Sexually Transmitted Diseases/White dots on Penis Head



Dear Mark,

I'm a 23 year old male from the US, and I was hoping you could help me by answering my question. So a couple of days ago I started experiencing an itch in the foreskin of my penis.

It doesn't itch all the time, it comes and goes, and if I handle the penis, if I retract the skin and feel the boundary between the skin and the head, the itch resurfaces. A day or two ago, the white dots shown in the pictures came up. They don't itch, I don't experience burning when urinating, and the head itself doesn't itch, only the foreskin area itches. The dots also seem to come and go; they were there last night, but weren't as prominent in the morning, and tonight they're fully visible again. A third and fourth symptom would be that the penis has become more stinky ever since this started, and I have had to clean the head a couple of times because of smegma in the head.

My last sexual encounter was about two weeks ago, and I received unprotected oral sex, that was all. In case it applies, I was treated for an inflamed bowel a week ago, and I went through a round of the antibiotic phenazopyridine, and I recall that symptoms started shortly after completing this treatment. I'm thinking this is either a yeast infection or herpes, and the latter alternative makes me uneasy. Thanks for your help, if I can answer anything else for you please let me know.


Hello Ray,
The white dots on the glans (and underside of your foreskin?) look very much like a skin fungus, much like the athlete's foot. I would apply terbinefine (Lamisil), miconazole (Micatin), or tolnaftate (Tinactin) to the affected skin according to the directions.  Things should improve within the next week or so. It does not look like herpes!

Good luck!

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Mark P. Behar


Almost any question or concern about gay men's health issues, sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), etc. There is no such thing as “d/d free” or “clean” (free of infection), so why do so many of us deceive ourselves into thinking that some people are indeed totally free from a potentially infectious disease, like HIV, herpes, hepatitis, syphilis, chlamydia, warts, gonorrhea, etc., just because they say so? Clinical laboratory tests are not perfect, and having a “negative” or “nonreactive” test does not mean that a person is free from infection. Perhaps at the moment the test was taken, the person was uninfected; or, perhaps, the test wasn’t sensitive enough to detect presence of the infection. There is really no way that anyone can determine that they are truly “disease free,” and there are over a hundred of infectious conditions that can be spread without your knowing anything. Rather than trying to “pre-screen” or “serosort” a potential sex-mate with deceptive questions that are impossible to know by today’s technologies, a wiser option may be to consider everyone infected with something, and either use appropriate protective measures (“safer sex”), or accept the responsibility and consequences of possibly “catching” something from someone who’s hotter than expected (pun intended!). There is much research that supports the contention that an HIV positive person reliably taking HIV medications, and having an undetectable viral load, presents a lower risk for transmission of HIV than people who may think or say they are HIV negative, but are not. Food for thought!


Family Practice PA since 1981; Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answered STD questions submitted to their web site. Professionally lectured at national and regional Physician Assistant and Nurse Practitioner conferences, and at national gay & lesbian health conferences on topics including HIV/AIDS, herpes, hepatitis, STDs, human papilloma virus (the cause of venereal warts), abnormal Pap smears, gay and lesbian health issues, among others.

Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.; American Academy of Physician Assistants; Wisconsin Academy of Physician Assistants; National Co-Chair (2012-16), National Association of Black and White Men Together: A Gay, Multiracial Organization for All People (NABWMT)

Journal of the American Academy of Physician Assistants (JAPA) Q Visions, Quarterly Newsletter of the NABWMT

Bachelor's of Arts, 1972 (University of Wisconsin, Milwaukee, WI) Graduate Credits Experimental Psychology, 1972-75 (Tulane University, New Orleans, LA) Physician Assistant, Bachelor's of Science, 1981 (George Washington University, Washington, DC); Masters in Physician Assistant Studies, 2000 (University of Nebraska Medical Center, Omaha, NE)

Awards and Honors
Colposcopy Recognition Award (CRA), the American Association of Colposcopy and Cervical Pathology; Distinguished Fellow, Clinical Preceptor, American Academy of Physician Assistants; Fellow, Wisconsin Academy of Physician Assistants

Past/Present Clients
Brady East STD Clinic, Milwaukee, WI Milwaukee Health Services, Inc. (Martin Luther King Heritage Health Center), Dept. of Family Medicine and Early Intervention Program for HIV Infected Persons

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