a Persistent Black Spot on the Penis: Skin or Urology Concern?

A dark spot on the penis?

About six months ago, during sexual intercourse, my partner put on a condom incorrectly, which caused some pulling and discomfort with my pubic hair.
After that, a black bump about 3 to 5 centimeters appeared near the hair follicle (it is neither painful nor itchy), and it hasn't gone away for over six months.
I thought it was a pimple, and I just tried to puncture it with a sterilized needle, but I wasn't sure if I inserted it in the right spot; I only managed to squeeze out a little blood without any other substance.
I would like to know if this could be folliculitis.
If I want to see a doctor about this, should I go to a dermatologist or a urologist? Thank you for your assistance, Dr.
Wu.

Chen, 20~29 year old female. Ask Date: 2017/09/27

Dr. Wu Yuxin reply Dermatology

First, consult a urologist.

Reply Date: 2017/09/27

More Info

When it comes to understanding a persistent black spot on the penis, it is essential to differentiate between various potential causes and to determine the appropriate medical specialty for evaluation and treatment. Based on your description, it sounds like you may be dealing with a condition related to the hair follicles, possibly folliculitis or a benign skin lesion, but it is crucial to have a professional evaluation to confirm this.

Understanding the Condition
1. Folliculitis: This is an inflammation of the hair follicles, often caused by infection (bacterial or fungal), irritation, or blockage. It can present as red or dark spots and may be tender or itchy. However, if the spot is not painful or itchy, it may not be folliculitis.

2. Benign Skin Lesions: The black spot you describe could also be a benign skin lesion, such as a seborrheic keratosis or a melanotic macule. These lesions can appear dark and are usually harmless. However, they can sometimes be mistaken for more serious conditions.

3. Skin Pigmentation Changes: Changes in skin pigmentation can occur due to various reasons, including friction, trauma, or hormonal changes. The history of your partner pulling on the condom could have caused some irritation or minor trauma to the area, leading to a localized pigmentation change.

4. Potential for Infection: If there is any concern about an infection, especially if you notice any changes in the spot (such as increased redness, swelling, or discharge), it is crucial to seek medical attention promptly.

Seeking Medical Help
Given the duration of the spot and your attempts to treat it at home, it is advisable to consult a healthcare professional. In terms of which specialty to visit, both dermatology and urology can address concerns related to the genital area:
- Dermatology: A dermatologist specializes in skin conditions and would be well-equipped to evaluate skin lesions, including those on the genital area. They can perform a thorough examination and may conduct a biopsy if necessary to rule out any serious conditions.

- Urology: A urologist specializes in the urinary tract and male reproductive system. If you have concerns about the functionality of your penis or if there are associated urinary symptoms, a urologist may be the appropriate choice.

Recommendations
1. Do Not Self-Diagnose or Treat: Avoid attempting to pop or manipulate the spot further, as this can lead to infection or scarring. The use of needles or other instruments can introduce bacteria and worsen the condition.

2. Schedule an Appointment: Make an appointment with a dermatologist or urologist to have the spot evaluated. Bring any relevant medical history, including the timeline of the spot's appearance and any associated symptoms.

3. Monitor Changes: Keep an eye on the spot for any changes in size, color, or sensation. If you notice any new symptoms, such as pain, itching, or discharge, inform your healthcare provider during your visit.

4. Discuss Other Symptoms: If you have other symptoms, such as irregularities in your menstrual cycle (if applicable), unusual discharge, or persistent itching, be sure to mention these during your consultation, as they may provide additional context for your healthcare provider.

In conclusion, while the persistent black spot on your penis may not be a cause for immediate concern, it is essential to have it evaluated by a healthcare professional to ensure proper diagnosis and treatment. Early intervention can help prevent potential complications and provide peace of mind.

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