Persistent Redness and Itching of the Glans: Causes and Solutions

Redness of the glans penis?

Earlier this year, after oral sex with my partner, I started experiencing itching on the glans.
I went to see a urologist and received a topical cream, which helped for a while, but after stopping the medication, the itching returned shortly.
I consulted the doctor again, and he prescribed the same cream.
However, the itching resumed again after a short period of stopping the treatment.
I went back to the doctor, who arranged for blood sugar tests, urinalysis, and tests for syphilis and HIV (all results were normal).
This time, he prescribed a tetracycline ointment and a corticosteroid cream to mix and apply.
After a few days of use, small bumps resembling herpes appeared on the glans, which would bleed when they burst.
I returned to the doctor, who said it looked like contact dermatitis and advised me to stop the medication and observe.
A few days later, the small bumps improved, but I still felt some itching.
I then saw another doctor, who suggested it looked like a fungal infection and prescribed another cream.
After three days of use, the itching subsided, but the previously affected area on the glans became wrinkled and redder than it was before.
During a follow-up visit, the doctor said it had healed, but after one or two months, the redness has not diminished, although there is no pain or itching.
Could it be that using too many topical treatments over the past six months has caused this? What should I do?

A-Wen, 20~29 year old female. Ask Date: 2021/08/28

Dr. Xu Wencang reply Urology

Observe first, and return for a follow-up if there are any issues.

Reply Date: 2021/08/28

More Info

Persistent redness and itching of the glans can be a frustrating and uncomfortable experience. Based on your description, it seems you've gone through a series of treatments and consultations, which is a good approach to addressing your symptoms. Let's break down the potential causes and solutions for your condition.

Possible Causes
1. Contact Dermatitis: This is a common cause of irritation and redness, especially if you've been using multiple topical medications. The skin on the glans is sensitive, and frequent application of creams or ointments can lead to irritation or allergic reactions. If the medications contain fragrances, preservatives, or other irritants, they could exacerbate the problem.

2. Fungal Infection: As you mentioned, one of the doctors suggested a fungal infection. Conditions like candidiasis (yeast infection) can cause itching, redness, and sometimes a rash. These infections can occur due to various factors, including antibiotic use, which can disrupt the normal flora of the skin.

3. Balanitis: This is an inflammation of the glans, which can be caused by infections (bacterial or fungal), irritants, or underlying conditions like diabetes. Since your blood sugar levels were normal, this may be less likely, but it’s still a consideration.

4. Sexually Transmitted Infections (STIs): While you tested negative for syphilis and HIV, other STIs could still be a possibility. Conditions like herpes can cause similar symptoms, although they typically present with more pronounced lesions.

5. Psoriasis or Other Skin Conditions: Skin conditions such as psoriasis can also affect the genital area, leading to redness and scaling. These conditions may require different treatment approaches.

Treatment and Management
1. Avoid Irritants: If you suspect that the topical medications may have caused irritation, it might be wise to stop using them for a while. Allow the skin to heal naturally without any products.
2. Gentle Hygiene: Maintain good hygiene by gently washing the area with mild soap and water. Avoid harsh soaps or products that can further irritate the skin.

3. Moisturizers: After stopping the medications, consider using a gentle, fragrance-free moisturizer to help soothe the skin. This can help restore the skin barrier.

4. Consult a Dermatologist: Since you’ve seen multiple doctors, it may be beneficial to consult a dermatologist who specializes in skin conditions. They can provide a more in-depth examination and possibly perform a skin biopsy if necessary to rule out other conditions.

5. Topical Treatments: If a fungal infection is confirmed, antifungal creams can be effective. If contact dermatitis is suspected, a topical corticosteroid may help reduce inflammation, but it should be used cautiously and under medical supervision to avoid skin thinning.

6. Follow-up: Regular follow-up with your healthcare provider is essential to monitor the condition and adjust treatment as necessary. If symptoms persist or worsen, further investigations may be warranted.

Conclusion
In summary, persistent redness and itching of the glans can stem from various causes, including contact dermatitis, fungal infections, or other dermatological conditions. It’s crucial to identify the underlying cause to tailor the treatment effectively. Given your history of using multiple topical medications, it’s possible that irritation from these products is contributing to your symptoms. A careful approach involving gentle care, avoidance of irritants, and consultation with a specialist can help you find relief. If the condition does not improve, further evaluation may be necessary to explore other potential causes.

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