Foreskin Discomfort

[CSmidge]

7 months ive had issues with my foreskin. Started as a burning feeling, then redness. My GP and Sexual Health nurses expected irritation as all standard blood n urine tests came bk negative. Now on steroid cream and my foreskins flared up and went very red and painful, its now like the picture and i paniced herpes. Any advice helpful.

[21jumpstreet]

This is balantitis. It’s likely a fungal infection. Treat with her a combination antifungal and steroid cream. Most common type is clotrimazole plus betamethasone. Treat for 3-4 weeks. Will start to itch and burn a little after applying the ointment but you will have significant improvement and eventual resolution. This is not herpes. All men or women you’re involved with should be treated and remain abstinent until treatment completed.

[CSmidge in reply to 21jumpstreet]

My gp gave me Fucidin H. Steroid and antibiotic. She did say i could also use Canasten which is obviously anti fungal. I shall start using that with my cream. Thanks

[Galen70 in reply to CSmidge]

Looking at your picture there is pronounced pallor ( whiteness ) to the skin. This may be Lichen Sclerosus ( affects about 1:300 patients attending sexual health services ) I would recommend attending a sexual health service in the UK for assessment, or a dermatologist.

[CSmidge in reply to Galen70]

I visited a sexual health clinic twice and had two examinations. One being yesterday and they said its deffo a dermo job and they took a swab for herpes althou sure it isnt but ruling that out. It all started 7 months ago with an itchy penis, they found thrush so treated me. It then began to burn and for months i had a burning feeling and kept visiting my GP. Then the penis started to become a little red. The day after i had masterbated my foreskin went very red and sore, i was the given steroid cream and only they did my skin go white and hard and i had a scabby ring around my skin which has now gone a lil tight. I was bathing in oilatum which helped and softened the white hard skin which i just assumed was related too the cream and skin dryness. I am awaiting a response to dermo.

Do you suspect Lichen Sclerosus then?

Thank you for your feedback

[Galen70 in reply to CSmidge]

Its hard to tell for sure from a pic on the net, and you need a proper examination. But there are few conditions that cause paleness ( pallor ) - chronic irritation, vitiligo, and Lichen sclerosus. Fissuring ( breaks in the skin ) that can look like herpes also can happen with LS.

[CSmidge in reply to Galen70]

Thank you. Well the skin has improved quite abit since bathing in Oilatum and using Fucidin H. My last visit to GP she felt my previous pure steroid cream had irritated my skin more. The white skin seems to be splitting and coming off and my discomfort isnt as bad. The skin is now itchy but i can see its dry as havent soaked for two days. I now an hour after ive applied Fucidin coat my foreskin in Vasline.

Hopefully my dermatology appointment comes soon, its been 3 weeks since i was referred and havent heard a peep. The fact the dry skin is tight is getting to me but it has loosened over the last few days and is easier to pull back.

Do you think bathing every other day in Oilatum is a good move? Sexual Health said the skin looked like id been in a bath too long. I really appreciate your time

[Galen70 in reply to CSmidge]

Im glad you have a dermatology appointment coming up. You can be sensitive to different components of ointments and creams , so it may be that your skin was reacting to , rather than the steroid itself. I still feel Lichen Sclerosus is the most likely diagnosis. A dermatology appointment in the NHS often takes months , not weeks Im afraid.

[CSmidge in reply to Galen70]

I just dont wish to cause anymore issues so i'll continue with my steroid under the guidance of my gp and use Vasline and Oilatum to help with skin i am awaiting a call from my GP to discuss my condition the steroid cream should help if its Lichen Sclerosus anyway. My skin is itchy today and my banjo is sensitive! Joys

[Galen70 in reply to CSmidge]

yes the steroid will certainly help, although we usually use more potent steroids than the hydrocortisone which is in Fucidin HC. The banjo string aka frenulum is often a site affected by LS. Youre doing all the right things to help the condition.

[CSmidge in reply to Galen70]

Thats good to know thank you. I was on Betnovate b4 Fucidin. Any idea how long it'll take for my foreskin to be pretty much back to normal?

Just baffled me it all got bad after id masterbated

Really appreciate your advice

[Galen70 in reply to CSmidge]

Please read the information from here : bad.org.uk/shared/get-file.... If the condition is indeed Lichen Sclerosus , symptoms usually improve after a course of topical steroid, which can be up to twelve weeks maximum. The paleness however may not resolve. Response to treatment is different for everyone . Betnovate is a moderate strength topical steroid.

[CSmidge in reply to Galen70]

Thank you so much. The white skin seems to be dropping off now and the crusty ring of skin seems to be loosening and i can much easily retract my foreskin. I was given the impression the Betnovate was a stronger cream than my Fucidin H but it seems to be making some form of difference. Ive had some leave from work also which has helped as ive not needed to wear trouser pants or have too much movement.

[Galen70 in reply to CSmidge]

Betnovate is stronger than hydrocortisone. I think the duration of treatment is important because it takes a while for this to improve. Your symptoms are getting better which is the main thing. I usually recommend up to 12 weeks of treatment in total depending on the response to steroid - obviously it can be stopped sooner if the person feels 100% better .

[CSmidge in reply to Galen70]

Ahh that makes sense. Maybe my skin just didnt like Betnovate or it just got worse before improvement. I'll continue the hydro for now until improved. Thank you

[Galen70 in reply to CSmidge]

you are most welcome

[CSmidge in reply to Galen70]

My skin dried up an aweful lot today in work. I coat in vasline 30mins after my steroid. Do you recommend any moisturizers? I have dermol 500 and Childs Farm moisturizer

[Parz in reply to CSmidge]

As an uncut guy I can confirm you definitely don't have an STD -- I've had Chlamydia as well as general yeast infections on multiple occasions (the chlamydia only the once, lol) -- This definitely looks like a dermatological issue, or / and balanitis, don't pick at it, don't irritate it by constantly scratching/touching it, and DO NOT MASTURBATE until it's healed, I have made all of these mistakes myself when having an issue with my foreskin, none of which were as severe as this, and it lead to some not so comfortable results.

--Cheers!

[CSmidge in reply to Parz]

Thanks. Well my skin is now pretty much back to normal and is my penis looking tons better. I still have like a slight burn sensation but looks like its on the right root. Most of the skin after soaking peeled off.

Thanks for your reply, i think masterbating when it wasnt right topped it over the edge

And funnily enough i had Chlamydia (once) and then thrush, then this. Hopefully i get nothing else. Im pretty much a nun now anyway after all this

[Galen70 in reply to CSmidge]

Glad to hear all better. LS can relapse though , I hope you read all of the literature on the condition , there is a small lifetime precancerous risk , thought to be less than 5% in males and in those who have used topical steroids. So the risk is likely extremely small, but you should attend a sexual health service or a urologist promptly if you develop any non -healing ulcers despite treatment ( or any other changes you are worried about )

[Galen70 in reply to 21jumpstreet]

I'm afraid this is completely incorrect. Treating partners of those with yeast infections ( mostly women ) makes absolutely no difference to the presence or recurrence of candida. It is balanitis - but see my reply to the original poster.

[Parz in reply to Galen70]

This is simply incorrect, if a partner has candida overgrowth, you can transmit the infection, and vice versa. I have given a woman a yeast infection on accident, and I've had two women, both vaginally AND orally, accidentally give me one.

[Galen70 in reply to Parz]

If you could transmit candida ( thrush ) between people it would be classified as an STI - which it isn't. Certainly men can get a transient candida colonisation of the glans and prepuce if the female partner has candida - using clotrimazole will take it away. People assume all skin changes on the penis are due to candida - but actually strep and staph infections can also cause redness and irritation. These are both common organisms in the mouth, When you say those women gave you yeast infections, did you have a swab that proved candida growth on your penis ?

[CSmidge in reply to Galen70]

Yes i did have a swab and was on antifungal meds and cream. Cos i had penile symptoms i was on 3 weeks worth of anti fungals and cream.

[Galen70 in reply to CSmidge]

Hi CSmidge, my reply was actually to Parz. I would almost bet money your swab showed nothing ( or normal skin bacteria ) . Im really pleased your skin has returned towards normal

[CSmidge in reply to Galen70]

All cleared up now and i am on the steroid once daily for a week now then been told to stop. I still have slight discomfort in a patch of foreskin and the head feels its burning. I am keeping on at applying Vasline and washing with Dermol 500. I bath with Oilatum over the weekend. I am assuming the burning sensation which is how it all started is LS?

[Galen70 in reply to CSmidge]

Itching or burning can be symptoms of LS - or recurrent breaks in the foreskin in men .

[CSmidge in reply to Galen70]

Any suggestions for managing this whilst i await to see a dermatologist for a diagnosis?

The burning started again just after my skin all healed and dropped off. Seems more present after passing urine. I am following the LS advice sheet u sent over. My penis now looks normal but as i mentioned still a bit tender. Shall i be applying my steroid to my end aswel as foreskin? My end peeled abit and cos i had no issues there i never applied cream then but it then had contact with cream when my foreskin folded up.

If my symptoms return once i stop my steroid i'll obviously revisit my GP but will also start cream again i guess.

Also, when would u suggest i can start sexual activity again?

[Galen70 in reply to CSmidge]

You can have sex anytime you want if the skin feels comfortable. if your skin is now back to normal , then bring the pic u posted here. Its difficult without a biopsy or clinical examination, but that skin looked to me like LS. They will likely just advise you about future monitoring. Stop the steroid when things feel comfortable and just use the moisturisers

[CSmidge in reply to Galen70]

I have a whole album to show the dermo! Lucky sole they'll be! From start to finish i took a picture diary whilst logging all my symptoms etc. Good news on the sex, just wish i could do more to reduce the burning sensation as its annoying.

Thank you for all your advice and support its been a big help

[Galen70 in reply to CSmidge]

More than happy to oblige

[CSmidge in reply to Galen70]

Hi. Im seeking your advice. Im all cleared up but still have the stinging sensation every now n then on my head. Any ideas on how to help this?

[Galen70 in reply to CSmidge]

I would try a soap substitute like aqueous cream when washing and a moisturizer like diprobase for the skin. There can act as barrier creams also. If it continues to be a problem you might need to have a chat with the GP about some oral medication that might help. Keep a close eye for any new skin changes that suggest a reactivation of the condition.

[CSmidge in reply to Galen70]

I'll get some diprobase. Currently wash with dermol 500 and Oilatum so will look for the stuff u suggest. Its so annoying! I'll calm down on the sex too

[Galen70 in reply to CSmidge]

To be honest both of those are good as skin washes. The diprobase is heavier and can be used as a barrier cream also.

[CSmidge in reply to Galen70]

Hey Doc, how many times would you say apply diprobase a day? Ive only been doing it once. Burning is back and redness, my GP has advises using my steroid once a day until sorted

[Galen70 in reply to CSmidge]

Hi CSmidge, Sorry to hear that. You can use diprovase as much as you want. What steroid are you using ?

[CSmidge in reply to Galen70]

Fucidin H but GPs said if skin looks to be flaring up use Betnovate. Thanks for advice