Foreskin and Glans Issues: Symptoms and Concerns

Problems with the foreskin and glans?

Hello, doctor.
I am a person with phimosis (the foreskin is long enough that it resembles a sausage with knots at both ends).
Recently, while showering, I noticed a small white bump on my glans (it is slightly raised but not large, resembling a small pimple).
At the same time, I sometimes feel itchiness on the tip of my glans/foreskin, which only subsides during urination.
After noticing this condition, I instinctively paid more attention to the hygiene of my genital area, but there seems to be no improvement.
While writing this, I used my phone's camera and discovered that those small white bumps seem to be ulcerated (red in the center with a white surrounding, resembling atolls); additionally, I found three smaller but similar white bumps at the meatus (also resembling atolls).
Could this be a result of excessive cleaning, or is it balanitis? I must admit that I have had unprotected sexual intercourse, but I have been tested for HIV and syphilis, with negative results (as I had experienced ulcerations on my glans similar to syphilis).
That test was conducted in June of last year, and the unprotected sexual encounter occurred in January of the same year.
Since then, I have used condoms during all sexual activities.
Therefore, I am quite anxious about the symptoms I am currently experiencing, and I would appreciate your guidance.
Thank you.

Li Wu, 20~29 year old female. Ask Date: 2022/01/10

Dr. Chen Jiansheng reply Urology

It is recommended to seek medical evaluation.

Reply Date: 2022/01/10

More Info

It sounds like you're experiencing some concerning symptoms related to your foreskin and glans, which can understandably cause anxiety. Let's break down your symptoms and potential concerns.

Symptoms Overview
1. White Bumps: The small white bumps you described on your glans could be a number of things. They might be pearly penile papules, which are harmless and common, or they could be a sign of a condition like balanitis (inflammation of the glans) or a sexually transmitted infection (STI).

2. Itching: Itching in the area, particularly during urination, can indicate irritation or inflammation. This could be due to a variety of factors, including hygiene practices, infections, or even allergic reactions to soaps or other products.

3. Ulceration: The description of the bumps appearing to ulcerate (red in the center with a white ring) is concerning. This could suggest an infection or another dermatological condition that requires medical attention.

Potential Causes
- Balanitis: This is an inflammation of the glans, often caused by poor hygiene, infections (bacterial or fungal), or irritants. Symptoms typically include redness, swelling, and sometimes discharge or itching.

- Sexually Transmitted Infections (STIs): Given your history of unprotected sexual encounters, it’s important to consider STIs. While you mentioned previous negative tests for HIV and syphilis, other infections like herpes or HPV could still be possibilities.

- Irritation from Cleaning: Overzealous cleaning can lead to irritation and inflammation. If you are using harsh soaps or scrubbing too hard, this could exacerbate your symptoms.

Recommendations
1. Avoid Irritation: For now, try to avoid excessive cleaning or using harsh soaps in the area. Gentle washing with mild soap and water is usually sufficient.

2. Consult a Healthcare Provider: It’s crucial to see a healthcare provider, preferably a urologist or dermatologist, to get a proper diagnosis. They can perform a physical examination and may take swabs or samples if necessary.

3. Monitor Symptoms: Keep an eye on any changes in your symptoms, such as increased pain, swelling, or discharge. This information can be helpful for your healthcare provider.

4. Sexual Health: Continue to practice safe sex, including the use of condoms, to reduce the risk of STIs. It may also be beneficial to have regular check-ups for sexual health, especially if you have concerns.

5. Mental Health: It’s understandable to feel anxious about these symptoms, especially given your history. Consider discussing your concerns with a mental health professional if you find that anxiety is affecting your daily life.

Conclusion
Your symptoms warrant a thorough evaluation by a healthcare professional. While some conditions may be benign, others could require treatment. It’s important to address these issues promptly to ensure your health and peace of mind. Remember, taking care of your sexual health is just as important as any other aspect of your well-being.

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