Persistent Peeling on Glans: Why Does It Return After Stopping Treatment?

The glans has peeling skin under the foreskin, and it relapses as soon as the medication is stopped?

There are flakes (peeling?) on the glans and foreskin, which can be washed away with water during bathing.
I visited a urologist who prescribed Daivonex ointment, stating it was a skin issue, as the skin appeared dry.
I wasn't aware that the foreskin could be retracted for cleaning, so I may have had an infection for several years, previously thinking it was just smegma.
During the treatment, I bathed daily, and the glans looked very clean without flakes or peeling.
However, every time I stop the medication, after two to three days, it recurs, and the flakes start to appear again.
I have used five tubes of Daivonex ointment.
Should I switch to a different ointment or continue using this one? Thank you.

Xiao Zhong, 30~39 year old female. Ask Date: 2023/04/25

Dr. Wu Yuxin reply Dermatology

After discontinuing medication, has the cleanliness routine also become inconsistent? Circumcision may be considered.

Reply Date: 2023/04/25

More Info

Persistent peeling on the glans can be a frustrating condition, especially when it seems to return shortly after stopping treatment. Based on your description, it sounds like you have been dealing with a skin issue that may be related to dryness or irritation, possibly exacerbated by improper hygiene practices in the past. The fact that you noticed improvement while using the prescribed medication (Daktarin cream) suggests that the treatment was effective in managing the symptoms, but the recurrence of peeling after stopping the medication indicates that the underlying issue may not have been fully resolved.

When it comes to skin conditions, particularly in sensitive areas like the glans, several factors can contribute to persistent symptoms. Here are some considerations:
1. Underlying Skin Condition: Conditions such as balanitis (inflammation of the glans), dermatitis, or even fungal infections can cause peeling and irritation. If the underlying cause is not addressed, symptoms may return after stopping treatment. It's essential to have a thorough evaluation by a healthcare provider to determine the exact nature of the skin issue.

2. Hygiene Practices: As you mentioned, not being aware of the need to clean under the foreskin may have led to a buildup of smegma, which can irritate the skin. Proper hygiene is crucial in preventing recurrence. Make sure to gently clean the area daily, especially if you have a retractable foreskin.

3. Moisturization: If dryness is a contributing factor, consider using a gentle, fragrance-free moisturizer after bathing to help maintain skin hydration. This can be particularly helpful if the skin appears dry or flaky.

4. Medication Use: If Daktarin cream was effective, it may be worth discussing with your doctor whether you should continue using it for a more extended period or if there are alternative treatments that may be more suitable. Sometimes, a combination of treatments or a different formulation may be necessary to achieve lasting results.

5. Follow-Up with a Specialist: If the problem persists despite treatment, it may be beneficial to return to a urologist or a dermatologist specializing in skin conditions. They may recommend additional tests or alternative treatments, such as topical steroids or antifungal medications, depending on the diagnosis.

6. Lifestyle Factors: Consider any lifestyle factors that may contribute to skin irritation, such as the use of harsh soaps, tight clothing, or irritants in personal care products. Switching to milder products and wearing breathable fabrics can help reduce irritation.

In summary, while it is understandable to want to continue using a medication that has shown effectiveness, the recurrence of symptoms after stopping treatment suggests that further evaluation is necessary. It is advisable to consult with your healthcare provider to discuss your ongoing symptoms, potential underlying causes, and the best course of action moving forward. They may suggest continuing the current treatment, adjusting the medication, or exploring other options to help manage and resolve the peeling on the glans effectively.

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