Red Spots on the Glans: Causes and Solutions for Persistent Discomfort

Red spots on the glans of the penis?

There are two or three red spots of varying sizes on the glans that are not raised.
Initially, there was itching, and the skin appeared wrinkled with some flaking resembling peeling.
Then, red spots appeared, and there was pain during sexual intercourse.
There are no unusual secretions.
The symptoms have been recurring for about 3 to 4 months.
Currently, there are only red spots, which are not very itchy, but there is still some discomfort.
(My boyfriend had a previous Chlamydia infection, which has been treated.
He mentioned that this condition started occurring after that.) The doctors in the UK seem quite casual; we both went to a GUM clinic for blood tests, and it was not a sexually transmitted infection.
The doctor suggested it might be thrush and prescribed a cream called clotrimazole B.P., but it has not been effective.
(It should not be thrush, as my test results showed no thrush.) Later, we consulted another doctor who suggested it might be a skin condition and prescribed two medications for him: the first one for 5 days with a restriction on alcohol, and the second one for 7 days.
Still, there has been no improvement, and the red spots persist! My boyfriend has excellent hygiene habits, and the weather in the UK is relatively dry and cool.
Could this be eczema or balanitis? Thank you for your time.

xià, 20~29 year old female. Ask Date: 2005/03/08

Dr. Liu Jianting reply Urology

It doesn't seem to be serious; it might be a fungal infection (Tinea).
Applying an ointment should help, but it can easily recur.

Reply Date: 2005/03/08

More Info

Red spots on the glans can be concerning and uncomfortable, especially when accompanied by symptoms like itching, peeling skin, and pain during sexual activity. Given the symptoms you've described, there are several potential causes for these red spots, and understanding them can help guide you toward effective treatment.

1. Irritation or Dermatitis: One common cause of red spots and discomfort on the glans is irritation or dermatitis, which can arise from various factors, including friction, allergic reactions to soaps, lotions, or condoms, or even excessive moisture. This condition can lead to symptoms like redness, peeling, and discomfort. If your boyfriend has a history of chlamydia, it’s important to ensure that any irritation is not related to residual effects from previous infections or treatments.

2. Balanitis: This is an inflammation of the glans (the head of the penis) that can be caused by infections, poor hygiene, or skin conditions. Symptoms typically include redness, swelling, and sometimes discharge. Balanitis can be caused by fungal infections (like thrush), bacterial infections, or even sexually transmitted infections. Since you mentioned that thrush was ruled out, it might be worth considering other types of infections or irritants.

3. Eczema or Psoriasis: Skin conditions like eczema or psoriasis can also manifest as red spots or patches on the glans. These conditions can cause dryness, peeling, and discomfort. If your boyfriend has a history of skin conditions, this could be a possibility.

4. Sexually Transmitted Infections (STIs): Although you mentioned that tests for STIs came back negative, it’s important to consider that some infections can be asymptomatic or may not show up in standard tests. Conditions like herpes or HPV can sometimes present with red spots or lesions.

5. Folliculitis: This is an inflammation of the hair follicles that can occur in the genital area. It can cause red bumps or spots and may be itchy or painful.

6. Contact Dermatitis: If your boyfriend has recently changed soaps, detergents, or personal care products, he may be experiencing contact dermatitis, which can lead to red spots and irritation.

Given that the symptoms have persisted for several months and have not improved with over-the-counter treatments, it is crucial to seek further medical evaluation. Here are some steps you can take:
- Consult a Dermatologist: A specialist in skin conditions may provide a more accurate diagnosis and treatment plan. They can perform a thorough examination and may suggest a skin biopsy if necessary.

- Consider Allergy Testing: If contact dermatitis is suspected, allergy testing can help identify any allergens that may be causing the irritation.

- Maintain Hygiene: Ensure that the area is kept clean and dry. Avoid using harsh soaps or products that may irritate the skin.

- Avoid Irritants: If you suspect that certain products (like lubricants or condoms) may be causing irritation, consider switching to hypoallergenic options.

- Follow-Up on Treatment: If prescribed medications are not effective, follow up with the healthcare provider to discuss alternative treatments or further investigations.

In summary, while the red spots on the glans can be attributed to various causes, persistent symptoms warrant a thorough evaluation by a healthcare professional. It’s essential to address any underlying conditions and to find a treatment that alleviates discomfort effectively.

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