Penile health problems are not so common in everyday medical practice and a vast majority of them are benign and easy to treat.
On the other hand, patients who have a penis-related health issue tend to be particularly sensitive about it. Often, the psychological pressure that a patient feels requires more attention than the penis condition itself.
Goose bumps On The Penile Skin (Fordyce Spots)
Fordyce spots are visible sebaceous glands seen on the shaft of the penis. Other than on the penile skin, they may appear on the face or in the mouth. They develop during puberty. During erection, Fordyce spots became more visible (stretching the skin makes them appear like white spots 1-3mm in diameter). It is a completely benign condition that requires no treatmen. Usually it is not very prominent, although in some individuals it may be quite visible. It is not a disease, but a normal anatomical variation.
Tyson's glands are sebaceous glands located on either side of the frenulum, the skin that appears as an elastic band under the glans – often absent in circumcised men. This is not an infectious condition and it’s not a disease but a normal anatomical variation. Treatment is not required.
Pearly Penile Papules
Pearly penile papules appear as a row, or in some cases 2-3 rows, of tiny lumps on the ridge of the glans penis. They may vary in a number and size (1-3mm). In some men, they may be quite prominent, affecting the quality of sexual life and confidence. A number of procedures can be used to remove papules. Those procedures are considered cosmetic, since treatment is not necessary because it is not a disease but a normal anatomical variation, and doctors do not recommend them unless the appearance of papules affects the patients sexual life.
Fordyce spots, Tyson’s glands, and Pearly penile papules are normal findings, and all three are quite common. They do not progress over time. Once established (during puberty), they remain the same and do not require any kind of treatment. In case they become symptomatic (itchy, painful, inflamed, or start to grow), a medical examination is needed.
Smegma is a combination of skin oils, sebum, shed skin cells, moisture, and bacteria that appears as a smelly, cheesy, white to yellowish mass in the folds of the skin between the ridge of the glans and preputium. It is asymptomatic. Uncircumcised men are prone to smegma production, especially in cases of phimosis (simply, components of smegma get trapped in the skin fold). It is not a disease, but men that produce a lot of smegma should take extra care of their genital area (personal hygiene, wiping the glans with a toilet paper after urination). Extra care is needed to avoid inflammation of the penile skin, a condition called balanitis.
Balanitis, Postithis And Balanoposthitis
Balanitis is an inflammation of the skin of the glans. Postithis is an inflammation of the prepuce and balanoposthitis is the combined inflammation of the glans and prepuce. Untreated balanitis or postithis progresses into balanoposthitis. The symptoms include itching, swelling, redness, soreness, and a smelly discharge in the affected area. The most common cause is inadequate personal hygiene (and in healthy individuals, improving personal hygiene alone is enough for treating mild cases). Immunocompromised patients (diabetes, HIV, hepatitis B/C, organ receivers, long term treatment with steroids, etc) tend to have severe symptoms. They need antibiotic treatment and their symptoms need to be followed by their physicians. Candida is another frequent cause and it's diagnosed using a microscopic analysis of collected material or by a fungal culture.
Circumcision is the best prevention for these conditions (since uncircumcised men are prone to this condition). There are a number of different surgical approaches and recent studies show that the best results are achieved with the DCSD technique (disposable circumcision suture device).
Occasional, mild episodes may be treated with proper personal hygiene. If, after 2-3 days of adequate hygienic care (2-3 showers a day, rinse and dry thoroughly the glans, keeping the area dry, abstinence from sexual intercourse or masturbation), symptoms don’t subside, a medical examination is needed.
Discharge From The Urethra
Smelly, purulent, slimy discharge from the urethra (especially if it's combined with other symptoms such as painful voiding, itch, redness, etc) should be treated by a medical professional. It can be a sign of a sexually transmitted disease or some other non-STD infection. In general, a few days of antibiotic treatment is enough to resolve the health issue, but having in mind the epidemiological and social significance of STDs, all of these has to be treated by medical professionals. The most common cause of purulent discharge in men is gonorrhea (a characteristic symptom is a dim, thick drop that appears in the morning on the tip of the penis, known in medical literature as a bonjour drop).
An Important Note
Any change on the penile skin that has a tendency of changing and worsening, especially if it's accompanied by other symptoms, needs to be examined by a health professional!
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