Chronic Fungal?

[charlie70]

I am 33.  I am uncircumcised.  Chronically, after energetic periods of sexual activity with my girlfriend, the head and shaft of my penis itches.  Then, the places where the itch was on the head and shaft break out in a red rash with tiny pimples.  The pimples remind me of whiteheads, but are tiny.  Then these whiteheads peel, like dead skin, almost like sunburned skin.  After this “sloughing,” the penis is back to normal.  This takes about a week.  As I wrote above, this is chronic (i.e. it happens every other week or so).  Of course, it’s scary.  I went to an STD clinic when this happened to me once before, about 2 years ago, and the doctor told me it was a fungal infection.  He gave me some hydrocortisone (1%) cream for the itch.  

My big questions are: why does this happen so often and what can I do to prevent it?  I’m very clean.  My girlfriend is on the pill and so we do not use condoms.  We have both been tested for STD’s in the past and she was diagnosed with and treated for HPV several years ago.  Since then, she’s had PAP smears every 6 months and they’ve all come up clean so her GYN feels that the HPV is out of her system.  All of my tests have come back negative but I was told that there is no test for HPV and that the Herpes test that I had was not 100% reliable.  

Anyway, my condition doesn’t look like warts.  The pimples are not “fleshy” or flat.  They are white-ish with a red rash base.  Finally, when this has happened before, the pimples do not leak a puss when they break, they do not hurt (sometimes an area on my head can be very sensitive when irritated but that seems normal), they do not scab over.  They just sort of peel…which I let happen on its own.  I resist the urge to peel it.  I just keep it clean and dry.  When this happened early this January I applied some clotrimazole (2%) cream because I thought it was a yeast infection but that didn’t seem to do any good.  Neither did the miconazole nitrate (2%) Curex powder.  

Enough.

What do you think?

Thanks.

[Alan Rockoff, MD]

I think it's friction-based irritation, that's all.  The doctor who told you it was "a fungus" gave you hydrocortisone, which would make a fungus worse.  I assume it made you better.  Hydrocortisone would be the right thing to use.  I suggest you ask a doctor one more time for reassurance, since you're still concerned, but I don't think you have anything to worry about.  Just use lubrication before sex and a little hydrocortisone after if needed.

Take care.

Dr. Rockoff

[ingleside]

I am posting this comment not to disagree with the doctor but to add more info about yeast infections so that you can better understand yeast infections.

First, what Dr. Rockoff said about hydrocortisone is important.  Hydrocortisone will not help a yeast infection get better.  It would sometimes have no effect or in other cases it will make it worse.  It might help with the itching of a yeast infection while slowing the healing.

Secondly, if it is a yeast infection and if you get over it in a week and after only one round of peeling then I don't think that any yeast specific medication would help you get over it any sooner.  In my observation it takes at least a week to get over a yeast infection.  If you look at the instructions on on the 1-day and 3-day yeast vaginal yeast medicine you will see that you only use those meds for 1 or 3 days but it can still take a week (or longer) to get over the yeast infection.

If you try the doctor's suggestions and the problem still persists then here are some additional things to think about regarding yeast.

The peeling part does sound like a yeast infection.

Diabetic males are more prone to yeast infections than non-diabetics.  If you are getting a yeast infection then you should make sure to have your "long-term" blood sugar checked (HgbA1C) to make sure that you are not an undiagnosed diabetic.

Does your girlfriend get yeast infections.  Here's how yeast infections work.  Some people are much more susceptible than others.  Yeast is present everywhere so a yeast infection can arise without transmission from anyone else.  But yeast is also slightly transmissible.  And if you have vigorous sex and do abrade the skin somewhat and if your girlfriend has a yeast infection or has a high level of yeast even without and infection then you will be more likely to come away with a yeast infection.

Most women are very aware of having a yeast infection, but it's possible for some women to carry a very high level of yeast and not know it.  Here's an experiment you can try.  Have your girlfriend use the vaginal yeast medicine for a week.  Make sure that the medication is one that treats yeast and doesn't just provide comfort (avoid vagisil).  After the week you should have very vigorous sex and see if you you develop your problem.  Of course either way won't prove anything, but it will suggest.  You could also try applying the vaginal yeast medication to your penis immediately after sex.  The best to use would be the 3-day type of creme and apply it right after sex, then for the next two days.

Other things that can be done about yeast include reducing sugar in your diet, eating yogart, taking acidophilus and other probiotic supplements.  It's important to understand that the level of yeast present in the dietary tract has a strong influence on your likelihood of developing genital yeast infections.  It's also important to understand that some people will get yeast infections at the drop of a hat and others will never get them at all.

One very good topical yeast medicine (by prescription) is a creme called Loprox.  Many doctors are unaware of Loprox.  It is my understanding that Loprox is not approved for vaginal yeast infections.

good luck

[big guy10]

hi, im 22 and on my penis i have little white things that look like little white pimples, i tried picking a few of them and white stuff came out, they also have little tiny hairs that i can see growing on them, like a mm big, do you know what this is? they don't hurt at all.