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Suggest Treatment For Inflamed Area On Penis Glans

Posted on Mon, 8 Jun 2015

Question: Hi, recently I used condom with a sextoy. It burst in the process and I noticed it only after feeling pain on my penis. The second day, I find the penis head (upper face) bright red in color but was not alarmed. On the 3rd day, there are 2 blisters wide apart over the reddish area and there are liquid flowing out. It is definitely no std as I had a comprehensive checkup about a month ago and believe it is due to the abrasion when using the sextoys. I am currently overseas where it is not possible to get commonly know cream but do have bactroban and zarin (anti-fungal) cream with me. Will these help? I am also using Pinetarsol and dettol to wash. I am just worried if the infection may spread.

Answered by Dr. Dr. Kakkar (36 minutes later)

Brief Answer:
May use topical bactroban

Detailed Answer:
Hello. Thank you for writing to us

I have taken note of your query and I have also reviewed the Image.

I can see an inflammed, red area on glans with some erosive lesions as well.

I would like to rule out a possibility of Genital Herpes.

I hope that screening tests that you took a month ago have adequately ruled genital herpes?
Is there any history of unprotected risky sexual contact after those screening tests?

Topically you may use bactroban, twice daily for erosions.

Avoid dettol and pinetarsol, as these may irritate skin further. Just use plain water to clean this area.

Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr. Kakkar (17 minutes later)

Yes, i did blood test and returned hsv 1 which the doctor says its commonly known as cold sores. And since this happened after the activity, i believe its due to abrasion because it was painful then. Now there is no itch but after 3 days can feel very slight irriration. Will try this and see if it works. Thanks.

Answered by Dr. Dr. Kakkar (11 hours later)

Brief Answer:
Keep me informed about the progress

Detailed Answer:
Hi.

Do you have a history of cold sores?
By the way, Hsv type 1 can also cause genital sores same as Hsv type 2.
The best way to confirm whether these sores are due to abrasion Or due to Hsv is to swab an sore/ erosion and do a PCR for Hsv.
Anyways, you may use bactroban, twice daily and keep me updated how it goes.

Regards

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

Follow up: Dr. Dr. Kakkar (12 hours later)

No i dont have. After applying it seems to be improving and red area reducing. Starting to feel itchy sometimes but not always. Hope this is normal.

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

Brief Answer:
I suggest a PCR test (for HSV) from erosions on glans

Detailed Answer:
Hi.

As I already said Hsv type 1 can infect genital mucosa same as Hsv type 2.

Since you deny any history of cold sores on lips/ oral mucosa but you do have a positive blood test for Hsv type 1, therefore one cannot reliably say that these lesion on your glans are not due to Hsv type 1 and are rather due to trauma.

If possible get a PCR test for Hsv from this area. This would be confirmatory whether the lesions on your glans are actually due to herpes or not.

You may continue with bactroban, topically.

Regards

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

Follow up: Dr. Dr. Kakkar (1 hour later)

Yes, i have cold sores around my mouth before but not the XXXXXXX area. I cannot do the test right now until I return home. if its hsv 1 lesion, is there anything i can do now before the test.

Answered by Dr. Dr. Kakkar (6 hours later)

Brief Answer:
Continue with bactroban

Detailed Answer:
Hi.

Ok. So you have history of cold sores around mouth but I though you denied it initially.
There is nothing specific that I would ask you to do for glans erosions right not until it is confirmed to be herpes.
Whether this is herpes Or not would only be revealed by swab test from this area. Get a swab test if you experience a recurrence of genital erosions.
For the time being just continue with bactroban ointment.

Regards

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

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

Hi Doc,

Your question is "Do you have a history of cold sores?". I had assumed you are asking about the XXXXXXX so I replied that I have none before.

Ok noted that I will perform a swab test if there is similar recurrence.

Also I have attached latest photo showing the recovery. Everything seems ok except that the left side lesion appears to be bleeding slightly (not profusely) after I have bathed. After cleaning up and left to dry, the blood clotted. There is no noticeable bleeding during the day, and there is no itch around these area as well. The right side seems to be getting smaller each day. I think it should be working fine but would like your thoughts on the current treatment apart from the possibility that this could hsv-1.

Answered by Dr. Dr. Kakkar (3 hours later)

Brief Answer:
I suspect genital herpes

Detailed Answer:
Hi.

I have reviewed the Images.
Redness is all gone. I can still see some erosions on glans. These erosions are what initially made me suspect genital herpes.

These erosions would heal within a next 2-3 days as herpes episodes are usually self resolving.
Just continue with bactroban ointment for these erosions.

One point to remember.. if you have genital hsv type 1, recurrences may not be as frequent as they are with hsv type 2 infection.
Genital Hsv type 1 infection is also milder as compared to genital Hsv type 2 infection.

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