Recurrent Itching Under the Foreskin: Causes and Solutions

Q: Recurrent Itching Under the Foreskin: Causes and Solutions

Hello： That is smegma, which is produced daily, so it should be cleaned regularly. <br>However, there is no need to scrub for 1-2 minutes; gently wash with lotion will suffice. <br>It is not a medical issue, and no further examinations are necessary. <br>It is recommended that yo

Recurrent itching of the foreskin?

Hello Doctor: I have a bit of phimosis, where the foreskin does not retract naturally during an erection, but I can manually expose the entire glans.
Therefore, I pay close attention to hygiene and wash with cold water (without any cleanser) for about 1 to 2 minutes every day during my shower.
My cleaning habits have not changed, but I am unsure why my condition keeps recurring.
The symptoms are as follows: the glans itself does not itch, but the foreskin (especially the area around the urethra beneath the glans) is particularly itchy and red.
I can also see a white layer on the foreskin that can be easily rubbed off, and the surface of the glans feels less smooth to the touch.

In terms of treatment, a few months ago, I experienced similar symptoms, and a urologist prescribed me Miconazole cream, which I applied for four days without improvement.
I then ignored it, continued my normal cleaning routine, and after about two weeks, it resolved.
Since then, I have maintained the same cleaning habits, and there were no recurrences.
However, I am puzzled as to why, despite the same cleaning routine, the symptoms have returned recently.
It is quite alarming that after showering at night, I wake up feeling very itchy, and upon washing again, I find the white layer, which means I have to wash within about six hours to avoid significant itching.

I recently started using Miconazole cream again, and I am unsure if it is improving because it has been two weeks or if the cream is effective.
I would like to know the reason behind this, or if this symptom description indicates a precursor to some condition.
This year, during my health check-up, I specifically tested for HIV, syphilis, chlamydia, herpes, and other common STDs, all of which came back normal.
I am uncertain what further tests I could undergo, as the laboratory mentioned that these four tests cover the general STDs.

Māomī, 20~29 year old female. Ask Date: 2013/02/17

Dr. Lin Hexing reply Urology

Hello: That is smegma, which is produced daily, so it should be cleaned regularly.
However, there is no need to scrub for 1-2 minutes; gently wash with lotion will suffice.
It is not a medical issue, and no further examinations are necessary.
It is recommended that you consult a dermatologist.
Wishing you peace and health.

Reply Date: 2013/02/17

More Info

Recurrent itching under the foreskin can be a frustrating and uncomfortable condition. Based on your description, it seems that you are experiencing symptoms that may be related to a few potential causes. Let's break down the possible reasons for your symptoms and discuss some solutions.

Possible Causes
1. Balanitis: This is an inflammation of the glans (the head of the penis) and can be caused by poor hygiene, irritants, or infections. The symptoms often include redness, itching, and sometimes a discharge. The white layer you mentioned could be smegma, a combination of dead skin cells, oils, and moisture that can accumulate under the foreskin.

2. Fungal Infections: Conditions like candidiasis (yeast infection) can cause itching and irritation. This is particularly common in individuals with diabetes or those who are immunocompromised. The presence of a white, flaky substance could indicate a fungal infection.

3. Contact Dermatitis: This can occur due to irritation from soaps, detergents, or even certain fabrics. Although you mentioned using only water for cleaning, it's possible that other products you come into contact with could be causing a reaction.

4. Sexually Transmitted Infections (STIs): While you have tested negative for common STIs, some infections can present with similar symptoms. It may be worth discussing with your doctor whether further testing is warranted.

5. Phimosis: Since you mentioned having a long foreskin that does not retract easily, this condition could contribute to hygiene issues and recurrent infections.

Solutions and Recommendations
1. Improved Hygiene: While you are already practicing good hygiene, consider ensuring that you are cleaning the area thoroughly but gently. Avoid using harsh soaps or cleansers, as these can irritate the sensitive skin. Instead, continue using lukewarm water and consider consulting with a healthcare provider about suitable cleansers.

2. Topical Treatments: You mentioned using a cream prescribed by your urologist. If you find that the cream provides temporary relief, it may be beneficial to use it as directed during flare-ups. However, if the symptoms persist, it’s essential to consult your healthcare provider for alternative treatments or a different diagnosis.

3. Avoid Irritants: Pay attention to any products that may come into contact with the area, including laundry detergents, fabric softeners, and personal care products. Switching to hypoallergenic products may help reduce irritation.

4. Consult a Specialist: If your symptoms continue to recur, it may be beneficial to see a dermatologist or a urologist who specializes in male genital conditions. They can provide a more thorough examination and may suggest additional tests or treatments.

5. Consider Circumcision: If phimosis is a significant issue and recurrent infections continue to be a problem, circumcision may be a long-term solution. This procedure removes the foreskin and can help prevent future issues.

6. Monitor for Other Symptoms: Keep an eye on any additional symptoms that may develop, such as discharge, pain during urination, or changes in the appearance of the skin. These could provide important clues to your healthcare provider.

Conclusion
Recurrent itching under the foreskin can stem from various causes, including infections, inflammation, or irritants. While maintaining good hygiene is crucial, persistent symptoms warrant further investigation by a healthcare professional. They can help determine the underlying cause and recommend appropriate treatments. If you continue to experience discomfort, do not hesitate to seek medical advice for a tailored approach to your situation.

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