White Bumps on the Foreskin: Causes and Solutions

Prepuce

I have small white spots on the upper part of my foreskin that look like tiny pimples, but they are not itchy or painful unless I press on them.
They are not located at the junction of the glans and the foreskin, but rather on the inner part of the foreskin, approximately half a centimeter in size, and they are small but concentrated in distribution.
Is this a sexually transmitted infection? Also, I can easily retract my foreskin when not erect, and I can still retract it when erect, but it feels a bit tight.
What should I do? Is foreskin restoration surgery a good option? Thank you, I am quite troubled.

Xiao Tuo, 10~19 year old female. Ask Date: 2008/07/31

Dr. Xu Weikai reply Urology

Hello, White Spot.
Many glands or infections can appear this way.
Further information is needed, or if convenient, please consult a physician nearby.
If there is pain when the foreskin retracts during an erection, it may indicate a condition of phimosis.
If so, you can frequently retract the foreskin or apply some topical corticosteroid ointment.
Ultimately, surgical correction may be necessary.

Regarding circumcision, I personally believe it is worth discussing.
The procedure involves removing the foreskin and filling the soft tissue into the coronal sulcus.
Since tissue is excised, similar to liposuction, blood vessels are damaged, leading to a higher rate of cell death.
Additionally, this surgery is claimed to reduce premature ejaculation, but conversely, it may decrease sensitivity, making arousal more difficult, and in severe cases, it could lead to erectile dysfunction.
In urology, there is a method of circumcision that only removes the epidermis while preserving the underlying soft tissue, leaving it in its original place.
In other words, this approach avoids vascular damage, and the penis may appear larger with less tissue absorption.
Many physicians innovate in circumcision techniques; I have even heard of a doctor who cuts the foreskin into a petal shape, claiming it has better functionality.
However, these methods are not part of traditional medical practice, so please consider this information carefully.
If there are any unclear points, feel free to ask again, and we can further discuss and research together.

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

Reply Date: 2008/07/31

More Info

Understanding white bumps on the foreskin can be concerning, especially when they appear suddenly or change in appearance. Based on your description, these white bumps resemble small pimples, are not itchy or painful, and are located on the inner part of the foreskin rather than at the junction with the glans (head of the penis).
There are several potential causes for these white bumps, and it's important to differentiate between benign conditions and those that may require medical attention. Here are some common causes:
1. Pearly Penile Papules: These are small, white or skin-colored bumps that typically appear around the corona of the glans. They are completely normal and are not a sign of disease or infection. They are often mistaken for sexually transmitted infections (STIs) but are harmless.

2. Fordyce Spots: These are small, painless, pale bumps that can appear on the genital area, including the foreskin. They are sebaceous glands that are visible through the skin and are also benign.

3. Folliculitis: This condition occurs when hair follicles become inflamed, often due to infection or irritation. It can cause small, red, or white bumps that may resemble pimples.

4. Lichen Sclerosus: This is a chronic skin condition that can cause white patches or bumps on the genital area. It may require treatment if it causes discomfort or other symptoms.

5. Sexually Transmitted Infections (STIs): While the bumps you describe do not seem to be painful or itchy, certain STIs can present with similar symptoms. It's essential to consider this possibility, especially if you have had unprotected sexual contact.

Regarding your ability to retract the foreskin, it is normal for the foreskin to feel tight during an erection. If you can retract it comfortably when flaccid and with some tightness when erect, it may not be a cause for concern. However, if you experience pain or difficulty retracting the foreskin, it could indicate a condition known as phimosis, which may require medical evaluation.

As for the question of circumcision, this is a personal decision that should be made in consultation with a healthcare provider. Circumcision can be beneficial for individuals with recurrent infections, phimosis, or other complications. However, it is not necessary for everyone, especially if there are no significant issues.

In summary, the white bumps you are experiencing are likely benign, but it is always best to consult a healthcare professional for an accurate diagnosis and personalized advice. They may perform a physical examination and, if necessary, conduct tests to rule out any infections or other conditions. If you are feeling anxious or concerned about your symptoms, seeking medical advice can provide reassurance and clarity.

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