Penile Skin Injuries: Causes, Treatments, and Concerns

Q: Penile Skin Injuries: Causes, Treatments, and Concerns

Hello： Regarding your condition： This facility is unable to provide a diagnosis, as it is mostly due to the presence of wounds and subsequent poor care. <br>Taking ACYCLOVIR before detection will not pose significant issues, unless there is an allergy. <br>The interpretation of t

Penile friction injury due to vigorous insertion?

Hello, due to work commitments, I am unable to return to Taiwan for a consultation in the short term, and I would like to seek your professional advice.

On February 21, I had sexual intercourse without lubrication, which resulted in a foreskin abrasion.
From February 25 to February 27, I applied a topical ointment called "Ruankang" (no improvement).
From February 28 to March 1, I used "Lifuh" (still no improvement, and the wound area gradually expanded).
From March 2 to March 11, I visited a urologist who prescribed oral Cefadroxil and topical tetracycline eye ointment.
Tests were ordered for syphilis, HIV, herpes simplex IgM, and a urinalysis.
On March 12 to March 18, I returned for a follow-up, and the doctor said all test results were normal.
He prescribed oral Amoxicillin and topical "Pidaifu" cream.
Initially, there was only an abrasion on the foreskin, but this week, I started to develop a wound on the glans as well.
From March 19 to March 25, I returned for another follow-up, and the doctor continued to prescribe oral Amoxicillin and topical "Pidaifu" cream (slight improvement, the wound was less red).
From March 26 to April 1, during my follow-up, the doctor noted that the wound appeared a bit dry and changed the topical treatment to "Winston Bida" eye ointment, without prescribing oral medication.
After using this ointment for a week, the wound worsened and became redder.
On April 2, I returned, and the doctor observed the worsening condition, suspecting it might be herpes, and prescribed oral Acyclovir and topical Spersin ointment.
Tests were ordered for herpes simplex IgG and Chlamydia antibodies.
Upon reviewing the ingredients of Spersin at home, I found that Ruankang, Lifuh, Bida, and Spersin all contain Neomycin, and every time I applied a cream containing this ingredient, the wound worsened.
I left the Spersin ointment unopened and only took Acyclovir.
On April 5, I consulted a dermatologist; by this time, the foreskin had turned inside out, and the wound was secreting a large amount of thick fluid, with pain akin to being cut multiple times with a utility knife.
I informed the dermatologist about my previous treatment at the urology clinic, and he prescribed oral Doxycycline, Ibuprofen, Dexamethasone, and Strocain; he also administered an injection of Lincomycin and prescribed topical Gentamicin ointment.

As of April 14 (I am currently abroad), I have been following the dermatologist's instructions for medication and topical treatment, and the secretion of thick fluid from the wound has gradually decreased, with slight improvement in pain.
I checked the hospital's website for my blood test results from April 2: Herpes Simplex IgG: <0.5, Chlamydia Ab (TIP): 8.0 RU/ml.

I have the following questions:
1.
Both herpes simplex IgM and IgG are <0.5, but the urologist prescribed Acyclovir before the test results were available.
I followed the prescription for a week; what impact could this have on my body?
2.
How should I interpret the Chlamydia Ab (TIP) result of 8.0 RU/ml?
3.
Since my wound worsens whenever I apply ointments containing Neomycin, could this indicate an allergy to this ingredient, or could there be other factors involved?
4.
After more than a month of using medications, especially antibiotic ointments for such an extended period, will this lead to thinning of the skin on the foreskin and glans, or could there be other long-term effects on my body?

Anderson, 30~39 year old female. Ask Date: 2024/04/15

Dr. Du Shixi reply Urology

Hello: Regarding your condition: This facility is unable to provide a diagnosis, as it is mostly due to the presence of wounds and subsequent poor care.
Taking ACYCLOVIR before detection will not pose significant issues, unless there is an allergy.
The interpretation of the presence of bacteria requires standard values, and NEOMYCIN is commonly used; if there are repeated adverse reactions, it should be avoided.
If the wound does not heal over a long period, there may be risks of pigmentation, scarring, or narrowing.
Currently, it is important to take good care of the wound, keeping it clean and dry, paying attention to diet, and temporarily avoiding sexual activity.
Wishing you good health.

Reply Date: 2024/04/15

More Info

Understanding penile skin injuries, particularly those resulting from friction or trauma during sexual activity, is crucial for effective treatment and recovery. Based on your detailed account, it seems you have been experiencing a significant and persistent issue following a friction injury to the penile skin. Here’s a comprehensive response to your questions, along with some additional insights into the management of such injuries.

1. Impact of Acyclovir: Acyclovir is an antiviral medication primarily used to treat infections caused by certain types of viruses, including herpes simplex virus. Given that your IgM and IgG results for herpes were both <0.5, indicating no active infection, the use of Acyclovir may not have been necessary. However, taking Acyclovir for a week is unlikely to cause harm, as it is generally well-tolerated. If there was a suspicion of a herpes infection based on clinical presentation, the physician may have opted for a trial of Acyclovir as a precautionary measure.
2. Chlamydia Ab (TIP) Result: The Chlamydia antibody test measures the immune response to Chlamydia trachomatis, a common sexually transmitted infection. A result of 8.0 RU/ml suggests a positive response, indicating possible exposure to the bacteria. However, the interpretation of this result should be done in conjunction with clinical symptoms and other diagnostic tests. If you are asymptomatic and have no other signs of infection, it may warrant further investigation or a repeat test to confirm the diagnosis.

3. Reaction to Neomycin: Neomycin is an antibiotic that can cause allergic reactions in some individuals, leading to contact dermatitis or worsening of skin conditions. Given your experience of worsening symptoms upon application of products containing Neomycin, it is plausible that you may have developed a sensitivity or allergy to this ingredient. It is advisable to avoid all products containing Neomycin and to inform your healthcare providers of this reaction for future reference.

4. Long-term Effects of Prolonged Medication Use: Prolonged use of topical antibiotics and corticosteroids can lead to skin thinning (atrophy), especially in sensitive areas like the genital region. While your current treatment regimen may be necessary to manage your symptoms, it is essential to monitor for any signs of skin thinning or other adverse effects. If you notice any changes in the skin's texture or thickness, or if symptoms persist, it would be prudent to consult your healthcare provider for a reassessment of your treatment plan.

Additional Considerations:
- Wound Care: Proper wound care is critical for healing. Keeping the area clean and dry, avoiding irritants, and using non-irritating topical treatments can help facilitate recovery. If you experience pain or discomfort, over-the-counter pain relief options may be beneficial, but always consult with your healthcare provider before starting any new medication.

- Follow-up Care: Given the complexity of your case and the persistence of symptoms, regular follow-up with a dermatologist or urologist is essential. They can provide tailored advice based on the evolution of your condition and may suggest alternative treatments if current therapies are ineffective.

- Psychological Impact: Chronic skin conditions, especially in sensitive areas, can lead to anxiety and distress. It may be helpful to discuss these feelings with a healthcare professional or counselor who can provide support and coping strategies.

In conclusion, while you have been proactive in seeking treatment for your penile skin injury, it is crucial to continue working closely with your healthcare providers to ensure the best possible outcome. Monitoring your symptoms, avoiding known irritants, and maintaining open communication with your medical team will be key to your recovery.

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