Brief Answer:
Seems like fungal infection

Detailed Answer:
Hi

Thanks for posting your query on XXXXXXX

It seems that you are having Balanoposthitis. It is an inflammation of the foreskin and the glans and it seems to be due to fungal (yeast) infection. It may be happening either due to moisture retained from condom use or it may also be happening from your sexual partner. Yeast is considered part of normal flora and is present on mucosa of mouth, vagina, etc. One thing is that it is harmless and clears up with topical anti-fungal agents. It may keep recurring.

For now you can use antifungal cream like Monistat cream. It is available over the counter and is considered to be useful for women, but works equally well for males. It will work for both the whitish skin and cracks and its effect stays for 2 -3 days. If this does not work, then you will need a prescription of mild corticosteroid (like hydrocortisone) plus antifungal cream.

Some lifestyle measures can also be helpful:

- Avoid keeping the condom on for long time. Apply cold cream or oil (like olive oil) before sexual intercourse
- Take enough fruits and vegetables in a day
- Take hygienic food and pure drinking water
- Get the regular blood tests done including fasting blood glucose levels.
- Use mildest soap for cleaning the skin.

Let me know if I can assist you further.

Dr Vaishalee

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Brief Answer:
Hi again

Detailed Answer:
Hi again

In Zocon-AS kit, fluconazole is an antifungal, azithromycin is an antibacterial and secnidazole is an anti-amebic. It is given when a definitive diagnosis has not been made and the combination is given to cover all three types of infections.

Oral medicines are better taken after confirming the diagnosis. For example in females pap smear and urinalysis can be done to figure out the type of infection. In males urinalysis and skin scrapings etc can be done before starting oral medicines.

It is always better to try topical anti-fungals first. Now after taking the oral medicine you have started developing white patches on other parts of skin. I think the medicines have altered the normal flora of the skin and causing other organisms to grow. Thus it may be called as weakened immunity.

The white spots are not emerging due to sexual intercourse or oral sex. These seem like fungal infection and can be easily taken care of with some lifestyle changes. These infections are very common and are not considered sexual disease but can be transmitted to males, causing mild symptoms like cracking of skin, dry skin, whitish patches, etc.

At this point my advice will be as following:
- Avoid taking more oral medicines
- Avoid keeping the condom on for long time. Apply cold cream or oil (like olive oil) before sexual intercourse
- Take enough fruits and vegetables in a day
- Take hygienic food and pure drinking water. This step usually helps a lot.
- Get the regular blood tests done including fasting blood glucose levels.
- Use mildest soap for cleaning the skin.
- May use topical anti-fungal cream if the symptoms re-appear.

After taking antifungals, candida may have been cured in your partner and you. Candida (a type of fungus) usually causes cracked skin. Thus a repeated episode may not happen on sexual exposure.
But other fungal infections may still be around and will remain so. These may be responsible for the new white spots on skin. A repeat oral dose is not advised to clear them up as it may result in resistant fungi to flare-up.

I hope I was able to explain.

Let me know if I can assist you further.

Dr Vaishalee

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Brief Answer:
Information in previous reply still applies

Detailed Answer:
Hi again

Even if the white spots appeared before taking oral medicines, the above written information still applies.

The best thing to do is to use topical medicines.
You can apply Monistat before having sexual intercourse. Itch guard cream is also a good alternative. Vaseline or oil are good enough moisturizers at other times. Vaseline can really help retain moisture. If cracks happen and are painful then lignocaine 1% gel can be applied to reduce the pain.
Anti-allergics like Tablet cetirizine 5 or 10 mg can also be tried during an episode.

Dermatologist should be consulted if the symptoms worsen or persist.

Regards

Dr Vaishalee

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