Bumps on the Glans: Causes and Concerns

There are two pimples on the glans?

Hello Doctor, I am someone with phimosis.
About two weeks ago, I engaged in safe sexual activity with my partner.
Four days later, I went hiking in hot weather while wearing three layers of pants (underwear, swim shorts, and beach shorts).
The next day, I noticed a burning sensation during urination, so I went to the hospital for an examination.
After an X-ray and a urine culture, it was found that there was no inflammation, no stones, and no bacteria.
Gonorrhea was ruled out (the urine test was negative, and there was no discharge of pus).
The doctor prescribed a three-day course of antibiotics, and my condition improved afterward.
One day while masturbating, I noticed a small wound on the frenulum when I retracted the foreskin, which I suspect may be the cause of the burning sensation during urination.
In the following days, I again retracted the foreskin and saw two small pustules on the glans that resembled pimples.
One had already ruptured, while the other was still intact.
They are not itchy but feel mildly painful, similar to pimples on the face.
A week later, I visited the doctor again, and the doctor prescribed tetracycline hydrochloride ointment for topical application.
After researching online, I believe it is unlikely to be syphilis (I had a syphilis infection four years ago, but the doctor confirmed that I have completely recovered and can engage in normal sexual activity), as the wound on the frenulum does not have a hard chancre and is very small.
Currently, aside from discomfort in the glans (possibly caused by the pustules), I also experience frequent urination, but there are no other significant symptoms.
The urine produced during frequent urination is normal and clear, with no unusual color, and there is no difficulty or pain during urination.
Doctor, what exactly am I suffering from? Thank you for your response.

Xiao Hao, 20~29 year old female. Ask Date: 2020/04/23

Dr. Cai Zhuorong reply Urology

Your condition may warrant further testing to rule out syphilis or herpes.
Skin and genital diseases require visual examination; a diagnosis cannot be made solely based on description.

Reply Date: 2020/04/23

More Info

Understanding bumps on the glans can be a source of concern for many individuals, especially when accompanied by symptoms such as burning during urination or discomfort. In your case, it appears that you have experienced a series of events leading to the discovery of bumps on the glans, which you describe as small pustules resembling acne.
Firstly, it’s important to note that the glans (the head of the penis) can develop various types of bumps or lesions due to a range of causes. These can include infections, inflammatory conditions, or benign growths. Given your recent history of sexual activity and subsequent symptoms, several potential causes can be considered.

1. Folliculitis: This is an inflammation of the hair follicles, which can occur due to friction, irritation, or infection. The heat and moisture from wearing multiple layers of clothing, especially in a warm environment, may have contributed to this condition. The small pustules you see could be inflamed hair follicles.

2. Pearly Penile Papules: These are small, benign bumps that can appear around the glans and are often mistaken for warts or other infections. They are normal anatomical variations and do not require treatment unless they cause discomfort.

3. Infections: While you have ruled out bacterial infections such as gonorrhea and have not shown signs of other sexually transmitted infections (STIs), it is still possible to have a viral infection, such as herpes, which can present with similar symptoms. However, the absence of pain, itching, or other systemic symptoms makes this less likely.

4. Contact Dermatitis: The irritation from soaps, lotions, or even the friction from clothing can lead to dermatitis, which may cause bumps or rashes on the glans.

5. Other Conditions: Conditions such as balanitis (inflammation of the glans) or lichen planus can also cause bumps and discomfort. These conditions may require specific treatments, such as topical steroids or antifungal medications.

Given that you have already consulted a physician and received treatment with antibiotics, it is reassuring that no bacterial infection was identified. The use of topical tetracycline may help reduce inflammation and promote healing of the affected area.

In terms of your urinary symptoms, the burning sensation during urination could be related to irritation from the bumps or the underlying condition causing them. Since you have not experienced any significant changes in urine color or consistency, this is a positive sign. However, frequent urination can sometimes be a sign of irritation or inflammation in the urinary tract.

Recommendations:
- Continue to follow up with your healthcare provider, especially if the bumps do not resolve or if new symptoms develop.

- Maintain good hygiene, but avoid excessive scrubbing or irritation of the area.

- Consider wearing loose-fitting underwear to reduce friction and moisture accumulation.

- If symptoms persist or worsen, further evaluation may be necessary, including a referral to a urologist or dermatologist for specialized care.

In conclusion, while the bumps on your glans may be concerning, they are often benign and can be related to irritation or minor infections. Monitoring your symptoms and maintaining communication with your healthcare provider will be key in managing your condition effectively.

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