Pin-sized whitehead on penis shaft?

Hi,

I am an 18 year old circumcised male and have never been sexually active. For as long as I can remember (like five years or so), I've had this one whitehead-like spot on my penis shaft. It has always been there. It's location is on the left, top side of the shaft right on or near the darkened "ring" that can be seen after you are circumcised.

If you look very closely there are two little pinhead-sized spots right by each other, a few mm apart. When you squeeze them initially, a small bit of whitish pus-like fluid comes out. When the skin is stretched tight, it almost looks like there is pus, or something, under the skin that is central to both of the spots, but can never come out. Although the spots are very small, you can feel them when running your finger over the area.

After squeezing them, they still remain present, just less visually noticeable for the time being. After some time, they do seem to come back or "refill".

I've done hours of research over the years trying to figure out what this is, especially since I've never been sexually active. I've looked at every major STD, and this doesn't seem to be symptomatic of any of them, but I am not convinced.  I am almost positive they are not pearly penile papules since, from the pictures I've seen, they generally appear around the glans (glands) and look differently. I was eased at one point when I heard that whiteheads on the penis are quite common and it could just be a bad hair follicle. However, I don't think it is this since it has been there for years and never seems to go away.

What I am most afraid of is that, when with a partner, it might be noticed and thought for an STD which would obviously be awkward.

It does not itch and from what I can tell, it does not retreat, like herpes does.

Do you have any ideas on what this could be? I am sort of at a loss here. Although I am unable to go to the doctor about this for the time being, but if I ever do, which type of doctor would I want to see. Dermatologist? Urologist? GP? Anything I can do for it?

[Bhupinder Kaur, MD]

Hello,
The symptoms are suggestive of sebaceous cyst. A sebaceous cyst is a closed sac occurring just under the skin which contains a "pasty" or "cheesy" looking substance called keratin. Blocked sebaceous glands, swollen hair follicles and excessive testosterone production will cause such cysts.

Generally no treatment is required but they become painful then it means they are infected,Then surgical excision by traditional wide excision, minimal excision, and punch biopsy excision may be required. It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your dermatologist. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.