Recurrent Glans Inflammation: Symptoms and Treatment Options

Two months ago, there was a case of balanitis that has improved. Currently, there are small white flakes present. Is this a recurrence, or could it be due to stopping the medication too soon?

Hello, Doctor: I had a circumcision when I was young.
Two months ago, I experienced symptoms of glans inflammation, including redness, swelling, and peeling.
I consulted a doctor and have been applying medication for about two weeks, specifically using Acyclovir cream, and my condition has improved and returned to normal.
However, after about half a month, while the redness, swelling, and peeling have resolved, I noticed "small white flakes" on the penis and glans that resemble peeling skin.
These flakes are not noticeable when not erect, but become more apparent after masturbation.
There is no pain, itching, or unusual odor.
Initially, I did not pay much attention to it, but after some time, I resumed applying Acyclovir cream for 5-6 days, but it does not seem to have improved.
After the inflammation improved, I resumed masturbation, but I have reduced the frequency (previously about once a day).
Since the glans inflammation, I have also stopped engaging in sexual activity.
I have cleaned and disinfected my hands and frequently touched objects.
My girlfriend has not exhibited similar symptoms.
Since the onset of glans inflammation, I have tried to avoid using body wash on the glans while showering, changed my underwear daily, and maintained dryness and ventilation (or went without wearing pants).
When sitting, I use clean clothing to cover the seat, and the environment is kept tidy.
"Although I usually do this, I just stopped using body wash." I would like to ask if this is also a symptom of glans inflammation? Can I continue using Acyclovir cream, or did I stop applying it too soon, thinking I was already healed when I actually wasn't? Or is it possible that masturbating once a day is too frequent? These are my current questions.
I apologize for bothering you; the information I found online is somewhat confusing or repetitive.

Mr. Chen, 30~39 year old female. Ask Date: 2022/04/24

Dr. Lin Wenxu reply Urology

It may flare up again; it is recommended to visit the urology outpatient clinic for evaluation and treatment by a physician.
Dr.
Lin Wen-Hsu from Nantou Hospital's Urology Department.

Reply Date: 2022/04/24

More Info

Recurrent glans inflammation, also known as balanitis, can be a frustrating condition for many individuals. It is characterized by inflammation of the glans penis, which can lead to symptoms such as redness, swelling, peeling, and discomfort. In your case, it seems that you have experienced an episode of balanitis that improved with treatment but has now returned in a different form, presenting as "white flakes" on the glans.

Understanding Your Symptoms
The symptoms you describe, particularly the presence of white flakes on the glans, could be indicative of several conditions. While it is possible that these flakes are remnants of the healing process following your previous inflammation, they could also suggest a few other possibilities:
1. Post-Inflammatory Changes: After an episode of inflammation, the skin may undergo changes, including peeling or flaking. This is a normal part of the healing process.

2. Fungal Infection: Sometimes, a fungal infection can occur, especially if the area remains moist. This can lead to symptoms similar to what you are experiencing.

3. Dermatological Conditions: Conditions such as psoriasis or eczema can also affect the glans and may present with flaking or scaling.

4. Irritation or Allergic Reaction: If you have recently changed soaps, detergents, or other personal care products, this could lead to irritation or an allergic reaction.

Treatment Options
Given that you have already seen improvement with the use of the topical medication (杏輝必健乳膏), it may be beneficial to continue using it, especially if you notice that it helps alleviate your symptoms. However, if you do not see improvement after a week or if the condition worsens, it would be wise to consult your healthcare provider again. They may recommend:
- Continued Use of Topical Treatments: If the cream has been effective in the past, it may be worth continuing its use for a longer duration, as sometimes treatment needs to be sustained for a full course to achieve complete resolution.

- Antifungal Creams: If a fungal infection is suspected, your doctor may prescribe an antifungal cream to address this.

- Avoidance of Irritants: Continue to avoid harsh soaps or products that may irritate the area. It’s good that you have stopped using body wash on the glans.

- Hygiene Practices: Maintaining good hygiene is crucial. Ensure that the area is kept clean and dry, as moisture can exacerbate inflammation.

Frequency of Sexual Activity
Regarding your concern about the frequency of masturbation, while it is generally considered a normal activity, excessive friction or irritation can lead to inflammation, especially if the skin is already sensitive. Reducing the frequency may help if you notice that it exacerbates your symptoms.

Conclusion
In summary, while the symptoms you are experiencing could be related to a recurrence of balanitis, they may also indicate other underlying conditions. It is essential to monitor your symptoms closely and maintain good hygiene practices. If the condition persists or worsens, seeking further evaluation from a healthcare professional is advisable. They can provide a more accurate diagnosis and tailored treatment plan based on your specific situation. Remember, self-diagnosing can often lead to confusion, so professional guidance is always the best route to take.

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