Suggest Treatment For Genital Herpes And Redness Of Glands

Posted on Tue, 17 Feb 2015

Question: The glans has been red in color for the last two weeks. There has been itching. Today I observed some bleeding. What could be the reason and what is the treatment.
I am suffering from Genital herpes but it is under control as I am using Aciclovir twice daily

Answered by Dr. Dr. Kakkar (51 minutes later)

Brief Answer:
I would like to have a look at an Image; also need some clarifications

Detailed Answer:
Hello. Thank you for writing to us at healthcaremagic

I have gone through your query and I have noted down your complaints.

Itching is more commonly a feature of candidal infection; candidal balanoposthitis can present with redness on glans and a swollen prepuce with vertical erosions/ breaks arranged circumferentially around the opening of prepuce which may bleed.
Bleeding suggests that there are breaks in the skin.
Itching and bleeding can be present in herpes genitalis though erosive lesions of herpes are usually painful Or have a burning sensation.

I would like to gather more information from you regarding your query.

-Is the redness localized or is it diffuse?
-Are there any erosion's/breaks in the skin of glans?
-Are you able to retract prepuce Or is it swollen and difficult to retract?
-I would also like to know your age and whether you are on some other Oral medication apart from acyclovir?

I request you to kindly upload a clear digital image so that I can understand the condition better and therefore guide you better.

To upload an Image you may go to the reports section

Or

You may also mail the images at YYYY@YYYY with the subject line as Attn: Dr. Kakkar

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (5 hours later)

The message closed automatically before I completed my follow up information.
Please inform whether you received my feedback

I am writing again the follow up

The prepuce is not swollen and there is no difficulty in retracting it

The redness is on the top of the glans in an area of 1cm by 1cm

The glans is smooth and the skin is getting peeled off in places
The opening through which the bleeding took place is not like usual herpes lesion

The skin is dry and scaly at the root of the penis

I don't see any breaks or Erosion on the glans

I am 54 years old
In addition to Zovirax twice daily I am using cellcept 250mg twice daily for my uveitis problem
For the last two days I am using paln killer and anti inflammatory medicines for my early spondilitis problem

I am attaching two pictures of glans and root of the penis

There is no pain or burning sensation like in genital herpes

In the picture you can see the black dot on the top of the glans which is like a black dot in the first picture

Answered by Dr. Dr. Kakkar (5 hours later)

Brief Answer:
I suggest you to try an OTC topical antifungal cream.

Detailed Answer:
Hi.

I have reviewed the Images and I have also gone through your replies.

This does not look like genital herpes. There is redness and scaling/chaffing. There are no erosions.

This seems like a fungal/candidal balanitis. I suggest you to try an OTC Topical antifungal e.g clotrimazole 1% cream, twice daily for a week.
Use just plain lukewarm water to clean this area and avoid soaps, cleansers etc.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (2 hours later)

Thanks doctor. In the shop nearer to offer place I could only get CLOTRIMAZOLE 1% Lotion. Shall I use that lotion or shall I try for cream. As lotion will not remain for a long time on the affected area, shall I apply it more than twice a day

Answered by Dr. Dr. Kakkar (2 minutes later)

Brief Answer:
Topical antifungal lotion would be fine.

Detailed Answer:
Hi.

Yes, you may use a lotion as well. Apply it twice daily and replace the prepuce over glans.
Twice daily is enough.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (8 hours later)

Hi Doctor,
I started using the anti fungal lotion but I am sceptical that the redness on the glans and the bleeding from the glans is due to dingal infection. Please clarify.
Thanks

Answered by Dr. Dr. Kakkar (53 minutes later)

Brief Answer:
This is suggestive of a fungal infection

Detailed Answer:
Hi

The involvement does look quite extensive but it is suggestive of fungal infection. Itching and scaling are findings that are in favor of fungal infection.

Therefore i suggested you to try a topical antifungal for a week.

Initially, before i had seen the image, my other concern was herpes but after looking at the image i rule out herpes.
I can see a small spot of clotted blood at the base of glans. Probably it is the result of scratching that might have caused bleeding from that spot.
Apart from that there are no erosive lesions that suggest herpes.

Regards

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar