Penis problems & solutions
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We get a lot of emails asking for help. And with the assistance of our sexual therapist we do our best to answer them all. If you would like to send in your problem feel free to do so. You'll get a personal reply and the question and answer may also be posted here (anonymously, of course) to help anyone else in similar straits. Send your problem to: moreinfo "at" penis-website.
Penis problems page 1 - click below to go to page 1
1 The retractile penis, issues of size, width and length, too big and too small
Penis problems page 2 (this page) - click on the problem below for our answer
Penis problems page 3 - click below to go to page 3
Penis problems page 4 - click below to go to page 4
Other medical problems
Glans penis problems
Q4 Whenever my glans rubs against my underwear it is actually painful. Even having sex can be uncomfortable, and masturbation often leaves my glans sore for days. I am uncircumcised.
A: The first thing to check is that you do not have balanitis or another fungal infection of your glans. This can cause the skin of the glans to flake and crack, leaving it sore and red. Balanitis is dealt with in another section of this page. It is of course always a good idea to get checked out for any underlying cause of such sensitivity. However...
...the more likely possibility is that you have simply got a very sensitive glans - a problem shared by many men.
One man I counseled had a glans so sensitive that after he ejaculated during sexual intercourse he had to apply ice to his penis to soothe it. While that extreme level of sensitivity may be unusual, it is not uncommon for men to report that they have difficulties with rubbing of clothing on their glans penis, especially if they have to be circumcised later in life for some reason.
The problem has been written about endlessly by proponents and opponents of circumcision, and much information is available on the internet.
I think what is clear from reviewing some of these articles, especially this: (The Joy Of Uncircumcising, is that a glans penis that is habitually covered by the foreskin is likely to be sensitive to friction and require lubrication - either natural or artificial - during sex and masturbation. In the case of masturbation, this lubricant could well be smegma.
My impression is that men who complain of penile hypersensitivity can have very enjoyable sex when the vagina is warm, moist and well-lubricated. Problems arise for men who have been circumcised and whose glans becomes keratinised and hard.
This natural reaction to the rubbing of the glans on underwear can so effectively desensitize it that sexual pleasure is diminished. It is from this group of men that the foreskin restoration movement has sprung.
Another group of men whose glans become over-sensitive are those who have had adhesion between the foreskin and glans prematurely detached; again, often by circumcision, or by parents forcing back the foreskin in infancy, or some other cause (hypospadias is a likely candidate here). For these men, the use of tight fitting underwear, to minimize friction, and the use of lube when masturbating may be essential.
Q5: I've got a red and itchy glans, and it looks peculiar too. It's discolored, with red patches all over the surface.
A: The simplest and most likely explanation of what you have described is a fungal infection - a bit like athlete's foot. This causes a condition called balanitis, which may or may not also affect the foreskin. In fact balanitis is a term which simply means inflammation of the glans.
Fungal infection, with Candida albicans, to be precise, is therefore only one possible explanation of why you have an inflamed foreskin, though it is the most common.
Other possible explanations include contact dermatitis (chemical irritation), eczema and psoriasis. In this page we focus on the fungal cause of balanitis. Funnily enough, while lack of hygiene can be the cause of fungal infections, so can over-washing - soap is a notorious irritant to the penis, and it can leave an environment in which the fungal organism candida - a kind of yeast infection - can flourish.
Anyhow, what's clear is that balanitis can result from yeast in men - yeast cells are normally present on the penis, but may grow rather too quickly in the warm and moist environment under the foreskin. As you may know, Candida is a common infection of the vagina, and you can pick it up from a woman who has thrush - in this sense, it is a sexually transmitted infection.
But because so many people use harsh chemicals on their genitals - in this context, even soap could be considered a harsh chemical - balanitis is common. Many women have thrush too, which acts a reservoir of infection for men.
Having said that, balanitis can occur on the penis even when you're not having sex, if you're not too scrupulous about penile and underwear hygiene - just as you can get athlete's foot from having sweaty and unclean socks.Balanitis can be diagnosed easily and simply - usually by its appearance, and certainly by taking a sample from the surface of the glans and looking at it under a microscope.
This is a non-painful process, and since the condition can be so easily cured, it's worth going to see a doctor as soon as the symptoms of itching and blotchy discoloration of the glans appear (of course, the same is true of any penile condition that looks out of the ordinary).
The cure is also simple - anti-fungal treatments which may be combined with steroid treatment. This usually takes the form of a cream to apply to the penis, although some more modern anti-fungal treatments are taken by mouth. It all depends on how severe the condition is.
As always, prevention is better than cure, so wash your glans and especially under your foreskin (if you are uncircumcised) once a day with a mild pH balanced soap that will not irritate your skin, preferably using a soap with no perfume.
Pull your foreskin all the way back and run your finger gently around the rim of your penis head to get all the smegma and dirt out. Rinse in clean water and dry well by patting gently with a towel.
Don't rub it hard, as this may irritate the skin further. Also avoid the use of bubble baths or other chemicals which may irritate your penis. Don't use latex condoms if they cause a red rash, try polyurethane ones instead.
If you develop balanitis after sex, a similar washing procedure shortly after sex may help stop it developing. Posthitis is an inflammatory condition of the foreskin. Symptoms include local irritation, burning and a red rash. Sometimes the skin appears to be peeling off as if scalded.
Bacteria and yeasts such as Candida can cause it. It is more common in older men and those with diabetes. Balanitis is infectious and may be sexually transmitted. It can be treated with appropriate antimicrobial creams.
Lichen sclerosis and balanitis xerotica obliterans (BXO): If you have white plaques on the foreskin and glans or shaft of your penis, plaques which may have no symptoms (though they may have a burning and itching sensations associated with them) you may have Lichen sclerosis.
Balanitis xerotica obliterans is a worse form of lichen sclerosis which is found on the foreskin. The preputial opening at the end of the foreskin may develop a white, fibrous ring that prevents it being drawn back over the glans penis, thereby affecting both sex and urination.
Both conditions need medical attention as they can lead to penile cancer, though this is rare: the most common effect is difficulty with sex and urination. In the worst cases, circumcision is needed.
There aren't really any risks to balanitis if it's treated early, though in a few cases it can lead to a more serious condition that will eventually require circumcision. And there are a few other conditions which look like balanitis but are in fact more serious, so again, the advice has to be to see a doctor.
Skin problems of the glans and shaft
Q6 If you have a look at the photograph that I have provided, you can see how my skin forms a web between the scrotum and the penis. Is there anything I can do to make this look more attractive?
A: This kind of webbing of the skin of the penis and the scrotum is not as uncommon as you might think, but it's hard to find information about it on the internet.
Enlarge for a picture of the webbed penis
It's pretty important to realize that even though you are calling this "webbed" skin, the condition of "webbed penis" is rather more serious - in small boys, it's a condition they are born with when their penis appears to be "buried" in their scrotum, sometimes because the skin of the scrotum actually forms the ventral (bottom) side of the penis.
This is a difficult condition to treat surgically, and it is not just a cosmetic condition like the one you have shown in your picture. Having said that, it's clear that having the skin of your scrotum joining so far up the penile shaft is neither good for its appearance nor for sexual intercourse. It certainly looks a bit strange.
The answer is to see a doctor who can refer you to a surgeon to have it surgically corrected, if it's bothering you so much that it's a problem. This should not be a difficult operation in most cases. The webbed penis is something that a good plastic surgeon can deal with. It is essentially a matter of releasing the skin which connects the scrotum and penile shaft.
A comprehensive article on the subject can be found here: Cirp library. This is a reprint of the article that appeared in Pediatrics, Volume 92, Number 6: Pages 794-799, December, 1993. You'll see that they are talking about children's penises of various kinds (the webbed penis, the inconspicuous penis, and so on), but the fact is that what we would call a webbed penis can still occur in adulthood.
A: They are the result of a badly performed circumcision. Skin bridges form where the raw wound of a circumcision heals. As you probably know, there is lots of information on the internet about circumcision - vehemently for or vehemently against it: a balanced view is hard to find.
Many anti-circumcision sites show the consequences of a botched (i.e. the average circumcision). But even this pro-circumcision site has pictures of skin bridges, offering advice on how to do a circumcision so as to avoid them. As one commentator said, that sounds a bit like chopping off someone's head to cure tiredness.
In some cases, skin bridges can occur even in a non-circumcised boy. When the adhesions between the foreskin and the glans are disrupted too soon (they don't normally separate until a boy is between five and eighteen years of age), they can form when the foreskin and glans come back into contact.
I have no doubt circumcision is wrong both morally and physically. To reinforce the view that a boy's penis is his own, and his parents have no moral right to decide whether or not to have him circumcised, here are some more pictures of the possible consequences of a bad circumcision here.
To suggest that women prefer a circumcised penis, as some of the pro-circumcision websites do, and therefore as mothers petition for their boys to be circumcised is extraordinary: if that is true, then why are we men allowing women to determine our sexual experiences and gender-dependent differences like that?
And could it not be that women say they prefer circumcised penises just because they are more familiar with them? But if it's not true, then why are fathers being so weak as to allow circumcision just because (presumably) it was done to them?
Anyhow, back to the subject of penile skin tags. The best answer, as always, is to see a doctor who can advise you on the possibility of a little cosmetic surgery (i.e., surgery designed to improve the appearance of you penis). One good reason for removing skin tags is that they can trap smegma and dirt and may be hard to clean, especially if they are true bridges rather than lumps of scar tissue.
Other pages of penile problems
Spots on the penis fall into several groups:
Ulcers are pits in the surface of the penis where the epidermis has been eroded - they may have a pus filled centre, or a crust with clear liquid underneath it. Any small raised lump is called a papule. Typically these are less than 1 cm in diameter. If they are bigger than this, they are called plaques.
Ulcers are not a good sign. For example, they may indicate the presence of syphilis. Syphilis is a serious STD caused by the spirochaete bacterium Treponema pallidum. The syphilitic ulcer is painless, single, and round. When the ulcer has an unpleasant smell, one tends to think of other STDs associated with tropical countries (Chancroid, granuloma inguinale, lymphogranuloma venereum.) Again, medical assistance is needed. The very rare condition of penile cancer - squamous cell carcinoma - may form an irregularly shaped ulcer. Again, it will be painless.
When you have more than one ulcer, you could be looking at Herpes simplex, the commonest precursor to genital ulceration. It causes repeated outbreaks of genital vesicles, which degenerate into small and painful ulcers. This disease is very infectious. When it first strikes it may be associated with a severe fever. Acyclovir is an effective treatment, though repeated outbreaks are common.
A group of ulcers linked together may be a sign of secondary syphilis. This is a serious infection which needs urgent medical attention. Less serious are apthous ulcers, small shallow and painful though they are; they resolve spontaneously and are of unknown origin They look like mouth ulcers, grey with a red border; their cause is unknown. However they can be confused with herpes ulcers and so a diagnosis from a licensed medical practitioner is advisory.
Chronic ulcers, that is to say, those which have been present for more than two weeks, can include Pemphigus, a disease of the skin, which needs rapid and urgent treatment; Behçet's disease, an inflammatory condition which affects the joints, skin, and other parts of the body and again requires urgent treatment; Reiter's syndrome, an inflammatory condition associated with arthritis. Men affected will have ulcers around the glans.
Papules. Most papules are not serious. Other conditions include Molluscum contagiosum, which is a common viral disease of the skin and common in childhood. In adults it may be sexually transmitted. It manifests as a collection of small dome shaped papules which may have a central plug. The papules can be treated, but they often occur in sexually promiscuous people who are not having safe sex.
We have also looked at Fordyce spots, which are modified sebaceous glands of the skin of the penis.
Balanitis is described to the left in the main column of this page.
Erythroplasia of Queyrat manifests as a painless, bright red plaque with a velvety surface. It may lead to cancer if not treated.
Another cause of the bright red plaque is Zoon's plasma cell balanitis, though this is harmless apart from its unappealing cosmetic impact: it may be confused with Erythroplasia, but that is a much more serious condition.