessary.