White Bumps Under the Penis: Possible Causes and Concerns - Urology

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When it comes to the appearance of white bumps or spots under the penis, particularly in the area of the coronal sulcus, there are several potential causes that could explain these symptoms. Given the details you've provided, it’s important to consider both benign and pathological conditions.

1. Pearly Penile Papules: One of the most common benign conditions that can present as small, white, or grayish bumps on the penis is pearly penile papules. These are normal anatomical variations and are not associated with any disease or infection. They typically appear as small, dome-shaped bumps around the corona of the glans and are harmless.

2. Fordyce Spots: These are small, painless, pale bumps that can appear on the shaft of the penis or the scrotum. They are sebaceous glands that are visible due to their proximity to the surface of the skin. Like pearly penile papules, they are completely normal and do not require treatment.

3. Genital Warts (Condylomata Acuminata): Caused by the human papillomavirus (HPV), genital warts can appear as small, flesh-colored or gray bumps. They may be flat or raised and can sometimes resemble cauliflower. However, you mentioned that the bumps you observed do not resemble typical warts, and they are not painful or itchy, which is a good sign.

4. Herpes Simplex Virus (HSV): While you have ruled out herpes due to the absence of pain or itching, it’s worth noting that herpes lesions can sometimes present as small, fluid-filled blisters. These typically cause discomfort and may be accompanied by other symptoms such as fever or swollen lymph nodes.

5. Folliculitis or Cysts: Small, fluid-filled bumps can also be due to folliculitis (inflammation of hair follicles) or sebaceous cysts. These conditions are usually benign and can resolve on their own.

6. Lichen Planus or Lichen Sclerosus: These are inflammatory skin conditions that can affect the genital area, leading to white patches or bumps. They may require medical evaluation and treatment if they cause discomfort or other symptoms.

Given that you have not experienced any pain, itching, or changes in size, and considering your recent sexual activity, it is understandable to be concerned about sexually transmitted infections (STIs). However, the characteristics you describe do not strongly suggest a typical STI.
It is crucial to monitor the bumps for any changes, such as increased size, pain, or the appearance of additional symptoms. Since you are currently in a location with limited medical resources, it may be beneficial to maintain good hygiene and avoid any irritants, such as harsh soaps or lotions.

When you return to Taiwan, I recommend consulting a healthcare professional, preferably a dermatologist or urologist, for a thorough examination. They may perform a visual inspection and, if necessary, conduct tests to rule out any infections or other conditions. In the meantime, try to stay calm and avoid self-diagnosing based on online information, as this can often lead to unnecessary anxiety.

In summary, while there are various potential causes for the white bumps you are observing, many of them are benign. It is essential to seek professional medical advice upon your return to ensure proper evaluation and peace of mind.