Struggling with Persistent Foreskin Pain: Seeking Answers After Multiple Doctors

Q: Struggling with Persistent Foreskin Pain: Seeking Answers After Multiple Doctors

Daming： Hello, I believe the issue may be related to your own practices. <br>Don't be too anxious; it's not due to insufficient cleanliness. <br>On the contrary, I suspect you place a high value on cleanliness. <br>You likely take great care in maintaining the glans, using not on

I consulted with 6 to 7 doctors!

Two years ago, while masturbating, I used a common green medicinal soap, and as a result, I experienced abnormal pain in the foreskin during washing.
This led to damage to the foreskin, and after consulting many doctors and undergoing numerous tests, including a urine protein test, I considered the incubation period for potential infections.
After two months, the condition had not improved, and the foreskin remained ulcerated.
All tests for sexually transmitted infections came back negative.
During this time, six different doctors provided varying diagnoses, including herpes (which was painless and itchy, with no signs of blisters, and typically heals within a week), balanitis, candidiasis, and general skin trauma, among others.

Six months ago, while using a condom, the foreskin was again torn.
I decided not to change doctors during this six-month period and consulted a dermatologist.
The same tests were conducted, revealing general skin trauma, candidiasis, balanitis, and herpes (both topical and oral treatments), but the foreskin remained ulcerated for six months.

After consolidating my findings, I realized that after the skin breaks, I should avoid swimming pools and hot baths, especially hot springs, as this causes red spots on the glans, leading to further skin breakdown.
However, even with this knowledge, vigorous masturbation still results in signs of skin tearing on the glans.
I am unsure what this condition is and what solutions are available.
Thank you.

Da Ming, 40~49 year old female. Ask Date: 2009/04/13

Dr. Xu Weikai reply Urology

Daming: Hello, I believe the issue may be related to your own practices.
Don't be too anxious; it's not due to insufficient cleanliness.
On the contrary, I suspect you place a high value on cleanliness.
You likely take great care in maintaining the glans, using not only soap but also various bathing products.
Such cleaning methods are effective and necessary for general skin care, but they can be overly irritating for the perineal area, especially the glans epithelium, and may easily cause damage.

Cleaning the glans should be approached similarly to cleaning the oral cavity or conjunctiva; they are all mucous membranes with a single layer of thin tissue, and do not require cleaning products.
It is generally recommended to clean the glans with plain cold water only—avoid hot water and soaps.
If you feel it is particularly dirty, using soap no more than once a week is advisable, and it is best to use a gentle soap or body wash that feels smooth, such as X brand.
Additionally, it is recommended to dilute the soap before applying it to the glans (for example, dispense 1CC of body wash into your palm and add 2-3CC of water to dilute it before applying to the glans, then rinse off immediately with cold water.
The entire contact process should be less than one minute).
If you frequently experience skin breakdown, consider applying baby oil (such as brands like Jiao X) or a fragrance-free moisturizing lotion (which is less irritating) to the glans after bathing for maintenance.
If you follow my recommendations, your glans should become healthy, and the epithelium will return to its proper state with appropriate care.
In summary, your condition is likely due to long-term irritation from chemical products and hot water, resulting in damage to the glans.
If there are any unclear points, feel free to ask again for further discussion.
Please let me know if you notice significant improvement, so we can confirm the diagnosis.

Sincerely,
Director of Urology,
Taitung Hospital, Department of Health, Executive Yuan
Xu Weikai

Reply Date: 2009/04/13

More Info

It sounds like you have been experiencing persistent and distressing pain related to your foreskin for quite some time, and I understand how frustrating it can be to seek answers from multiple healthcare providers without finding a resolution. Based on your description, it appears that you may be dealing with a combination of factors that could be contributing to your ongoing symptoms.

First, it is important to recognize that the foreskin and glans (the head of the penis) are sensitive areas that can be affected by various conditions, including infections, inflammation, and trauma. Given your history of using a soap that caused an initial injury, it is possible that you may have developed a sensitivity or allergic reaction to certain products, which could exacerbate your symptoms. Additionally, repeated trauma from vigorous masturbation or friction during sexual activity can lead to micro-tears in the skin, resulting in pain and delayed healing.

You mentioned that you have undergone numerous tests for sexually transmitted infections (STIs) and have seen multiple doctors who have provided differing diagnoses, including herpes, candidiasis (yeast infection), and general skin trauma. It is crucial to ensure that any potential infections are thoroughly ruled out, as they can contribute to inflammation and pain. However, since your STI tests have come back negative, it may be worth considering other non-infectious causes.

One possibility is that you may be experiencing a condition known as balanitis, which is inflammation of the glans, often associated with irritation or infection. Balanitis can be caused by poor hygiene, irritants (such as soaps or lotions), or underlying skin conditions like eczema or psoriasis. If you have not already, it may be beneficial to consult a dermatologist who specializes in skin conditions to evaluate your symptoms further.

Another consideration is the role of friction and trauma in your situation. If you find that vigorous masturbation is leading to recurrent injuries, it may be helpful to modify your technique or use a lubricant to reduce friction. Additionally, avoiding hot baths or swimming in pools until your symptoms have fully resolved is wise, as you have noted that these activities seem to exacerbate your condition.

In terms of treatment, if you have not already tried topical corticosteroids, they may help reduce inflammation and promote healing in the affected area. However, these should be used under the guidance of a healthcare provider to avoid potential side effects. If a fungal or yeast infection is suspected, antifungal creams may also be appropriate.

Lastly, if your symptoms persist despite these interventions, you might consider discussing the option of a circumcision with your healthcare provider. This surgical procedure can eliminate the foreskin, which may help prevent future episodes of pain and irritation, particularly if you have ongoing issues with sensitivity or trauma.

In summary, it is essential to continue seeking medical advice, particularly from specialists who can provide a comprehensive evaluation of your symptoms. Keep track of any patterns you notice regarding your symptoms and activities, as this information can be valuable in guiding your treatment. Remember, healing can take time, and it is important to be patient with yourself as you navigate this challenging situation.

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