Small Skin Lesions Under the Foreskin: Causes and Concerns - Urology

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Understanding small skin lesions under the foreskin can be a complex issue, especially when there is a history of genital herpes and concerns about phimosis (tight foreskin). The symptoms you describe—small, non-painful, and non-itchy lesions that sometimes appear after sexual activity—could be attributed to several factors.

Firstly, the lesions you are experiencing may not necessarily be directly related to herpes. While genital herpes can cause sores, the characteristics of your lesions—being small, not painful, and sometimes appearing without sexual activity—suggest that they could be due to friction or irritation rather than an active herpes outbreak. Friction from sexual activity or even from daily activities can lead to micro-tears in the skin, especially in sensitive areas like the foreskin. This can result in small lesions that may heal quickly, as you have noted.

The redness and darkening of the surrounding skin could indicate irritation or inflammation, possibly due to friction, moisture, or even a mild infection. It’s important to maintain good hygiene in the area, but also to avoid excessive washing or scrubbing, which can exacerbate irritation.
Using herpes medication when you notice these lesions is understandable, especially if you have a history of herpes outbreaks. However, if the lesions are not painful and heal within a week, it may be more beneficial to focus on preventing irritation. Consider using a gentle, fragrance-free moisturizer to keep the area hydrated and reduce friction.
If you notice that these lesions are recurring frequently, or if they change in appearance, it would be wise to consult a healthcare professional, preferably a dermatologist or urologist. They can perform a thorough examination and may recommend tests to rule out other conditions, such as a fungal infection, contact dermatitis, or other skin disorders.

In terms of prevention, here are some strategies you might consider:
1. Hygiene: Maintain good hygiene by gently cleaning the area with mild soap and water. Avoid harsh soaps or products that can irritate the skin.

2. Moisturization: Use a gentle, hypoallergenic moisturizer to keep the skin hydrated, especially after washing.

3. Friction Reduction: If you engage in activities that may cause friction, consider using a lubricant during sexual activity to minimize irritation.

4. Clothing Choices: Wear loose-fitting underwear and clothing to reduce friction and allow the area to breathe.

5. Monitor Symptoms: Keep track of when the lesions appear and any activities that may correlate with their onset. This can help identify triggers.

6. Consultation: If the lesions persist or worsen, seek medical advice for a proper diagnosis and treatment plan.

In summary, while the lesions you describe may not be typical herpes sores, they warrant attention to ensure proper care and management. Consulting a healthcare professional will provide you with the best course of action tailored to your specific situation.