Small red spots on the glans?
Hello, Dr.
Hsu.
I had previously asked some questions in early to mid-April regarding the small red spots on my glans and balanitis.
Now, nearly two months have passed, and the redness and swelling of the foreskin have subsided, and it generally no longer itches (although sometimes I feel a slight discomfort, which I’m unsure if it’s just psychological or due to the glans' surface still healing from abrasion).
However, the small red spots are still present.
During this period, I consulted three different doctors and applied three different medications (tetracycline, Canesten, and Mingde ointment from a dermatologist), but since these red spots are only about the size of a ballpoint pen tip when erect, the doctors were unable to observe them during the examinations, and all three said there shouldn't be any major issues.
One suggested it might be caused by the foreskin and that I shouldn't worry about it.
Another mentioned it could be a result of using body wash, similar to how freckles develop from sun exposure on the face, and that it should resolve in 2-3 months.
The last doctor said that as long as the spots haven't increased in size or number, there’s no need for concern (and indeed, they haven't changed in size or number, just haven't disappeared).
To be honest, I’m not very keen on continuing to apply ointments, but the fact that it hasn't improved in nearly two months is starting to cause me some stress.
Therefore, I would like to ask for your advice: should I see a different doctor, or would it be better to continue washing with cold water for another 1-2 months and observe? I apologize for bothering you again.
Sam, 20~29 year old female. Ask Date: 2010/06/07
Dr. Xu Weikai reply Urology
Sam: Hello, it's really difficult to diagnose without seeing the lesion.
However, all three doctors believe it is not a major issue, so it should be fine.
Additionally, it could be considered whether it is caused by cleaning activities.
For example, the habit of using cleaning products to clean the glans or frequently using hot water for cleaning could potentially cause damage to the epidermis.
Recommendation: It is advisable to clean with cool water regularly.
If necessary, after cleaning, you can use baby oil or lotion to care for the glans.
If there are any unclear points, feel free to ask again, and we can discuss and research further.
This response is from Dr.
Hsu Wei-kai, Director of Urology, Taitung Hospital, Department of Health, Executive Yuan.
Reply Date: 2010/06/07
More Info
Understanding red dots on the glans can be a source of concern for many individuals, especially when accompanied by discomfort or changes in the appearance of the skin. Based on your description, it seems that you have been dealing with this issue for a couple of months, and while some symptoms have improved, the presence of the red dots remains.
Firstly, it is important to recognize that red dots on the glans can arise from various causes. These may include:
1. Irritation or Allergic Reactions: Products such as soaps, lotions, or even certain fabrics can cause irritation or allergic reactions, leading to redness or small red spots. If you have recently changed any personal care products, this could be a contributing factor.
2. Infections: Conditions like balanitis (inflammation of the glans) can cause redness and discomfort. Fungal infections, bacterial infections, or sexually transmitted infections (STIs) can also present with similar symptoms. However, since you mentioned that the inflammation has subsided and you have been treated with antibiotics and antifungal medications, this seems less likely.
3. Pearly Penile Papules: These are small, harmless bumps that can appear on the glans and are often mistaken for other conditions. They are normal anatomical variations and do not require treatment.
4. Fordyce Spots: These are small, painless, pale bumps that can appear on the genital area and are also harmless.
5. Dermatological Conditions: Conditions such as psoriasis or eczema can affect the genital area and may present as red spots or patches.
Given that you have seen multiple doctors and have been reassured that there is no significant concern, it may be beneficial to take a conservative approach. Here are some recommendations:
- Observation: Since the red dots have not changed in size or number, it may be reasonable to monitor them for a bit longer. If they remain stable and do not cause discomfort, this could indicate that they are benign.
- Gentle Hygiene: Continue to maintain good hygiene by washing the area with mild soap and water. Avoid using harsh soaps or products that could irritate the skin.
- Avoid Irritants: If you suspect that certain products may be causing irritation, consider eliminating them from your routine.
- Consult a Dermatologist: If the red dots persist beyond a few months or if you develop new symptoms, it may be worthwhile to consult a dermatologist who specializes in skin conditions. They may provide a more thorough examination and potentially a biopsy if necessary to rule out any underlying conditions.
- Stress Management: It’s understandable to feel anxious about persistent symptoms. Engaging in stress-reducing activities may help alleviate some of the psychological pressure associated with this condition.
In conclusion, while it is always prudent to seek medical advice for persistent symptoms, the current situation you describe does not seem to indicate an urgent issue. Monitoring the condition while maintaining good hygiene practices and avoiding irritants may be the best course of action for now. If you notice any changes or if the discomfort increases, do not hesitate to seek further medical evaluation.
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