Penis Rash - Recurrent

[Healthquester]

For about a year I have had a rash that continues to show up on my glans penis.  It is a very strange red rash that used to sort of concentrate around the Urethra but now seems to have generalized around the the glans.  It used to hardly ever be visable until after sex when a subtle red rash would appear.(a year ago, and sometimes it mostly goes away to this point)  Now the red rash is visable all the time and after any friction it is very apparent.   I have searched images on the internet endlessly to identify this and the closest thing I found was psoriasis.  The rash gets much more apparent after any friction – including sex, masturbation, or just clothes rubbing at night, sometimes I get an erection in the morning because I have to pee and that seems to really make it worse.  It doesn’t itch it’s more of a burning or pinching type of sensation.  Sometimes it seems to go into the Urethra but I’m not sure.(seems like it used to but lately it’s been a mild rash on the glans.  It will almost go away at times but as soon as a friction even occurs it comes back.  I feel like maybe there is some scar tissue building or something as it almost seems like very small skin tags are developing.  I have been dealing with this for over a year, initially it wasn’t bad but seemed to be concentrated near the Urethra.   I tried some pretty radical self prescribed treatments like cleaning with Betadine, because I thought it was a fungal or bacterial infection.  I have also tried Monistat(which made it worse)  Protopic(which I think may help a little) and recently I’ve applied a vitamin D cream which also seemed to provide some relief.    I’m concerned that I misdiagnosed and complicated the problem.  I do have HSV2 but I don’t think this is related as that looks much different and affects a different area, but it did come about shortly after the HSV2, possibly because my initial response to the HSV2 infection was to cleanse the area vigorously with things like Betadine(and Dynimaclear which has some sort of sulfur compound) as I thought it was a microbiological infection.   I do have a history of psoriasis in my family but I have not shown any symptoms that I know of.  I thought maybe HPV as I have been dating women from Herpes dating sites, and it's pretty common for some to have HPV as well.

I have never had any discharge from my urethra, but sometimes it looks red inside and I think I can see a little sore in there.  Mostly the problem is on the head of the penis but there has never been anything on the shaft.  My HSV2 outbreaks however have been on the shaft and never on the glans.  Any theories would be appreciated.

[Bhupinder Kaur, MD]

Hello,
From the symptoms that you have mentioned, it can be rash due to friction rub or lichen planus. Lichen planus is an inflammatory disease that affects the skin and the oral mucosa, and presents itself in the form of papules(flat spots) or rashes. Treatment is available only on prescription and consists mainly of steroids, retinoids, hydroquinone and phototherapy.

My sincere advice is to consult a dermatologist and get it evaluated. Also get a complete STD panel tests done. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[Healthquester]

Thank you for your last response Dr. Bhupinder.  I have taken your advice and gotten a full STD panel done excluding HPV, all except HSV2 (which I've known about and doesn't resemble this) came back negative.  

I have now seen a few different dermatologists, the one I have spent the most time with assured me that he could help me figure out what the issue was.  So far I have spent over $1000 dollars with him to get a biopsy, do a scraping, and several other tests.  Nothing has come back, no bacteria or yeast of concern(they said)  I have tried a few steroid creams(Hydrocortisone valerate .2%, Hydrocortisone butyrate .1% neither of them seemed to help, only Protopic has so far seemed to make any difference but this is slight and I am worried that it may be shutting my immune response down temporarily so that when I stop taking it the real problem bounces back worse, but I'm very unsure of that.  

The Dermatologist has assured me that this is not contagious but I think he's guessing about the problem having diagnosed it as some type of "dermatitis or balanitis."  He keeps prescribing me random cortisteroid applications stating that "eventually we'll find something that works"  and he wants me to keep seeing him.  Today he prescribed me Pramosone(hydrocortisone acetate 2.5% and pramoxine HCL 1%) I told him that the cortisteroids have had no effect and this doesn't itch it burns but promoxine as I understand is for itching.  So this seems like a bad call to me for the next step because there isn't anything in this that would likely work better than what we've already determined isn't working.  I am thinking that maybe I should try a systemic antibiotic for the next step.  I feel like he should take a look with a magnifying glass or something which might help him know what this is.  

Anyway it has been spreading and can be seen slightly on the shaft.  I've been sexually active with one partner who knows what I'm dealing with, and that seems to make it worse.  Possibly a latex allergy?  I don't know but masturbation has been just as bad on it possibly something in the lotion I use?  It seems to come up after friction and stays around for a long time.  I got desperate the other night and tried putting monistat 7 on it thinking maybe it was a yeast infection.  That made it inflamed...  Then I tried putting vinegar on it to see if it might possibly turn white from HPV.(which I haven't been tested for, and may be the only STD I suspect could be playing a role here.  

I just don't get it, I have strong skin everywhere else and rarely have any issues and I don't have diabetes.

Why doesn't this want to heal?  And why is it getting worse?  

My thought on the possible problems in order from most to least likely..

Psoriasis - my dad and grandma on moms side both have it pretty bad
Dermatitis - possibly seborrheic(although the description doesn't sound like it really
Contact or atopic Dermatitis - would have to be multiple things, friction, latex, lotions, soaps
Lichen Planus -  I haven't seen a case on the internet that looks much like this
HPV - I really worry about this one because it's the only STD I'm not sure about and I could be exposing my girlfriend...

Any thoughts would be appreciated.

[dpoland266]

I've got the same thing!  my urologist went down a Jock itch route and after using a couple creams its still getting worse.  Have you found anything else out???

[jay277167]

I also have the same thing off and on for years with the severe rash, but most time when the rash is not there i feel like its not ok in my groin area. Just spent $500 on STI test all negative not sure what to do..I got this after my first hSV2 out break in 2001 and then it would go from my eyes to my penis. Any help would be good.

[lgs2783]

I have also been experiencing a very similar thing for the past 4 years except that I have never had HSV. It has been near impossible to find any information on anything that even resembles this. It has been very frustrating to say the least, and any time I find a discussion like this it seems to just die without anyone offering anything conclusive! If anyone has any answers please don't leave us in the dark!

[people17]

Im experiencing the same problem at this moment..sincerely hoping a solution to cure this condition..as what u suspect, lichen planus or psoriasis maybe more possible i think..any dermatology please give a clue..thankyou very much.

[people17]

Im experiencing the same problem at this moment..sincerely hoping a solution to cure this condition..as what u suspect, lichen planus or psoriasis maybe more possible i think..any dermatology please give a clue..thankyou very much.

[dumbguy90]

I have the same symptoms, Ive posted on the herpes board, thats what I think I have - but I have never been tested. It gets me nervous that two people on this thread have hsv2 - could this condition be a result of the virus????

[Timmyleee]

Does anyone have any answers for this yet??? man...  just wanna go back to normal,  had it for 3 motnhs now,  any info would be realy helpful

[abzk]

I've had this for about 3.5 years now.  The following outlines the situation:

1) Saw three doctors in Chicago, including a North Western specialist.  Results = inconclusive
2) Saw a doctor in Beverly Hills after I moved to LA two years ago.  He performed a biopsy but it only showed a build up of skin.  No treatable condition.  He said it's probably psoriasis but I have no family history or skin problems anywhere else.  That's where it's left off.
3) I've tried lots of remedies (neem oil, DMSO, anti-yeast, anti-fungal, cortisone, neosporin, lotions, and several prescription creams).  Results = not much.  Nothing really helps.

I too have herpes but I've had that for 12 years.  This just started 3.5 years ago.  I don't have an answer to this but I'm continually trying.  I've seen several other forums out there and all of them are similar to this one, inconclusive.  Right now all we can do is manage the situation in terms of symptoms and continue to seek answers.  

Good luck to all

[mhseelz]

I have had this for about a year now, my case is more mild than healthquesters but I have not been very sexually active, however, the times that I have had sex it get's pretty red. I also have what I'm pretty sure is fordyce spots, and my doctor said that while it unusual to have them on your glans it is possible.. I thought it was this until the rash became more evident. Lichen Planus seems to me like the most likely.. psoriasis is a possibility but I have never had it before, it does not run in the family, and why the papules?

Can anybody direct me to a forum where people actively discuss this?

[mhseelz]

I read about this constantly and I'm convinced it is Lichen Planus or Lichen Nitidus, or possibly both as Planus sometimes appears with Nitidus and imitates it. Either way go ask your doctor about that and ask him for topical Tacrolimus (Protopic). I have read several reports of this being an effective treatment for both.

[snowshoeyak]

I too have the same symptoms although I think mine could have been cause by sexual transmission. I slept with this girl for months and one time she wanted Anal. So I did but I had a small concern cause I thought I saw a couple of white curds in crack area. I thought it would probably be a yeast infection and since I was so in the mood, decided I could clear it up if anything were to show up. (I have seen pictures of yeast infections and they dont look the same as to what I saw and cant find anything that looks similiar. I also asked her for help and she has no idea) That was in late october and and I stopped dating her in December. In late Feb, I noticed just a small red irritation on the side of my shaft but not on the colored part of my skin. I haven't had any discharge, painful urination or anything other than red irritation that know went around my penis but not on the shaft. I went to the doctor and he couldnt see anything. Its been a year and a half and the only thing I know that works and makes it feel better is using hydrocortison and putting on some gold bond afterwards to keep it dry. If I don't I feel discomfort, tenderness and sinsitivity around the tip of my penis. I too feel that its red in my urethra and may see a sore but cant tell. I know started to see small little bumps trying creep down the shaft as if it were trying to infect the pores of my penis. Or it may be due to the powder I use that do that but I dont think so. I was given cicloporox by my doctor, along with Diflucan. At one point, I thought I had a UTI and went to the doctor but came back with negative results. I had some abdominal pain but went away with ciprofloxacin. I still have this red irritation and if I dont keep it dry, it stays tender. I dont have any other symptoms other than I have always had small ecsema on hands if i dont keep them lotioned.
Any help would be appreciated.

[indianboy007]

I also Have dis..i have rashes on my penis but can be seen only when its enlarged..and i got rashes inside my mouth also.i tested for std n results were all ok.n my dermatologists told me its yeast infection n gave me clotrimazole but its still not working..wat could it be.? How will i get cure.

[mhseelz]

My previous guess at this being Lichen Planus, or Nitidus i think is wrong.. Protopic is also most likely to be harmful and cancer causing... anyways, because of this being closely affiliated to friction, I got reading on "Keratinization" which is your glans drying out due to, friction, from not having a foreskin because of circumcision. You can restore your glans as well as your foreskin and I encourage those desperate for a cure to give it a go, cause it's not looking like there is a cure.

[671]

I'm uncircumcised and have the same problem. mine started when I had sex with my girl friend for the first time. I got a yeast infection that time from a LOT of sex. We did it like 9 times per day at the beginning for 3 days in a row. After that my glans was in pretty bad shape and in a few days I developed and yeast infection. This infection cleared up with a topical cream accompanied by a 10 day course of Fluconazole 100mg (one per day) but the red bumps under the skin remain. As some other have commented, the bumps are most apparent when erect and are made worse with friction of any kind. I suspect this may be viral and given that it's been there for one year now I think it will not clear by itself. If I had to guess this is probably related to the HSV... unfortunately.

[Ra1234]

HSV is very obvious and I don't think is your problem. I had a recurrent balanitis for 1.5 years and everything started after a yeast infection. I took fluconazole and used ointments and nothing helped me, the red spots were still there. Finally I went to another Urologyst and he suggested me to circumsice my penis and after thinking so much about it I went for it. The redness cleared right after the surgery, More than a year since the operation and my penis still looks very healthy without any rash. Your problem may be different than mine, so I suggest you to consult an Urologyst.

[joeytoo]

I have had the same problem for the past two months.  I had an encounter of a sexual nature, but no sex, just friction - no penitration.  Also, I had many other environmental factors that could be at play - bad diet, lots of alcohol, hot weather, and some other factors.

After many hours and hours of research, I figured that I have an issue with Yeast/ candida.

I am trying the candida diet right now, and I will see if that helps.  Ill keep you all posted

[mhseelz]

I don't know about Candida, that stuff looks pretty crazy, but keep us posted for sure!

[h2b]

i havw hasd this weird rash below the  head of my penis like just under the crown on my forskin then it moved to my gland also for 4 months now i got it 2 days after having sex with my girl friend went to the doctor a month after i got the bumps and he said i had yeast infection gave me diflucon pills and cream didnt do anything for me sent me to dermatoligest gave me econozole cream did nothing then did a biopsy from the rim of my gland came back as nothing there i also did the std panle test all came back nothing im getting frusterated with this the rash semms to gradualy covering my whole penis gland and my gland around the rim is a little swollen raised up looking the rash is like small tiny bumps like pinhead size and my penis looks redish purple when standing up when i am erect u can see the bumps in the skin also my penis used to be nice and (smooth) looking and now it looks like textured u can see lines and grooves in my skin gland where the rash bumps are the doctors keep telling me there is nothing there i show them pictures when erecet and they say that it looks like a skin iritation and i did get a cotizone shot that i requested because the creams were not working and doing anything and he gave me one i have been to 3 doctors one regular and 2 dermatoligest nobody knows what it is they say skin iritation and i know there is something wrong i know what my gland looked liker before i got this infection i think its an infection of some sort because none of these creams are doing anything i also used tropicort cream am trying that now it been 1 day so far said 2 times a day for 2 weeks any input will be grerat i dont know why these doctors cant figure this out if anyone has any updated info on a cure to get rid of this let me know

[lgs2783]

I don't have any comments about your penis, but your post desperately needs some punctuation. At least use some periods ... damn.

[slant6mopar]

Hey Guys Suffering and Lady Doctors from India,

Got a thought. I was circumcised at 22 because of frequent (about annual) minor problems with my foreskin from childhood on. I love circumcision and I'm glad I had it done, wish it was done at birth. I like it better in every way. Let's put it in the bluntest of terms to shut up the anti-circ Nazis: I lost no sexual pleasure or any enjoyment of daily life to my circumcision. It wasn't even painful - I expected ice packs and crotch wraps for weeks, but it was done under a local anesthetic and I was back at work two days later. I would immediately call a doctor to schedule a new circumcision if my foreskin magically reappeared overnight.

Any uncircumcised readers (and your patients, Good Lady Doctor) can easily "test drive" what it would feel like to be circumcised. Buy 3M Nexcare bandage tape. After your shower (morning or night), tape your foreskin back so your head is always bare. Peel off yesterday's tape and wash the bunched-up skin in the shower. Then dry off, and apply new tape. Do it every day for a month. The first week or so will be itchy, but the next three weeks are a very good approximation of how it feels. My doctor insisted that I do this before he circumcised me. I liked it a lot, so I laid on his table.

It's been nearly 16 years since I was circumcised, long enough I believe, to have "adapted" to it, and experienced everything about it. The foreskin was important protection before man started wearing clothing - now it's a redundant liability.

But circumcision didn't cure my last group of foreskin problems. You see, sometime in my last year of high school, I stupidly started smoking. And I inherited a Zippo lighter from my grandfather.

Loaded with Zippo fuel, in my left front pocket (and I hang to the left!) my "area" was always bathed in fumes of naptha and other volatile hydrocarbon compounds.

Being around machines, cars, engines since I was a child, I've been exposed to lots of related hydrocarbons like benzene, xylene, and naptha - all of which are found in gasoline and used motor oil. Your immune system can become sensitized to them, causing painful and irritating rashes, eczema, etc.

My grandfather's Zippo needed a new wick, and I couldn't find a genuine Zippo part in town for 6 months. Bics were a temporary solution. Two days after I got a new wick and started carrying the Zippo again, red sore rashes on my head and my inner mucosa (the skin between the ridge at the back of your head and the "color change" on your shaft where your foreskin was removed).

I am an Engineer, a professionally-trained scientist. I stopped and tried to consider what variables had changed recently. Laundry detergent? Nope. Fabric softener? Nope. New underwear? Nope. New sexual partner in a while? Nope. Zippo back? Yup.

Parked the Zippo, problem went away in a few days. Brought the Zippo back, being conscious not to change any brands or behaviors or anything else. Yup. Rash, swollen mucosa. One of my favorite things about being circumcised is that pleasant feeling of my head rubbing gently in my underpants. Three days with the Zippo made every step feel like I'd just done a marathon with sandpaper inside my underpants.

I stopped carrying my grandfather's WWII Zippo, and instead moved to a Bic.

Not one single problem since. And that was in 1998.

***@****

[slant6mopar]

See if it's fungal.

Fungus, and many bacteria, like dark anaerobic (no oxygen) warm and moist places. Like under the foreskin.

Tape your skin back so your head is always bare. Do it every day for a month. (You will be itchy for the first week. You will also be seeing whether or not you'd like circumcision, but if you'd prefer to keep your foreskin and a month of your head being dry kills a fungal or anaerobic infection, just stop using the tape.)

[slant6mopar]

See if it's fungal.

Fungus, and many bacteria, like dark anaerobic (no oxygen) warm and moist places. Like under the foreskin.

Tape your skin back so your head is always bare. Do it every day for a month. (You will be itchy for the first week. You will also be seeing whether or not you'd like circumcision, but if you'd prefer to keep your foreskin and a month of your head being dry kills a fungal or anaerobic infection, just stop using the tape.)