Pearly Penile Papules and Balanitis in Young Men

Pearl lesions and balanitis?

Hello, doctor.
I am 20 years old and a college student.
Last Sunday, I engaged in sexual activity, which only involved oral sex (my partner likely does not have HPV).
I didn't experience any symptoms for the first two days, and I washed immediately after the sexual activity.
However, today I started feeling an itch on my glans, and while showering, I noticed small bump-like lesions in the glans sulcus, along with some redness and skin irritation on my penis.
I'm not sure if this is pearly penile papules or just simple inflammation.
Additionally, I can normally retract my foreskin, but I don't clean it regularly; I only wash it when there is a noticeable odor or a buildup of smegma.
After washing, I dry it and immediately retract the foreskin again, so I'm wondering if this could have led to the inflammation.
Lastly, I would like to ask the doctor if I should regularly retract my foreskin to expose the glans.

gjuu, 20~29 year old female. Ask Date: 2020/12/21

Dr. Jian Weihong reply Urology

There are various types of skin rashes on the penis.
Although most are merely mild allergies or infections, if the symptoms are more severe or persist for an extended period, a physical examination is necessary, and sometimes a biopsy may be required for a definitive diagnosis.
Each individual's constitution is different, and their cleaning methods may vary.
If your previous cleaning methods and frequency have maintained cleanliness and comfort, there is no need for significant changes.
Similar to the skin on other parts of the body, inadequate or excessive cleaning can lead to discomfort.
Regarding retraction, individuals with a longer foreskin do not need to intentionally retract it regularly, while those with a shorter foreskin or who find retraction more comfortable do not need to deliberately pull it down to cover it.

Reply Date: 2020/12/21

More Info

Pearly Penile Papules (PPP) and balanitis are two conditions that can affect young men, particularly those in their late teens and early twenties. Understanding these conditions is essential for proper management and to alleviate any concerns you may have.

Pearly Penile Papules are small, benign growths that typically appear around the corona of the glans (the head of the penis). They are usually white or skin-colored and can resemble small pimples or bumps. PPP is a normal anatomical variant and is not associated with any disease or infection. They are harmless and do not require treatment unless they cause psychological distress or concern for the individual.

On the other hand, balanitis refers to inflammation of the glans penis, which can be caused by various factors, including poor hygiene, infections (such as yeast infections or sexually transmitted infections), or irritants (like soaps or lotions). Symptoms of balanitis can include redness, swelling, itching, and sometimes a discharge. In your case, the itching and redness you are experiencing could indicate a mild case of balanitis, especially if you have not been cleaning the area regularly. The presence of white discharge or odor may also suggest a buildup of smegma, which is a combination of dead skin cells, oils, and other bodily secretions.

Regarding your question about hygiene, it is important to maintain proper genital hygiene to prevent conditions like balanitis. Regularly cleaning the area, including retracting the foreskin (if you are uncircumcised), is essential. This practice helps remove smegma and reduces the risk of irritation and infection. It is advisable to gently clean the area with warm water and mild soap, ensuring that you rinse thoroughly and dry the area afterward. This will help keep the skin healthy and reduce the likelihood of developing balanitis.

If you notice any persistent symptoms, such as severe itching, pain, or unusual discharge, it is crucial to consult a healthcare professional for an accurate diagnosis and appropriate treatment. They may perform a physical examination and, if necessary, recommend topical treatments or medications to alleviate your symptoms.

In summary, while Pearly Penile Papules are a normal and harmless condition, the symptoms you are experiencing may indicate balanitis, which can be managed with proper hygiene practices. Regular cleaning and care of the genital area are essential for maintaining health and preventing infections. If symptoms persist or worsen, seeking medical advice is the best course of action.

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