OpenHealth Q&A

Understanding the Red Spots on My Glans

I’m a Caucasian male in my mid-30s, and I visited a urologist late last year due to some issues I was experiencing. I noticed some redness on my glans, along with an increase in the thickness and toughness of the skin at the tip, coupled with tightening of the foreskin. Additionally, I was dealing with an uncomfortable, burning pain in my penis and an achy sensation in my right testicle, which tended to worsen at night. For years, there was also a peculiar sour odor associated with my penis that would dissipate after washing but would soon return. The persistent redness on my glans, which I overlooked until the situation worsened, became a cause for concern. The urologist assured me that my condition was not serious and prescribed miconazole cream for me. After using it for six weeks, I noticed only minor improvements in the redness. Subsequently, I received a prescription for a mixture of oxytetracycline and hydrocortisone cream and used that for two weeks, but it did not yield any positive results; rather, my skin became flaky and irritable. On a brighter note, I believe the odor has improved now, and there has been some reduction in the redness as well. I endured the discomfort for about a month before contemplating a visit to a dermatologist, during which time I began applying Vaseline to my glans 1-2 times daily. This practice led to a significant reduction in pain. Recently, I’ve observed the emergence of red spots on my glans, and I suspect they have been present for a couple of days. I’m curious if the Vaseline might be contributing to this. Currently, there is minimal pain in that area, but I do experience a consistent burning sensation at the tip. I am currently on Finasteride, taking 1.25 mg daily for hair loss since late last year, which has caused some erectile issues. Additionally, I take Fexofenadine for allergies and Pantoprazole for acid reflux. In my research online, I encountered the term Balanitis circinata, but my symptoms do not seem to match the associated images. I read that it might be linked to reactive arthritis, which can be triggered by chlamydia. I suspect that I may have had a chlamydia infection about 10-15 years ago; however, I never got tested or received treatment. Back then, I experienced a somewhat smelly discharge, though I don’t recall any accompanying pain or itching, although it’s possible there was some. There were rumors that the partner I was with at the time may have been affected as well, and I believe that’s when the chronic odor began. It’s regrettable that I didn’t get tested, but I was young and naïve. Additionally, for the past decade, I have been dealing with persistent lower back pain, sacroiliac joint pain, and hip discomfort. My eyes often appear red due to dilated vessels, and I frequently experience conjunctivitis; it seems that my episcleral vessels are the most affected. I think my eye issues began around the same time I might have contracted chlamydia, while my back pain started a few years later. I also suffer from long-standing allergies to pollen and dust, and I’ve been diagnosed with dry eyes, which may have developed as a result of taking Accutane in my youth. Moreover, I have been struggling with severe acid reflux for about ten years, with a noticeable deterioration over the last 2-3 years. An endoscopy merely indicated that my lower esophageal sphincter was loose. I also contend with seborrheic dermatitis, particularly noticeable on my scalp, for which using ketoconazole twice weekly provides some relief. Last year, I detected white patches on my hands, chest, and neck, possibly indicative of vitiligo. This is a rundown of my health history, likely relevant to my current concerns. Could it be that I'm experiencing symptoms of reactive arthritis stemming from a past chlamydia infection? Alternatively, could this be an indication of psoriasis? My ocular and back issues have been persistent for years, and except for the odor and some redness on my penis, the noticeable symptoms in that area are relatively recent. Regarding my back, I have undergone MRIs over the years; findings included some minor facet joint arthritis in the lower back and disc bulging in that area, but nothing was pressing on nerves. There was also a diagnosis pointing towards ischiofemoral impingement.

Answers (1)

3/27/2025, 12:20:50 AM

OpenHealth AI

Main Points: You have been experiencing redness and irritation on your glans, along with other concerning symptoms. While ongoing issues may indicate a need for further evaluation, taking a structured approach to your symptoms can help you find relief and inform your next steps.

Explanation: The symptoms you've described, including redness, burning sensation, and the emergence of red spots on your glans, may be related to several factors, including ongoing irritation, potential infections, or inflammatory skin conditions. The history of odor and the chronic nature of your symptoms suggest that there may be an underlying issue that hasn't been fully addressed. Reactive arthritis or psoriasis are both plausible considerations due to your symptoms, but a definitive diagnosis would require more specialized evaluation.

The use of Vaseline may help by providing moisture and a barrier to irritation, but it could also contribute to follicular irritation if the skin becomes too occluded or if there's an allergic reaction. Hence, it's important to monitor how your skin responds.

Next Steps:

1. Continue Moisturizing: Keep using a gentle moisturizer like Vaseline if it has helped reduce pain, but do so moderately to prevent irritation.

2. Observe Symptoms: Make note of any changes, especially regarding the redness and the appearance of the new red spots. Track any new symptoms such as increased pain, itching, or discoloration.

3. Adjust Hygiene Practices: Ensure you're washing the area gently and thoroughly with a mild, unscented soap to avoid further irritation. Pat dry rather than rubbing.

4. Consider Allergy Management: As you're dealing with allergies (Fexofenadine helps), ensure that your environment is as allergy-free as possible to avoid worsening existing conditions.

5. Seek Dermatological Evaluation: Given the persistence and complexity of your symptoms (especially the red spots and ongoing discomfort), consult a dermatologist. They can provide a focused assessment of your skin findings and could explore conditions like psoriasis or irritation due to other factors.

6. Monitor Urinary Health: If you experience any changes in urination or worsening testicular pain, it’s important to share these with your healthcare providers.

Hopefully, these steps can help address your concerns while continuing to find the right approach for your skin and overall health. Let me know if you have any further questions or specific areas you'd like to delve into.