Dark Red and Purple Spots on the Glans: Causes and Treatments - Dermatology

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The presence of dark red or purple spots on the glans (the head of the penis) can be concerning and may arise from various causes. Based on your description, the spots have increased in size and have a distinct coloration, which warrants careful evaluation. Here’s a breakdown of potential causes and considerations for treatment.


Possible Causes
1. Pigmentation Changes: The dark red or purple spots may represent benign pigmentation changes. These can occur due to various factors, including friction, irritation, or even normal anatomical variations. However, the fact that the spots are expanding is noteworthy and should be monitored.

2. Fungal Infections: As suggested by your dermatologist, a fungal infection could be a possibility. Conditions like candidiasis can lead to discoloration and irritation of the skin. The use of antifungal creams like Bifonazole (Mycoson) is appropriate, but it may take time to see improvement. If there is no response after two weeks, further evaluation may be necessary.

3. Granuloma Annulare: This is a benign skin condition that can present as ring-shaped lesions. It is often asymptomatic and can resolve on its own. The description of a ring-like appearance with a darker center could align with this condition.

4. Lichen Planus: This is an inflammatory condition that can affect the skin and mucous membranes, presenting as purple, itchy lesions. While it typically causes discomfort, some forms can be asymptomatic.

5. Other Dermatological Conditions: Conditions such as psoriasis, eczema, or even sexually transmitted infections (STIs) could also present with similar symptoms. Given that you have ruled out unclean sexual practices, STIs may be less likely, but they should still be considered if other symptoms arise.


Recommendations
1. Follow-Up with Dermatology: Since your symptoms have persisted and expanded, it is crucial to follow up with a dermatologist, especially one who specializes in genital dermatology. They may perform a biopsy or other tests to rule out more serious conditions.

2. Monitor Symptoms: Keep an eye on any changes in size, color, or associated symptoms (such as itching, pain, or discharge). Documenting these changes can provide valuable information for your healthcare provider.

3. Avoid Irritation: Continue to practice good hygiene, but avoid any products that may irritate the area. Wearing loose-fitting underwear and avoiding tight clothing can help minimize friction.

4. Consider Allergies or Irritants: Sometimes, skin reactions can be due to contact dermatitis from soaps, detergents, or even latex in condoms. If you have recently changed any products, consider reverting to previous ones to see if symptoms improve.

5. Patience with Treatment: If a fungal infection is suspected, it may take time for the antifungal treatment to show results. Ensure you complete the full course of treatment as prescribed.


Conclusion
While the dark red or purple spots on your glans may not be immediately alarming, the expansion of the lesions and the lack of improvement with initial treatment warrant further investigation. It is essential to maintain open communication with your healthcare providers and follow their recommendations closely. Early diagnosis and treatment are key to managing any potential underlying conditions effectively. If you experience any new symptoms or significant changes, seek medical attention promptly.