How to effectively manage recurring balanoposthitis?

Question

Hi doctor,

For the second time this year, I have developed a rash on the glans of my penis. This time, the rash appeared more intensely colored. There has been no itching or pain associated with this rash, just a concerning appearance. I was tested for all STDs (sexually transmitted diseases) a month ago, including HIV (human immunodeficiency virus), chlamydia, gonorrhea, syphilis, and HPV (human papillomavirus), and all results were negative. The testing included a full blood test and urine sample.

I am 36 years old and married, with the same sexual partner for the past 10 years. I have a tight foreskin that cannot be fully retracted over the head of my penis but can be pulled back about 75 percent. Over the past three weeks, the rash has gradually subsided, and the redness is slowly diminishing. I have used Hydrocortisone 1 percent and Clotrimazole cream for two days each. I also have an antifungal cream, which was prescribed for the first occurrence of this rash earlier this year.

My main concern is penile cancer, although I understand it is rare. The possibility of a tumor worries me. Alternatively, could this be balanitis? Another concern is the development of white markings on my penis over the past month. My personal hygiene is excellent; I use only warm water twice a day and do not apply soap to the glans. I have attached some images of the rash and would appreciate any advice you can provide.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

First of all, try not to worry—penile cancer is unlikely. What you are experiencing appears to be a recurrent case of balanoposthitis. I recommend getting tested for diabetes. Regarding your tight foreskin, circumcision might be necessary. Additionally, if you are using condoms or any lubricants during intercourse, they could be irritating your penis. Consider avoiding condoms and any other substances on your penis to see if that helps.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

It should heal within two to three weeks. Maintain proper hygiene by cleaning your penis with water twice a day. Avoid using soap or any other irritants. Also, make sure to get the blood test done as I suggested.

Regards.

Answer 3

Hi,

Welcome back to icliniq.com.

I have reviewed the images you sent (attachments removed to protect the patient’s identity). There appears to be improvement in the rash, as seen in the images. At this point, it is not something to be overly concerned about since the rash is nearly cleared. The key is to maintain proper hygiene, including washing your penis thoroughly after sexual intercourse. You may apply an antifungal ointment twice a day, with the consent of your dermatologist.

The image also suggests that you have a tight penile foreskin, which could contribute to the issue. Friction during intercourse may also be a factor. Follow the recommended ointment and conservative measures.

Kind regards.

Answer 4

Hi,

Welcome back to icliniq.com.

I have reviewed all three images you sent (attachments removed to protect the patient’s identity). Two of the images look good to me. In one image, there is a slight white area in the middle of the redness, which appears to be a fungal infection. Rest assured, it is neither contagious nor cancerous, so there is no need to worry. This should not affect your ability to conceive. Be sure to clean the head of your penis by gently pulling back your foreskin and washing with water only—avoid using soap. You can apply the ointment mentioned earlier. It should help resolve the issue, but if it does not improve, consider consulting a urologist for a second opinion. It is also not lichen planus, so there is no need for concern.

Thank you.