Irregular Black Spots on the Penis: Causes and Concerns - Dermatology

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When it comes to irregular black spots on the penis, particularly on the foreskin behind the glans, there are several potential causes that should be considered. The description of the spots being irregularly shaped, not circular, and slightly raised, along with a history of redness and swelling after intercourse, raises some important clinical considerations.

One possible cause of these black spots could be related to post-inflammatory hyperpigmentation. This occurs when the skin darkens in response to inflammation or injury. If there was a previous episode of irritation or infection, such as balanitis (inflammation of the glans), the skin may have reacted by producing excess melanin, leading to the appearance of dark spots.

Another possibility is the presence of seborrheic keratosis or other benign skin lesions. These can appear as raised, irregular spots on the skin and are generally harmless. However, they can sometimes be mistaken for more serious conditions.

A more concerning possibility is the presence of a sexually transmitted infection (STI) or a dermatological condition such as genital warts (caused by the human papillomavirus) or molluscum contagiosum. These conditions can present with irregularly shaped lesions and may require specific treatments. The fact that the spots are associated with previous redness and swelling after intercourse could suggest an infectious process.

It is also important to consider the possibility of a more serious condition, such as melanoma or other skin cancers, especially if the spots change in appearance, size, or color over time. While this is less common, any new or changing skin lesion should be evaluated by a healthcare professional.

Given the symptoms you described, including the history of redness and swelling, it is crucial to seek medical attention. A healthcare provider, particularly a dermatologist or urologist, can perform a thorough examination and may recommend a biopsy of the lesions if there is any concern for malignancy. This will provide a definitive diagnosis and guide appropriate treatment.

In the meantime, it is advisable to avoid any irritants, such as harsh soaps or lotions, and to practice good hygiene. Keeping the area clean and dry can help prevent further irritation or infection. If you are sexually active, consider discussing your symptoms with your partner and practicing safe sex to reduce the risk of transmitting any potential infections.

In summary, while there are several benign explanations for the irregular black spots on the penis, the combination of your symptoms warrants a professional evaluation to rule out any serious conditions. Early diagnosis and treatment are key to managing any potential issues effectively.