White Spots on the Penis: Causes and Concerns

Milia

Hello, Doctor.
About two and a half months ago, I had unprotected oral sex with a sex worker.
Two days ago, I noticed a few small white spots on my glans.
They are not painful or itchy.
Today, I discovered that two of them have broken skin, but they still do not hurt or itch.
In the past month, I have been tested for HIV, syphilis, gonorrhea, herpes, chlamydia, and other STDs.
The doctor noted some mild inflammation of my foreskin and recommended circumcision.
All my STD test results came back negative.
Does this mean I have an STD, or could the previous tests have been inaccurate? I have been unable to eat or sleep for the past two days and am very distressed.
I would appreciate your response.
Thank you.

Kunrao bu yi, 30~39 year old female. Ask Date: 2005/02/01

Dr. Xu Weikai reply Urology

Hello, without protection, there is indeed a risk of infection.
Typically, we recommend retesting for HIV, syphilis, and other sexually transmitted infections three months after exposure for more accurate results, which helps avoid the window period.
Previous tests cannot be deemed inaccurate; however, sometimes infections may not be detectable in a short time frame, and antibodies may not yet be present in the serum.
Generally, testing three months later can provide reliable results.
In other words, if the test results are normal after three months, it indicates no infection.

Regarding the small white spots on the glans, if they are located in the sulcus of the glans, they may simply be normal glands—pearly penile papules—and there is usually no need for concern.
However, if they appear in other areas, it would be advisable to consult a physician for peace of mind, as they could be related to ulcers or infections caused by bacteria or fungi, which may require localized treatment.

Sincerely,
Dr.
Hsu Wei-Kai,
Director of Urology, Taitung Hospital, Department of Health, Executive Yuan.

Reply Date: 2005/02/01

More Info

The appearance of white spots on the penis can be concerning, especially after potential exposure to sexually transmitted infections (STIs). Based on your description, it seems you have already taken proactive steps by undergoing testing for various STIs, including HIV, syphilis, gonorrhea, herpes, and chlamydia, all of which returned negative results. This is a positive sign, but it does not completely rule out the possibility of other conditions.

The small white spots you are observing on the glans (the head of the penis) could be due to several benign causes. One common condition is pearly penile papules, which are small, harmless bumps that can appear around the corona of the glans. These are normal anatomical variations and are not associated with any disease or infection. They are typically painless and do not require treatment.

Another possibility is a condition known as balanitis, which is inflammation of the glans. This can occur due to poor hygiene, irritation from soaps or lotions, or infections. Balanitis can lead to symptoms such as redness, swelling, and sometimes the formation of small white spots or patches. If your healthcare provider noted some inflammation of the foreskin, this could be related to balanitis, and circumcision may be recommended to prevent future occurrences.

You mentioned that two of the spots have broken skin but are not painful or itchy. This could indicate a mild irritation or a superficial skin issue rather than a serious infection. However, if the skin continues to break down or if you develop additional symptoms such as pain, discharge, or persistent itching, it would be prudent to seek further evaluation from a healthcare provider.

It’s also worth noting that while your STI tests were negative, there are some infections that may not be detected immediately after exposure, such as HIV or herpes, which can take time to show up in tests. However, given that you have been tested multiple times and received negative results, the likelihood of an undetected STI is low.

In terms of your anxiety regarding this situation, it is understandable to feel worried, especially when it comes to sexual health. Stress and anxiety can also affect your appetite and sleep, as you mentioned. It may be beneficial to talk to a mental health professional or a counselor who can help you manage these feelings.

In summary, while the white spots on your penis could be benign, it is essential to monitor them closely. If they change in appearance, become painful, or if you develop new symptoms, please consult a healthcare provider for a thorough examination. Maintaining good hygiene and following your doctor's advice regarding circumcision may help prevent future issues. Remember, it’s always better to seek medical advice if you have concerns about your health.

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