Flat Rash on the Glans: Causes and Treatment Options

Rash on the glans penis?

Hello Dr.
Chen,
I have researched a lot of information online, but I still cannot determine my condition.
I visited both a clinic and a hospital, and during one of the visits, I had a safe sexual encounter around March 4.
On March 8, while showering, I noticed an abnormality: on the right half of the glans, just before the coronal sulcus, there was one flat lesion and two small bumps.
I consulted a urology clinic, where I was prescribed a topical antibiotic ointment and oral antibiotics.
I finished the medication around March 12, but there was no improvement.
I continued to apply the ointment twice daily to the affected area.
On the evening of March 25, I went to the hospital for a follow-up.
The doctor advised that pulling back the foreskin after applying the ointment might affect its efficacy and suggested that I keep the glans exposed after application.

The symptoms are neither painful nor itchy.
Normally, my foreskin can cover the glans, and I pull it back to clean during showers.
After washing, I use a hairdryer to dry the groin area, including the glans and foreskin.
I would like to ask if you could recommend something to cover the affected area after applying the ointment.
The ointment applied to the affected area tends to get on my underwear as well.

Cheng Xiansheng, 20~29 year old female. Ask Date: 2019/03/29

Dr. Chen Jiansheng reply Urology

The foreskin is elastic and difficult to fix; increasing the frequency of applying medication can help.

Reply Date: 2019/03/29

More Info

Understanding a flat rash on the glans can be concerning, especially when it persists despite treatment. Based on your description, it seems you have already sought medical advice and received a topical antifungal cream and oral antibiotics. However, since you have not seen any improvement, it is essential to consider various potential causes and treatment options.

Possible Causes of Flat Rash on the Glans
1. Infections:
- Fungal Infections: Conditions like candidiasis can cause flat, red, or white patches on the glans. These often occur in warm, moist environments and can be exacerbated by poor hygiene or tight clothing.

- Bacterial Infections: Bacterial infections, including sexually transmitted infections (STIs) like herpes or syphilis, can present with rashes or lesions on the glans.

- Viral Infections: Certain viral infections can cause rashes or lesions on the genital area.

2. Dermatological Conditions:
- Contact Dermatitis: This occurs due to irritation from soaps, lotions, or other products that come into contact with the skin.

- Psoriasis or Eczema: These chronic skin conditions can also affect the genital area, leading to flat, scaly patches.

3. Other Causes:
- Lichen Planus: This inflammatory condition can cause flat-topped lesions on the glans and may be associated with itching or burning.

- Lichen Sclerosus: This is a chronic skin condition that can cause white patches and thinning of the skin.

Treatment Options
1. Topical Treatments:
- Continue using the antifungal cream as prescribed. If there is no improvement, it may be necessary to switch to a different antifungal or consider a steroid cream to reduce inflammation.

- If a bacterial infection is suspected, a different antibiotic may be needed.

2. Hygiene Practices:
- Ensure that the area is kept clean and dry. After washing, gently pat the area dry instead of rubbing it.

- Avoid using harsh soaps or products that may irritate the skin.

3. Covering the Area:
- After applying the medication, it is advisable to allow it to dry completely before covering the area. You can use a loose-fitting cotton gauze or a breathable bandage to cover the rash. This will help protect the area while allowing it to breathe.

- Avoid tight underwear or clothing that may cause friction or irritation.

4. Follow-Up Care:
- If the rash does not improve after a week of treatment, or if it worsens, it is crucial to return to your healthcare provider. They may consider further diagnostic tests, such as a biopsy or cultures, to determine the exact cause of the rash.

- If you suspect a sexually transmitted infection, it is essential to get tested and inform any sexual partners.

Conclusion
In summary, a flat rash on the glans can arise from various causes, including infections and dermatological conditions. Since you have already been treated with antifungal and antibiotic medications without improvement, it is essential to follow up with your healthcare provider for further evaluation. They may recommend alternative treatments or diagnostic tests to identify the underlying issue. Meanwhile, maintaining good hygiene and protecting the area with breathable materials can help manage symptoms. Always consult your healthcare provider before making changes to your treatment plan.

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