Red Spots on the Glans: Causes and Concerns - Urology

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Excessive red spots on the glans?


Hello, doctor.
I have a condition of phimosis where I can pull it down during an erection, but it feels a bit tight.
Usually, it is covered.
I apologize for the details, but I am gay.
Recently, I had what I suspect was an unsafe sexual encounter where the other person performed oral sex on me, and I also performed oral sex on them for about half a minute without them ejaculating.
However, I did taste something salty, which I assume was pre-ejaculate.
I have been very worried about this.
Since the incident happened less than three months ago, I have not yet undergone HIV testing.
Recently, I have noticed red spots frequently appearing on my glans.
Sometimes they disappear after two or three days, but then they reappear again.
This time, there are even more red spots, and they have persisted for many days without disappearing.
Here is a photo: http://img828.imageshack.us/img828/3829/98986545.jpg.
I am unsure what the issue could be.
I wash thoroughly while showering and rinse with water or wipe with tissue after using the restroom.
The foreskin also itches occasionally, but sometimes it does not.
Additionally, I noticed small white bumps under the glans that I had never paid attention to before.
I only noticed them last time.
I am unsure what they are...
Here is a photo: http://img42.imageshack.us/img42/7205/14145943.jpg.
I am really worried, but due to not being able to test for HIV yet, I have been unable to give myself a clear answer.
I think about this issue constantly, and it has become quite exhausting.
Thank you, doctor.

Xiao Kou, 20~29 year old female. Ask Date: 2010/09/06

Dr. Xu Weikai reply Urology


Hello, the red rash you see is likely due to localized inflammation, which could be an infection, but it is more probable that it is caused by local irritation from substances like soap or cleaning products.
You can apply petroleum jelly locally, and it should improve in 3-5 days.
Additionally, when washing in the future, use cold water.
Avoid hot water and do not use any cleaning products to clean the glans.

Regarding the second photo, it appears to be a normal gland.
You can monitor it to see if it increases in number or size.
Furthermore, in addition to testing for HIV, I recommend including a syphilis screening, as I have seen quite a few cases in the outpatient clinic recently, and I'm not sure why! If you have any further questions, feel free to ask, and we can discuss and research it together.

Sincerely,
Department of Urology, Taitung Hospital, Ministry of Health and Welfare
Director: Dr.
Hsu Wei-Kai

Reply Date: 2010/09/06

More Info


It sounds like you're experiencing some concerning symptoms related to your glans, including the appearance of red spots and itching, along with a history of potential exposure to sexually transmitted infections (STIs). Let's break down the possible causes and concerns regarding these symptoms.


Possible Causes of Red Spots on the Glans
1. Irritation or Allergic Reaction: The skin on the glans can be sensitive, and irritation from soaps, lotions, or even friction during sexual activity can lead to redness and spots. If you've recently changed any products you use for personal hygiene, this could be a factor.

2. Infections: Given your history of potential exposure during sexual activity, it's important to consider sexually transmitted infections. Conditions such as herpes, syphilis, or human papillomavirus (HPV) can present with red spots or lesions on the genital area.
3. Balanitis: This is an inflammation of the glans, often caused by infections (bacterial or fungal) or irritants. Symptoms can include redness, swelling, and sometimes discharge. It can occur more frequently in individuals with phimosis (tight foreskin), which you mentioned you have.

4. Pearly Penile Papules: These are small, harmless bumps that can appear around the corona of the glans. They are normal anatomical variations and not a cause for concern.

5. Fordyce Spots: These are small, painless, pale bumps that can appear on the glans and are sebaceous glands that are not associated with any disease.


Recommendations for Management
1. Hygiene: Continue to maintain good hygiene by gently washing the area with mild soap and water. Avoid harsh soaps or products that could irritate the skin.

2. Avoid Irritants: If you suspect that any products you are using may be causing irritation, consider discontinuing them and see if your symptoms improve.

3. Monitor Symptoms: Keep an eye on the red spots. If they persist, change in appearance, or if you develop additional symptoms such as pain, discharge, or fever, it’s important to seek medical attention.

4. STI Testing: Since you mentioned a potential exposure, it is crucial to get tested for STIs, including HIV. While you may feel anxious about the timing, many tests can be done sooner than three months after exposure, and knowing your status can help alleviate some of your concerns.

5. Consult a Healthcare Provider: Given your symptoms and the anxiety they are causing you, it would be wise to consult a healthcare provider or a urologist. They can perform a physical examination, possibly run tests, and provide a definitive diagnosis and treatment plan.


Conclusion
Your symptoms could be due to a variety of causes, ranging from benign to more serious conditions. It's understandable to feel anxious, especially with your recent sexual history. However, the best course of action is to seek professional medical advice. They can provide you with the appropriate tests and treatments to address your concerns effectively. Remember, early intervention is key in managing any potential health issues.

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