Penis problems

If you are uncircumcised and notice the head of your penis (glans) is red, irritated, itchy, or has discharge around it, you could have balanitis. Balantis is a common condition, primarily affecting individuals who are uncircumcised, that often occurs when the head of penis isn’t adequately cleaned, resulting in a build up of sweat and dead skin that bacteria and fungi thrive in. The typical culprit is a yeast infection, and less commonly, bacteria and other skin conditions can cause it as well. Common symptoms of balanitis can include:

5 Penis Issues You Shouldn’t Ignore

It can be scary to find a new bump, lump or rash on your penis, but many times, skin conditions affecting the penis aren’t serious or may be normal for you. When in doubt, your primary care provider can help you understand what this skin change means for you and how you can remedy the issue.

Experiencing discomfort or symptoms? Here are some common skin conditions that can affect the penis and how your primary care provider can help.

Balanitis

If you are uncircumcised and notice the head of your penis (glans) is red, irritated, itchy, or has discharge around it, you could have balanitis. Balantis is a common condition, primarily affecting individuals who are uncircumcised, that often occurs when the head of penis isn’t adequately cleaned, resulting in a build up of sweat and dead skin that bacteria and fungi thrive in. The typical culprit is a yeast infection, and less commonly, bacteria and other skin conditions can cause it as well. Common symptoms of balanitis can include:

• Bumpy, flat ,blotchy, or red rash on or underneath the foreskin
• White discharge around the head of the penis (not the urethra)
• Pain or itching around the genital area
• Foul smell
• Swelling of the head of the penis and difficulty retracting foreskin (sticky and swelling)

Balanitis is not only uncomfortable, but if left untreated, it can result in chronic inflammation and scarring.

How a provider treats balanitis depends on the cause. If your primary care provider diagnoses you with balantis, they may first recommend simple hygiene improvement. Washing the head of the penis with a saline solution (salt water) is a gentle way to clean the area and can clear up most infections. If the infection does not improve, your provider can prescribe antifungal creams, such as clotrimazole, which will treat balanitis caused by a yeast infection. If the infection persists, your provider may offer alternative treatment or connect you with a urologist for assistance.

Molloscum

Noticing some dome-like bumps on your genitals? It could be an infection called molloscum contagiosum, a skin condition that’s caused by a type of virus called a poxvirus. It is a common childhood disease, but can also occur in adults. It spreads through skin-to-skin contact, but can also be transmitted through fomites (objects that carry infection) such as shared towels or clothes. Scratching and rubbing an infected area can also transmit it to other spots of the body. In sexually active adults and adolescents (not children), mollescum can be found in the genital area due sexual contact and is considered a sexually transmitted disease. Individuals who are immunocompromised (on immunosuppressant medication, HIV, etc) should seek care for prompt treatment as they are more susceptible for mollescum and will get many more mollescum than the average individual.

Common symptoms of molloscum contagiosum include:

• Firm, skin-colored dome shaped bumps that can have a central indentation.
• Bumps are about 2-5mm wide, occurring anywhere on the body, but typically not the palms of the hands or soles of the feet.
• Bumps are painless but itching may be present

Molloscum is self limiting, meaning it will resolve on its own. However, treating outbreaks early can be helpful in reducing transmission when it’s on the genital area. Because molloscum is caused by a virus, antibiotics won’t work. Instead, your primary care provider may recommend a topical skin treatment, such as cryotherapy. Cryotherapy is when your provider uses liquid nitrogen to freeze the bumps, stimulating an immune response for your body to fight off the infection. Other treatments are available as well and your primary care provider can help you decide the best one for you.

Genital warts

If you notice brown or skin-colored, cauliflower-like bumps in the genital area, you may have genital warts. One of the most common sexually transmitted infections, genital warts are caused by a virus called the human papillomavirus (HPV) that is spread through microabrasions in the skin when in contact with infected skin or mucosa. While warts can occur on the penis, they can also spread to a partner’s genitals, anus, or mouth during sex. The virus can be passed even when warts are not present, but the risk of transition may be higher when they are due to the high viral load within them. While there is no cure for HPV, some individuals may clear the virus on their own. The HPV vaccine is also a great option to prevent contracting HPV all together. If you have a wart, it is best to avoid shaving over it, as the shaving can cause microtears in your skin and spread the virus.

Common symptoms of genital warts include:

• Small brown or pink swellings on or around the penis
• A cauliflower-shape that’s caused by warts close together
• Often painless but can occasionally itch

Certain strains of HPV are associated with penile cancer, though the majority of individuals with genital warts have no symptoms beyond the warts themselves. Similar to mollescum contagiosum, genital warts can resolve on their own or can be treated with topical therapies such as cryotherapy. If you have an outbreak, your primary care provider can help treat it and provide tips on how to prevent transmission to sexual partners.

Pearly penile papules

Have you noticed a new bump along the head of your penis, but are wondering if it has always been there? Also called hirsutoid papillomas, pearly penile papules are small, flesh-colored bumps (papules) that can form around the penis head. Pearly penile papules are neither contangeous nor dangerous. They occur after adolescence and are more common in individuals who aren’t circumcised. Pearly papules are not infectious and are not a sexually transmitted disease. While the cause of these bumps is relatively unknown, they are benign and normal for many people. While the papules don’t usually cause pain or discomfort, they’re associated with some key characteristics:

• Small, raised pimple-like growths that don’t produce pus
• Smooth
• Measuring 1-4 mm in diameter
• Form one or two rows around the base of the glans (head of the penis)

Pearly penile papules may look alarming, but they’re usually harmless, don’t need treatment, and can fade over time.

Contact dermatitis of the penis

Suddenly developed a rash after using a condom or new lubricant? Skin irritation caused by an outside factor is called contact dermatitis. Contact dermatitis of the penis can occur after an irritant is exposed to the skin. This can be allergy related, such as using a latex condom if the individual has a latex allergy, or due to a skin irritating ingredient that touches the penis (lubricants, metal piercings, leftover detergent on underwear, etc). Common symptoms of contact dermatitis include:

• Red, itchy spots
• Swelling and possible vesicles (fluid filled blisters)
• Leaking fluid around the spots

Contact dermatitis can be uncomfortable, but is treatable. If your primary care provider thinks your penile rash is contact dermatitis, they will ask you to recall any potential irritants you may have been exposed to and ato void further contact with them. A short course of a steroid cream can ease irritation and help you heal faster. Overuse of steroid creams can be harmful to the skin, so speak with your primary care provider for guidance before applying it.

Skin conditions of any kind can be uncomfortable, especially when they occur on the genitals. While many skin conditions of the penis are not life threatening, they can cause quite a bit of stress and fear, as genital issues can feel stigmatizing and hard to talk about. Before jumping on the internet to search for a diagnosis, know that your primary care provider is available and ready to provide judgement-free care no matter the issue. While it may be tempting to use a virtual visit, an in person visit is best so your provider can better evaluate your new lump, bump, or rash and provide treatment if needed.

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Penis problems

If you’ve got a problem around your penis, you should go to your GP or a sexual health clinic to get it checked out.

Some of the most common penis problems are:

• itchy pubic area
• blisters on your penis
• spots on the penis
• discharge from the penis
• intense itching around the penis
• small fleshy growths
• inflamed penis head
• foreskin problems

Penile cancer can also affect the penis. But it is a rare type of cancer. It occurs on the skin of the penis or within the penis. It most commonly affects men over the age of 50.

Early penile cancer can present as an area of inflammation while larger tumours present as a noticeable lump on the penis.

Itchy pubic area

Itchy red spots in the pubic hair region may be a sign of a pubic lice infection, also called crabs.

Lice droppings can leave a dark-coloured powder on your skin or underwear. Blue spots, caused by lice bites, may appear on your skin.

You may notice nits. These are empty lice eggshells that look like white oval dots, attached to the base of your hairs. Pubic lice is usually easily treated with insecticide medicines. These are available in most pharmacies.

Blisters on your penis

Painful red blisters that burst to leave open sores on and around your penis could be a sign of genital herpes.

Genital herpes is a virus usually caught through sex. Many people don’t know they have it because there are often few or no initial symptoms. Although there’s no cure, genital herpes can be effectively controlled using antiviral drugs.

Spots on the penis

Spots or abnormal patches of skin on the penis could be a sign of molluscum contagiosum (MC).

The lesions are usually less than 5mm across with a central dimple. They’re usually firm, raised and painless. They may appear in clusters. They may rupture to give out a yellowy-white substance.

Treatment isn’t always recommended as MC usually clears up by itself. The virus is highly infectious. Squeezing or scratching the lesions could cause it to spread.

Discharge from the penis

It’s normal to produce some whitish or clear fluid from the tip of the penis when you’ve been sexually excited or first thing in the morning.

But a thick white, yellow or green discharge and pain when you pee may be symptoms of gonorrhoea or chlamydia. Both are sexually transmitted infections (STIs). Both are easily treated with antibiotics.

If left untreated, gonorrhoea and chlamydia can lead to serious long-term health problems and infertility. If you’ve ever put yourself at risk of an STI, get yourself checked.

Intense itching

Intense itching around the sexual organs that gets worse at night could be a symptom of scabies.

Scabies is caused by tiny mites that burrow into the skin. Their bites can cause a skin rash, which can leave crusty sores if you scratch it. Scabies is mainly spread through skin-to-skin contact and it can take up to eight weeks for symptoms to appear. It can be easily cured using a prescription cream or lotion.

Small fleshy growths

Small fleshy growths that are firm and raised with a rough surface could be genital warts. This is a common type of sexually transmitted infection (STI). You should contact your GP to get it checked.

You may have a single wart or clusters of warts, with a cauliflower-like appearance. Genital warts are usually painless. But they can be itchy and unpleasant to look at. They’re usually treated using prescription creams or by freezing with liquid nitrogen.

Bent penis

A significant bend in the penis may cause pain or difficulty having sex. A bend in the penis could be a symptom of Peyronie’s disease.

Other signs include a thickened area or hard lump in the shaft of the penis.

Various non-surgical treatments are available. But there’s little evidence to support their effectiveness. Surgery is an option. But it’s not recommended immediately as the condition can sometimes improve on its own.

Many men do not need treatment as the condition may not cause them any discomfort.

Inflamed penis head

Swelling, redness and soreness of all or part of the head of the penis and lumpy discharge under the foreskin may be a sign of balanitis.

Balanitis is when the foreskin, head of the penis or both become inflamed and infected.

Causes of balanitis include:

• thrush
• skin conditions such as eczema or psoriasis
• germs building up under the foreskin
• poor hygiene
• unprotected sex

Treatment may simply involve practising good hygiene and washing with plain water. Avoid certain skin irritants such as perfumed soap, or using prescription creams if there’s an infection.

Persistent balanitis that does not clear up after treatment should be seen by a specialist.

Foreskin conditions

There are a number of conditions which can cause pain and discomfort around the foreskin of the penis.

• tight foreskin (phimosis)
• paraphimosis
• balanitis xerotica obliterans

Circumcision is sometimes considered a treatment option for these conditions. This is usually only when other treatments haven’t worked.

Tight foreskin (phimosis)

This is where the foreskin is too tight to be pulled back over the head of the penis (glans). This can sometimes cause pain when the penis is erect. In rare cases, passing urine may be difficult.

Topical steroids can be used to treat most cases of phimosis. These help soften the skin and make it easier for the foreskin to retract.

Paraphimosis

This is when the foreskin cannot return to its original position after being pulled back. It causes the head of the penis to become swollen and painful. Immediate treatment will help avoid serious complications. For example, restricted blood flow to the penis.

A specialist may rub a local anaesthetic gel on the glans. This will help reduce pain and inflammation. They may then apply pressure to the head of the penis while pushing the foreskin forward. In severe cases, a local anaesthetic gel is applied to the penis. A small slit is then made in the foreskin to help relieve the pressure.

Balanitis xerotica obliterans

This condition causes tight foreskin. In some cases it also affects the head of the penis. The head can become scarred and inflamed.

Balanitis and balanitis xerotica obliterans can sometimes be treated using:

• corticosteroid ointment, gel or cream
• antibiotic creams
• antifungal creams

Content supplied by the NHS and adapted for Ireland by the HSE

Page last reviewed: 23 March 2021
Next review due: 23 March 2024

This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 123.