Painful skin on penis

For the past 3 months or so, I have been experiencing pain at the
tip of my penis, and also in the back of the head area. I have noticed that the skin in the areas of pain has seemed to have changed color a bit. The skin is whiter, or pale in those areas.
There is also some redness in certain spots. The pain is a burning type and very unconfortable. Some days it hurts all day
and others not, but it is always painful to the touch. I have been to two urologists(both twice) and my regular doctor twice.
No one can seem to find anything wrong. I've had numerous urine
tests. No infection is present. I've even had a sonogram on my urinary tract, but nothing was found. I've also had my prostate checked and the doctor says its perfectly normal. I have been tested for hiv, gonnorea, syphillis (syphilis), and clymidia. All negative. The last uro I saw said I should see a skin doctor, so I did, but to no evail. He said he sees nothing wrong and that I should go back to the uro!!! (I'm going crazy!!). Somtimes I feel a burning in my anus, but I've had hemorrhoids for a long time, so its hard to tell if its from that or not. The last uro also gave me anti-fungial cream (Lotrisone).I used it for two weeks, but no help. I have no warts, or blisters. I am at my wits end!!
I don't know what else to do. Should I still be worried about an
STD? The doctor says I should wait it out, but my anxiety level
is through the roof. I know somthing is wrong. Does this sound
like it could be a skin related? I don't know what to think!!
Please help me.

[Kevin Pho, MD]

Hello - thanks for asking your question.

Without examining you, it is impossible to say what it is, especially if you have already been evaluated by a dermatologist or urologist.

Here are some thoughts.  Infections such as an STD (gonorrhea or chlamydia) can cause this presentation - make sure that these diseases are checked for.  

Chronic prostatitis is a notorious cause of genitourinary discomfort.  This can be evaluated by prostatic massage to culture and sample the prostatic secretions.  An ultrasound can also be considered to image to prostate to look for any abscesses.  Typically the antibiotic treatment course is 4-12 weeks.  

Anatomical lesions such as urethral polyps or strictures can also cause discomfort.  This can be evaluated by a cystoscopy.  

Finally, fungal or allergic reactions (dermatitis) are possibilites.  However, this would have been diagnosed by the dermatologist.  

You may want to consider and discuss these tests with your urologist for further evaluation.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

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