White Spots

[SauT]

A little over a month ago I noticed a small flat white spot on the head of my penis about 2-3 mm in diameter.  2 or 3 other small spots about 1 mm or less in diameter have also appeared in other areas on the head of my penis.  They are located within about a 1 cm proximity of my urethra.  They are not raised in any way, have become more noticeable over time, and are highly visible under fluorescent light.  It also appears to be spreading at a very slow rate, maybe 1 new spot every 2 weeks.  There also is some slight redness in the area around my urethra, though it could just be the color contrast with the white spots.  They appear nowhere else other than on the head of my penis.  There is no itching or discomfort.

I am 26, circumcised, and in overall good health.  I don’t smoke or drink.  I saw a general physician recently who told me the spots were nothing to worry about and said he didn’t know what it was, but it wasn’t an STD.  I’d like to know though, so I can get it taken care of before it continues to worsen.  If it’s a fungal infection of some kind, what over the counter treatment could I begin?  If it’s not a fungal infection, what could it possibly be?

Thanks

[Dr Smitha Mathews]

Hi,

DO NOT use any steroid cream concurrently with either an antifungal or antibacterial ointment!

It just complicates the infection and can even generate drug resistance in some instances.

Yes, it would be best to apply the antifungals alone and maintain hygiene.

Do keep us posted on your progress.

Regards

[SauT]

I have changed soaps from a moistorizing body wash to Lever2000 and began taking showers in the morning and at night.  I used Lamisil AT Antifungal, Terbinafine Hydrochloride 1% Spray Pump for 7 days while waiting for 1% hydrocortisone cream and 1% Clotrimazole Lamisil cream to be delivered.  I saw no change with the Terbinafine Hydrochloride.  Once delivered, about a week ago, I then used the hydrocortisone and clotrimazole cream for 6 days, applying the hydrocortisone first, allowing to dry, and then the clotrimazole.  It has seemed like more spots are beginning to appear, so at this point I've stopped using the hydrocortisone for fear that it is being counterproductive and am just going to use the clotrimazole for the next 7 days before I report back.

I was wondering if perhaps what I have is Tinea Versicolor.

[SauT]

Excellent.  Exactly the information I was looking for.  Thanks for the advice and quick response.

[Dr Smitha Mathews]

Hi,

Sometimes, sebaceous glands enlarge and appear as white spots on the glans.
In such instances, no intervention would be necessary except maintenance of gentle hygiene.

If they are accompanied by inflammation appearing as redness, they could be a fungal infection.
You can try applying an antifungal such as Lotrimin or Lamisil twice daily for 2 weeks.

If they are associated with itching and appear to be eczematous, steroid creams would need to be applied.

At present, hygiene and the local application of antifungal ointment would help.

Do keep us posted on your doubts and progress.
Regards