Painful Red Spots on the Inner Foreskin: Causes and Treatment - Urology

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The presence of painful red spots on the inner foreskin can be concerning and may arise from various causes. Given your description, it is essential to consider several potential factors that could contribute to this condition.

1. Irritation or Inflammation: The most common cause of red spots or lesions on the inner foreskin is irritation or inflammation, which can result from friction during masturbation or sexual activity. This irritation can lead to conditions such as balanitis, which is inflammation of the glans (the head of the penis) and can extend to the foreskin. Symptoms may include redness, swelling, and pain, especially when touched.

2. Infections: Another possibility is a sexually transmitted infection (STI) or a fungal infection. Conditions like herpes, candidiasis (yeast infection), or other STIs can manifest as painful lesions or spots on the genital area. If the red spot is accompanied by other symptoms such as discharge, itching, or fever, it is crucial to seek medical attention.

3. Allergic Reactions: Allergic reactions to soaps, lotions, or condoms can also cause irritation and red spots. If you have recently changed any personal care products, this could be a contributing factor.

4. Pearly Penile Papules: These are small, painless bumps that can appear on the glans or inner foreskin and are considered a normal anatomical variant. They are not harmful and do not require treatment.

5. Fordyce Spots: These are small, painless, pale bumps that can appear on the genital area and are caused by enlarged sebaceous glands. They are harmless and do not require treatment.

6. Other Dermatological Conditions: Conditions such as psoriasis or lichen planus can also affect the genital area, leading to red spots or lesions. These conditions may require specific treatments.


Treatment and Management
- Avoid Irritation: If the red spot is due to irritation, try to avoid activities that may exacerbate the condition, such as vigorous masturbation or sexual activity until the area heals.

- Topical Treatments: Over-the-counter hydrocortisone cream may help reduce inflammation and discomfort. However, it is essential to consult a healthcare provider before applying any topical treatment to ensure it is appropriate for your condition.

- Maintain Hygiene: Keeping the area clean and dry is crucial. Use mild, unscented soap and avoid harsh chemicals that could irritate the skin.

- Consult a Healthcare Provider: If the red spot persists, worsens, or is accompanied by other symptoms (such as discharge, fever, or systemic symptoms), it is essential to seek medical attention. A healthcare provider can perform a physical examination, possibly conduct tests (such as swabs or blood tests), and provide a definitive diagnosis and appropriate treatment.

- Surgical Intervention: Surgery is generally not required for red spots on the foreskin unless there is a specific diagnosis that necessitates it, such as a significant infection or a condition that does not respond to conservative treatment.

In conclusion, while painful red spots on the inner foreskin can be concerning, many causes are treatable with proper care and attention. It is crucial to monitor the symptoms and consult a healthcare provider for an accurate diagnosis and tailored treatment plan.