Scaly, Itchy, red bumps on penis head

[Rob1988]

Im 21 years old and have been with my girlfriend for almost 2 years. Monogamous relations for both of us of course. Problem is somewhat frequently after we have sex, the head of my penis will develop a rash with several small red spots and it looks very shiny when erect. As I lose the erection the skin on the head gets wrinkled, dry and begins to peel in small patches. In the following days it begins to itch and  the bumps also appear on the inside of my foreskin as well. Also smegma does show up sometimes with a pretty bad odor. Im thinking it could be balanitis/ thrush but im really worried because it will go away then come back in a few weeks when we have sex again. It all started after one session of anal sex that went back and forth between vagina and anus. It has been recurring for about a year now and comes and goes. Dont even know were to go to get it checked out and she has come clean several times on her STI checks... Any information would be appreaciated.

[Bhupinder Kaur, MD]

Hello,
The symptoms that you are having can be due to balanoposthitis. Balanoposthitis is the inflammation of the glans penis along with the prepuce. It can occur from a number of causes like physical trauma, irritation by environmental substances or by infection. The treatment depends on the underlying cause.

Oral course of antibiotics is needed. In addition, please don’t use any cosmetics on the penis, instead use some topical antimicrobials like Bacitracin or Lotrimin. Also corticosteroids and topical immunosuppressants can be used but they are available under prescription. Also retract the foreskin daily and soak in warm water to clean penis and foreskin. In case the symptoms persist then please consult a urologist/dermatologist for evaluation and antimicrobials and steroids prescription.

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.

[Rob1988]

Also, one time it was really bad where the actual foreskin itslef was dry, peeling and cracked and even bled (painful) and sometimes I get one or two small dry peeling patches on the shaft as well.