Itchy Redness and White Bumps on the Penis: Causes and Solutions

The penis is red, swollen, and itchy, and two small white bumps have appeared on the top, which are also itchy?

I consulted a urologist before asking my question, but the doctor told me it was just a bacterial infection.
However, after taking the prescribed medication and applying the ointment, my skin has not improved, which is why I am inquiring further.
About 2 to 3 weeks ago, I had sexual intercourse with a 45-year-old man.
One to two days later, I experienced itching at the base of my penis, which I frequently scratched, leading to redness and swelling of the skin.
It was itchy, and the area above seemed to be connected to the hair follicles.
I initially thought it was just an inflammatory reaction due to sweating.
After a week, the redness and swelling developed into two separate areas, which were also itchy.
Due to the proliferation, I sought urological consultation.
Within a week, I noticed two small white pearl-like bumps appearing on the shaft of my penis, spaced about one centimeter apart.
They resembled the original hair follicles on the penis but became noticeably raised even when flaccid.
Within two days, these two white bumps and the two red swollen areas at the base seemed to flare up, with the surrounding area becoming red and also starting to itch.
Upon returning to the urologist, the doctor confirmed that applying medication helped reduce the redness and swelling back to skin color, but the area where the swelling was still felt somewhat firm when pinched.
The doctor mentioned, "The swelling has improved," but it still itches.
During itching episodes, it becomes slightly swollen and warm.
When I squeezed it at home, a clear fluid mixed with a bit of blood would ooze out from the hair follicle above.
The urologist acknowledged that the two additional white bumps on the shaft were indeed unusual but advised me to continue taking the antibiotics and applying the ointment.
Since I am unable to find a cause, I am seeking online advice from a doctor and kindly request your response.

Nìmíng, 20~29 year old female. Ask Date: 2021/08/07

Dr. Wu Yuxin reply Dermatology

Because dermatology is different from general medicine, it is difficult to make a diagnosis based solely on verbal descriptions; it is necessary to examine the skin visually.
I recommend that you seek treatment from a dermatologist as soon as possible and inform them about any sexual encounters with partners of the same sex.

Reply Date: 2021/08/07

More Info

It sounds like you're experiencing a complex issue with your genital skin that has not improved despite treatment. Based on your description, there are several potential causes for the itchy redness and white bumps on the penis, and understanding these can help guide further action.

Firstly, the symptoms you describe—itchiness, redness, and the presence of white bumps—could be indicative of a few different conditions. One possibility is a fungal infection, such as candidiasis (commonly known as a yeast infection), which can cause similar symptoms, particularly in warm, moist areas. Another possibility is a bacterial infection, which your urologist has already mentioned. However, if the prescribed treatment did not yield results, it may be worth considering other factors or conditions.

The white bumps you mentioned could be a condition known as pearly penile papules, which are harmless and common in men. They appear as small, white, or skin-colored bumps around the corona of the penis and are not a sign of infection or disease. However, if these bumps are new and accompanied by redness and irritation, it could suggest an inflammatory response or infection rather than a benign condition.

Another potential cause could be folliculitis, which is the inflammation of hair follicles. This can occur due to irritation, infection, or blockage of the follicles, leading to red, itchy bumps that may also produce pus or clear fluid. Given that you mentioned squeezing the bumps, this could exacerbate the condition and lead to further irritation or secondary infection.

Given the complexity of your symptoms and the fact that they have not improved with treatment, it would be advisable to seek a second opinion from a dermatologist or a specialist in sexually transmitted infections (STIs). They can perform a thorough examination and may recommend additional tests, such as a culture or biopsy, to determine the exact cause of your symptoms.

In the meantime, here are some general recommendations that may help alleviate your symptoms:
1. Avoid Irritation: Refrain from scratching or squeezing the affected areas, as this can lead to further irritation or infection.

2. Keep the Area Clean and Dry: Maintain good hygiene by washing the area gently with mild soap and water, and ensure it is thoroughly dried afterward. Avoid using harsh soaps or products that may irritate the skin.

3. Wear Loose-Fitting Clothing: Opt for breathable fabrics like cotton to reduce moisture and friction in the genital area.

4. Avoid Sexual Activity: Until you have a clear diagnosis and your symptoms have resolved, it may be wise to abstain from sexual activity to prevent potential transmission of an infection.

5. Follow Up with Your Doctor: If your symptoms persist or worsen, return to your healthcare provider for further evaluation. They may consider alternative treatments or refer you to a specialist.

In summary, while your initial consultation with a urologist provided some insight, the persistence of your symptoms suggests that further investigation is warranted. A dermatologist or an STI specialist may offer additional perspectives and treatment options. Remember, it’s essential to communicate openly with your healthcare provider about your symptoms and any concerns you may have.

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