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Sexually Transmitted Diseases/Darker 'sinking' spots and white spots on penis glans...


White spots
White spots  

Darker, \'sinking\' spots
Darker, 'sinking' spot  
Hello Doctor,
I hope you would be able to help me with an advice. I'm 37 years old, uncircumcised, currently not sexually active, aside of occasional masturbation. There are a couple of things I'm curious (worried) about:
a) First, I've noticed quite a few white spots on the glans of my penis and skin (picture 1). It seems they're not disappearing; new spots occur, from time to time.  
b) Second, there are two, slightly darker spots, separated by a white spot (picture 2). The thing with these 'darker' areas is they appear to be 'sinking' into the skin. I've noticed these a couple of weeks ago.
As of now, I haven't experienced any pain, itchiness, or anything like that, but I am concerned, especially about the latter.
If you could tell me what are possible causes for these, and what kind of action I should take, it would mean a world to me.
Thanks in advance,

Hello Mick,
Although HPV (human papillomavirus) can sometimes be associated with white dots and patches on the skin of the penis, other benign causes may also be responsible. It may be helpful to think of the unkeratinized skin of the glans (head) and foreskin as multilayered, with the top most sheet or layer of cells being very moist and easy to dislodge. When there are extra collections of cells in patches, it looks whitish or lighter; when there are worn away sections of cells, it looks red or darker. These imperfections are usually transient, and may change day by day or week by week due to the exposure to urine, friction, etc. This is what I think you may have. In other words, nothing to worry about, unless it persists for more than several weeks.

You may apply plain vinegar for 30-60 seconds to the skin, and if anything (including previously white or dark areas) turn really, really white, than this may suggest having HPV.

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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