It can be scary to find a new bump, lump or rash on your penis, but many times, skin conditions affecting the penis aren’t serious or may be normal for you. When in doubt, your primary care provider can help you understand what this skin change means for you and how you can remedy the issue.
Experiencing discomfort or symptoms? Here are some common skin conditions that can affect the penis and how your primary care provider can help.
If you are uncircumcised and notice the head of your penis (glans) is red, irritated, itchy, or has discharge around it, you could have balanitis. Balantis is a common condition, primarily affecting individuals who are uncircumcised, that often occurs when the head of penis isn’t adequately cleaned, resulting in a build up of sweat and dead skin that bacteria and fungi thrive in. The typical culprit is a yeast infection, and less commonly, bacteria and other skin conditions can cause it as well. Common symptoms of balanitis can include:
- Bumpy, flat ,blotchy, or red rash on or underneath the foreskin
- White discharge around the head of the penis (not the urethra)
- Pain or itching around the genital area
- Foul smell
- Swelling of the head of the penis and difficulty retracting foreskin (sticky and swelling)
Balanitis is not only uncomfortable, but if left untreated, it can result in chronic inflammation and scarring.
How a provider treats balanitis depends on the cause. If your primary care provider diagnoses you with balantis, they may first recommend simple hygiene improvement. Washing the head of the penis with a saline solution (salt water) is a gentle way to clean the area and can clear up most infections. If the infection does not improve, your provider can prescribe antifungal creams, such as clotrimazole, which will treat balanitis caused by a yeast infection. If the infection persists, your provider may offer alternative treatment or connect you with a urologist for assistance.
Noticing some dome-like bumps on your genitals? It could be an infection called molloscum contagiosum, a skin condition that’s caused by a type of virus called a poxvirus. It is a common childhood disease, but can also occur in adults. It spreads through skin-to-skin contact, but can also be transmitted through fomites (objects that carry infection) such as shared towels or clothes. Scratching and rubbing an infected area can also transmit it to other spots of the body. In sexually active adults and adolescents (not children), mollescum can be found in the genital area due sexual contact and is considered a sexually transmitted disease. Individuals who are immunocompromised (on immunosuppressant medication, HIV, etc) should seek care for prompt treatment as they are more susceptible for mollescum and will get many more mollescum than the average individual.
Common symptoms of molloscum contagiosum include:
- Firm, skin-colored dome shaped bumps that can have a central indentation.
- Bumps are about 2-5mm wide, occurring anywhere on the body, but typically not the palms of the hands or soles of the feet.
- Bumps are painless but itching may be present
Molloscum is self limiting, meaning it will resolve on its own. However, treating outbreaks early can be helpful in reducing transmission when it’s on the genital area. Because molloscum is caused by a virus, antibiotics won’t work. Instead, your primary care provider may recommend a topical skin treatment, such as cryotherapy. Cryotherapy is when your provider uses liquid nitrogen to freeze the bumps, stimulating an immune response for your body to fight off the infection. Other treatments are available as well and your primary care provider can help you decide the best one for you.
If you notice brown or skin-colored, cauliflower-like bumps in the genital area, you may have genital warts. One of the most common sexually transmitted infections, genital warts are caused by a virus called the human papillomavirus (HPV) that is spread through microabrasions in the skin when in contact with infected skin or mucosa. While warts can occur on the penis, they can also spread to a partner’s genitals, anus, or mouth during sex. The virus can be passed even when warts are not present, but the risk of transition may be higher when they are due to the high viral load within them. While there is no cure for HPV, some individuals may clear the virus on their own. The HPV vaccine is also a great option to prevent contracting HPV all together. If you have a wart, it is best to avoid shaving over it, as the shaving can cause microtears in your skin and spread the virus.
Common symptoms of genital warts include:
- Small brown or pink swellings on or around the penis
- A cauliflower-shape that’s caused by warts close together
- Often painless but can occasionally itch
Certain strains of HPV are associated with penile cancer, though the majority of individuals with genital warts have no symptoms beyond the warts themselves. Similar to mollescum contagiosum, genital warts can resolve on their own or can be treated with topical therapies such as cryotherapy. If you have an outbreak, your primary care provider can help treat it and provide tips on how to prevent transmission to sexual partners.
Pearly penile papules
Have you noticed a new bump along the head of your penis, but are wondering if it has always been there? Also called hirsutoid papillomas, pearly penile papules are small, flesh-colored bumps (papules) that can form around the penis head. Pearly penile papules are neither contangeous nor dangerous. They occur after adolescence and are more common in individuals who aren’t circumcised. Pearly papules are not infectious and are not a sexually transmitted disease. While the cause of these bumps is relatively unknown, they are benign and normal for many people. While the papules don’t usually cause pain or discomfort, they’re associated with some key characteristics:
- Small, raised pimple-like growths that don’t produce pus
- Measuring 1-4 mm in diameter
- Form one or two rows around the base of the glans (head of the penis)
Pearly penile papules may look alarming, but they’re usually harmless, don’t need treatment, and can fade over time.
Contact dermatitis of the penis
Suddenly developed a rash after using a condom or new lubricant? Skin irritation caused by an outside factor is called contact dermatitis. Contact dermatitis of the penis can occur after an irritant is exposed to the skin. This can be allergy related, such as using a latex condom if the individual has a latex allergy, or due to a skin irritating ingredient that touches the penis (lubricants, metal piercings, leftover detergent on underwear, etc). Common symptoms of contact dermatitis include:
- Red, itchy spots
- Swelling and possible vesicles (fluid filled blisters)
- Leaking fluid around the spots
Contact dermatitis can be uncomfortable, but is treatable. If your primary care provider thinks your penile rash is contact dermatitis, they will ask you to recall any potential irritants you may have been exposed to and ato void further contact with them. A short course of a steroid cream can ease irritation and help you heal faster. Overuse of steroid creams can be harmful to the skin, so speak with your primary care provider for guidance before applying it.
Skin conditions of any kind can be uncomfortable, especially when they occur on the genitals. While many skin conditions of the penis are not life threatening, they can cause quite a bit of stress and fear, as genital issues can feel stigmatizing and hard to talk about. Before jumping on the internet to search for a diagnosis, know that your primary care provider is available and ready to provide judgement-free care no matter the issue. While it may be tempting to use a virtual visit, an in person visit is best so your provider can better evaluate your new lump, bump, or rash and provide treatment if needed.
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