Persistent Pain and Itching in the Glans: Seeking Solutions

Discomfort in the glans penis?

Hello doctor, I have been experiencing itching and pain in the glans for quite a while.
Initially, the doctor diagnosed it as eczema, and after applying medication, it improved for a while.
However, I later developed skin breakdown and even ulceration.
I have tried many medications, including Meikang, Betadine ointment, Betamethasone, and zinc oxide.
While there was some improvement for a few days, the symptoms always relapse after some time, and I am unable to stop the medication.
I have undergone blood and urine tests, and the doctors said everything was normal.
Later, they advised me to return for a follow-up if the discomfort persists, which has made me quite depressed as I don't know what to do.

The latest situation is that when I visited the doctor, they suspected I might have herpes and asked me to get a blood test and return for the results.
However, during the past few days of applying the medication, I suddenly started feeling discomfort in my penis, especially when I need to urinate, which feels itchy and prickly.
The foreskin and glans are noticeably red.
What should I do? I apologize for the lengthy message, but this is really troubling me.
Thank you for your help!

A-Zhi, 20~29 year old female. Ask Date: 2016/03/04

Dr. Li Xinyi reply Urology

Writing this way does not address the fact that there are many topical medications that have been tried, including Meikang, Betadine ointment, Betamethasone, and Zinc oxide.
Personally, I do not recommend using these; it is better to return for a follow-up appointment to review the report before proceeding.

Reply Date: 2016/03/04

More Info

Persistent pain and itching in the glans can be a frustrating and distressing condition, especially when it has been ongoing for an extended period. Based on your description, it seems that you have already tried various topical treatments without long-lasting relief, and you are experiencing symptoms that include itching, pain, and even skin breakdown in the area.
From a medical perspective, there are several potential causes for your symptoms. These can range from dermatological conditions, such as eczema or dermatitis, to infections, including fungal or viral infections like herpes simplex virus (HSV). Given that your doctor has suggested the possibility of herpes, it is essential to follow through with the recommended blood tests to confirm or rule out this diagnosis.
Eczema or dermatitis can often present with itching and redness, and while topical treatments may provide temporary relief, they may not address the underlying cause. If the skin barrier is compromised, it can lead to secondary infections, which may explain the breakdown and ulceration you mentioned.
In cases where topical treatments have failed, it may be beneficial to consider a more comprehensive approach. Here are some recommendations:
1. Follow-Up Testing: Ensure that you complete the blood tests for herpes and any other relevant tests your doctor may suggest. This will help clarify the diagnosis and guide treatment.

2. Dermatological Evaluation: If you haven't already, consider seeing a dermatologist who specializes in skin conditions. They may provide a more in-depth evaluation and suggest alternative treatments, such as prescription-strength topical steroids or immunomodulators.

3. Avoid Irritants: Pay attention to any products you are using in the genital area, including soaps, lotions, and laundry detergents. Switching to hypoallergenic and fragrance-free products may help reduce irritation.

4. Moisturization: Keeping the area well-moisturized can help restore the skin barrier. Consider using a gentle, fragrance-free moisturizer specifically designed for sensitive skin.

5. Oral Medications: If herpes is confirmed, antiviral medications such as acyclovir can be prescribed to help manage outbreaks and reduce symptoms. If eczema or dermatitis is the diagnosis, your doctor may consider systemic treatments if topical therapies are ineffective.

6. Lifestyle Modifications: Stress can exacerbate skin conditions, so incorporating stress-reducing activities such as yoga, meditation, or gentle exercise may be beneficial.

7. Regular Follow-Up: Since your symptoms have been persistent, regular follow-up appointments with your healthcare provider are essential to monitor your condition and adjust treatment as necessary.

8. Support: Living with chronic symptoms can lead to feelings of anxiety or depression. Consider seeking support from mental health professionals or support groups where you can share your experiences and coping strategies.

In conclusion, persistent pain and itching in the glans can stem from various underlying issues, and a thorough evaluation is crucial for effective treatment. By following up with your healthcare provider and possibly seeking a specialist's opinion, you can work towards finding a solution that alleviates your symptoms and improves your quality of life. Remember, you are not alone in this, and there are resources available to help you navigate these challenges.

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