Dermatology/spots on penis


Hi, I'm 16 and I've never had sexual intercourse. I have spots on my penis that I'm very worried about and I am too embarrassed to see a doctor or a GP since my parents would then know about it.

I have checked many sites and I am fairly sure that I have Fordyce spots however it is not this I am worried about.

I also have two or three spots that are raised (the largest is raised by 1mm). None of my spots are painful and I can masturbate without experiencing any pain at all. I think that these may have been caused by me popping them (since I thought they were like pimples). What can I do to get rid of these raised ones? Are they different to Fordyce spots?

I also have a third type of spot that is only visible when I have an erection. It is a small circle (about 1mm in diameter) that is slightly redder with a very small cavity in the middle of the circle that looks almost clear. I have very few of these and only on the rim of my penis.

Thank you for your help.

Without seeing the spots it is very difficult to make a diagnosis. Treatment of the spots would be based on the diagnosis. Below is a list of bumps that can occur on the penis.

These little spots do not usually have a serious cause, but some are infectious. Particularly if you are over 50, it's important to seek prompt medical advice about penile papules.
Molluscum contagiosum: a common, benign, infectious viral disease affecting the skin and mucous membranes. It is a common skin condition in childhood when it is transmitted through ordinary skin-to-skin contact. In adults it may be sexually transmitted and this is probably the commonest cause of penile molluscum in adult men. It appears as multiple, small, dome-shaped papules, often with a central depression or plug. A curd-like discharge can be squeezed from them. It may disappear without treatment, but freezing or cautery may get rid of it. Molluscum contagiosum is a marker for 'unsafe' sexual practices in adulthood and those affected should be screened for HIV
Hair follicles and sebaceous (sweat) glands: these are extremely common and a normal part of the skin's anatomy. They are commonly found on the penile shaft, particularly on the ventral surface (underside). They may be visible as small nodules or might only be felt as small lumps in the skin. They will have a hair arising from them that reveals their true nature. They are quite normal.
Pearly penile papules: multiple, small (about 1-3mm) papules running around the circumference of the crown of the glans penis. They typically develop in men aged 20 to 40, and around 10 per cent of all men are affected. They may be mistaken for warts, are not infectious and require no treatment.
Fordyce spots: small (1-5mm) bright red or purple papules that can appear on the glans, shaft or scrotum and which usually affect younger men. They may occur as a solitary lesion, but frequently appear in crops of 50 to 100. They are painless and not itchy, but may cause embarrassment because of their appearance, or a fear that they might be sexually transmitted which they are not! They are abnormally dilated blood vessels, covered by thickened skin. They may bleed if injured or even during intercourse. They are not infectious and their cause is unknown. Although a number of approaches have been tried, there is no simple, reliable treatment to remove them. Troublesome bleeding spots can be sealed with a device that uses a small electric current (electrocautery).
Psoriasis: most commonly affects other parts of the body, particularly the knees, elbows and scalp, but occasionally first appears on the penis, usually on the glans or inner surface of the foreskin. Psoriasis appears as thickened red papules or plaques with a well-defined edge. It often t has a scaly surface. It rarely causes irritation. There are a number of effective treatments available, such as steroid creams and calcipotriol cream (Dovonex).
Warts: a number of different types of wart commonly appear on the penis. Genital warts are caused by human papilloma virus (HPV) and are infectious. They may be single or multiple, skin-coloured, pink or brown, with a moist surface. HPV infection is associated with the development of cervical and anal cancer, so it is important that sexual partners are screened for evidence of infection. They can be treated in a variety of ways, from skin paints to cautery, but are sometimes difficult to eradicate.


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Michael S. Fisher, <B>Ph.D., M.D.</B>


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