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I have a red rash on my foreskin. I previously asked about…

Hi,I have a red rash...
Hi,I have a red rash on my foreskin. I previously asked about it on here and was told that it was skin irritation (not herpes), and that is just needed to be kept dry and clean and it would go away. I did this and it got better. However, since then, it has resurfaced.Could you please tell me what you think it is? Could it be an STD/STI?Thank you.
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Answered in 9 minutes by:
1/21/2018
Dr. Muneeb Ali
Category: Medical
Satisfied Customers: 8,693
Experience: MBBS, MD, MCCM. Currently working in Critical Care Medicine with 10 year experience in Medicine
Verified

Hi,
Welcome to JA and thanks for this question. I'm sorry to hear about your symptoms. Actually, from the pictures, it does NOT seem like that this is an STD, the reason being that STDs would usually not fade away and then reappear as in your case. Usually, they would be persistent and would progressively get worse. Secondly, herpes would cause blisters and a painful rash, this looks more like inflammation or irritation being caused by a personal hygiene product which you may be using repeatedly. This can even be the detergent that you use to wash your clothes. It looks more like contact dermatitis rather than an STD. In fact no STD would present in this manner for example chlamydia, gonorrhea would cause urinary symptoms like burning or increased frequency, syphilis would cause a painless ulcer to form in the area, genital warts would form a pink or brown wart on the penis or groin region and herpes as I said would cause painful blisters.

I would suggest that you try using OTC hydrocortisone cream ion the area and see if that helps, it should fade within a few days with the use 0of hydrocortisone but I would also suggest that you search for a product in your daily use which is causing this repeatedly.

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Customer reply replied 1 month ago
Hi,Thanks for the reply. I have used OTC hydrocortisone on this area before. It does get better but whenever I stop using the cream, it comes back. Is it possible that this redness is due to the cream? I have read that hydrocortisone can be 'addictive' to the skin and that the skin can go through a withdrawal phase.

That happens when you have been using hydrocortisone for more than a couple of months on a daily basis and in that case 1-3% of patients may experience redness or irritation because of withdrawing use. That does not occur commonly, in your case i think it is likely that you are being exposed to a product which is causing this repeatedly. It is much more likely for you to have an allergic or irritant reaction to a product then experiencing a rare side effect of hydrocortisone, especially when you have not used it for long. I would even suggest allergy testing by visiting your doctor so we can determine what is the exact underlying cause here.

Do you have any more questions?

Please leave a POSITIVE rating by clicking on the stars above, until you do i am not compensated for my time. You can continue to ask follow-up questions even after the POSITIVE rating. You can also ask questions from me directly by going on the link below,

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Customer reply replied 1 month ago
I used it on a daily basis, twice a day, for about three weeks.I have seen a doctor, face to face, where I live but sadly we do not speak the same language so I don't fully understand the answers being given, hence my coming here.That doctor gave me potassium permanganate tablets to dissolve in water. I then have to use that water to soak my penis. I have done this and the rash does lessen, but whenever I stop bathing in this solution, it comes back.Would you recommend to keep using the potassium permanganate tablets or to stop using them?

He is treating balanitis which is a medical term used to indicate inflammation of the head or shaft of the penis. This can be due to eczema or allergic contact dermatitis or due to an infection (which may be bacterial or fungal in nature) I would advise that you DO continue to the potassium permanganate tablets as they are helping you. But at the same time if this is not resolving even with hydrocortisone and allergy testing reveals no abnormalities then get evaluated for fungal infections. Candidates in males can present in this manner and it would be wise to get evaluated for that issue as well. It would be treated with topical anti fungal medications or even oral fluconazole if that does not work.

Do you have any more questions?

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Customer reply replied 1 month ago
I was also given fluconazole.In your opinion, if I have used potassium permanganate tablets, hydrocortisone and fluconazole, but still have the redness. What is most likely to be the cause?

Two possibilities, resistant fungal infections (which may require a prolonged course of fluconazole - usually 6-12 weeks) OR an autoimmune cause for the inflammation in which case PRESCRIPTION strength steroid creams may be required or even oral steroids. Balanitis Xerotica Obliterans is a possibility which i would consider at the end when all treatment options have been exhausted as it is more or less a diagnosis of exclusion. It would require specialized medications.

Do you have any more questions?

Please leave a POSITIVE rating by clicking on the stars above, until you do i am not compensated for my time. You can continue to ask follow-up questions even after the POSITIVE rating. You can also ask questions from me directly by going on the link below,

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Customer reply replied 1 month ago
Ok, thank you.I have made another doctor's appointment for Feb 10th. I am going to get checked for STIs/STDs and have a fungal swab. I will then decide what to do after those results are back.In the meantime, I shall continue to use the potassium permanganate solution, and change my shower gel and washing powder.If you think of anything else, please let me know.

The fungal swab is a good decision, it will show if it is anything which is resistant. Let me know what the results are, i think the STD screen should be negative but it is better to be sure.

Would you like to know anything else? Any clarifications or additional questions that you might have, i would be happy to answer them for you. If done for now, please remember to leave a positive rating as that is the only way we are compensated for our time spent helping you. You can continue to ask follow-up questions even after the rating.

Dr. Muneeb Ali
Category: Medical
Satisfied Customers: 8,693
Experience: MBBS, MD, MCCM. Currently working in Critical Care Medicine with 10 year experience in Medicine
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