Sexually Transmitted Diseases/Itchy painful red scars on penus


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Was wondering if you can provide your suggestions. I am uncircumcised and have regular sex with my wife. Happily married for several years, and has never had this issue. From last 6 months, I slowly started getting red spots and they were not painful. I ignored for a while, but now it seems to have spread in more area around the head. Not sure what it is, but it is quite itchy, and red scars clearly shows skin lesions.

I apply the triple antimicrobial OTC cream (which has 3-4 antibiotics), which initially (for about a month) seemed to work, but is no longer working. After reading a few posts I was going to try antifungal for a while, but scared that this might be something serious since it is a constant itching and now painful to even pull the skin back completely.

Not sure what is it and which kind of doctor do I need to visit. Appreciate if you can direct me to the specific kind of medical practitioner depending upon what you think. Attaching the pics for clarity. Thanks.

Greatly appreciate your advise.


Hello Adesi,
It appears that you have balanitis (inflammation, redness, swelling of foreskin and glans (head) of the penis. You may try an antifungal cream such as terbinefine (Lamisil AF), and avoid sex until everything heals. Also, avoid the antimicrobial cream, as this is not only ineffective (no bacteria to treat) but also may cause sensitivity (and delayed healing with worsening symptoms).  

If no improvement, than any family practice or internal medicine doctor or specialist such as dermatologist or urologist.

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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