Long term penis irritation

[medquestion07]

I have posted on the STD forum before, but Dr. HH said he thinks my symptoms are likely not an STD. About 10 months ago, I had inflamed red rashes on my penis, with some oozing white areas, a day or few days after havinh unprotected sex with my gf. At first thought it was herpes (and maybe i still do have it, have had conflicting tests) At the time I thought it might be a yeast infection, used OTC fungal cream, seemed to get better pretty quick. Then it came back a month later with two areas having oozing areas on inflamed skin and if it matters I had recently spent a whole day in soaked underwear without showering. Anyhow, my ongoing problem has been since these occurences, I have had on and off sensitivity and burning sensations from usually the same spot, but also sometimes others, on my penis, right under the foreskin, near the rim of the glans. No sores, just a little redness. Over the last few months I have used a lot of creams for herpes, and things like tea tree oil, antiseptics, etc in sort of confused panic (doctors have sent me in circles). But I have also stopped for like a week before and it didn't seem to get better. At some points the pain was pretty bad, making walking painful, and the entire glans was sore. About 2 months ago I decided to treat it as fungal and within like 2 days felt relief and since then have gotten better, but it still comes and goes, but less painful than before I treated as fungal. I tried or Itraconazole for about 10 days and this seemed to help a lot at first, but after that was done, the irritation is still present though maybe reduced. I note that I now put anti fungal cream 2-3x daily, for the last 3 weeks or so. What do you think this is? Can a fungal infection be so persistent and nasty at times? Can fungal creams cause balanitis? I am uncircumcized btw and living in Hong Kong (tropical). Keep in mind 10 months ago I had oozing white sore patches, but I have been negative for HSV from an IGG test. Thanks.

[medquestion07]

I also sometimes get burning, soreness in the crease between my leg and scrotum, but no real visible rash, plus sometimes feel a mild warmth in my pubic area and have had jock itch in the past. Do you still think I should rule out recurrent yeast infection causing balanitis? Thanks.

I have now stopped using anti-fungal and I will let it just be without medication for a week or so to see what happens. Then will try hydrocortisone after that.

[Alan Rockoff, MD]

No, this doesn't sound like herpes or fungus.  It does sound like balanitis, or eczema of the penis.  This should be treated with a mild cortisone cream.  This condition comes and goes, for no specific reason.  Anyhow, that's what it sounds like to me.  Please confirm this in person with a skin doctor.  You are not helping yourself by thinking about herpes, fungus, or an STD.

Best.

Dr. Rockoff

[medquestion07]

Also, to clarify, when I say that I tried Itraconazole for 10 days, it means I took oral anti-fungal tablets for 10 days, from a doctor who suggested I try it.