[Question #1241] Mild red spots on penis. Need advice

47 months ago
I seem to have minor red spots on the head of my penis. I have noticed these red spots for the past 6 weeks or maybe more. I can only notice them if I use the flash light on my phone or if I extend the skin. These red spots don't seem to have any discharge or they don't seem painful.  I don't seem to have any fever or flu like symptoms so far. I have been obsessively paying close attention to them for the past few weeks. Three days ago, while I was constantly looking at them, the red spots seemed way more prominent.  The very next day when I checked, it subsided and look like how it was before.  The red spots still look the same now. It almost seems like they exist underneath the skin.  They don't look like blisters or anything like that. Just mild spots or maybe bumps.

Please note that I had outbreaks on penis in 7 months ago when I had contracted chicken pox as an adult for the first time. I have never had any outbreaks before or after until these red spots. I also had received oral sex from someone about four months ago who later said that she occasionally gets cold sores.  (Not at that time). I did not have any outbreaks on my penis after that occasion.  I am very anxious that I may have contracted a STD like Herpes.  What are these red spots? Are they just regular spots that can be seen in that area or is this an infection? Psychologically, I am obsessing over it.  Can you please advice?
47 months ago
I've also noticed that I seem to have redness and itching at the right side of my buttocks area.  As far as I've seen, there aren't any bumps in that area. But it is red and its been itchy.  Please also note that currently I am visiting a part of the world, where toilet paper is not common, and water is used to wash the backside. I am not sure if that sudden change may be causing the redness and the itching sensation.  I am going through a lot of anxiety now. I'd appreciate your guidance. Thanks.
Edward W. Hook M.D.
Edward W. Hook M.D.
47 months ago

Welcome to the Forum.  I'll try to help.  I find myself wondering what called your attention to these spots in the first place.  The lesions that you describe do not sound at all like herpes.  As I understand it the lesions are rather difficult to see, have been present continuously for six months, and have not ulcerated.  None of this is in any way suggestive of herpes or, for that matter, any other STI.  This may be normal variation in skin color which went unnoticed until you began to inspect yourself so closely or possibly, a fungal, non-STI skin infection.  Either way, what you describe certainly sound like nothing to worry about and could well be normal.  I would urge you to stop inspecting yourself so often or so closely.

I would offer the same advice about the redness and itching on your buttock.  This is not suggestive of an STI.  I would make efforts to keep your buttocks clean and dry and consider use of an antifungal powder.

I hope these comments are helpful.  EWH

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47 months ago
Thanks for your prompt response Dr.Hook. The reason why I've been closely inspecting my penis is because of my anxiety and perhaps being a hypochondriac about STIs.  One correction in your observation is that, I haven't noticed these spots for the past six months. I probably noticed these spots say 6-8 weeks ago on close inspection.

As I had mentioned in my post, three days ago, I kept obsessing (Kept looking and examining through touch) over these red spots, and suddenly the next day on inspection again, the red spots became way more pronounced. (I have never had any prominent spots like this on my penis since my chicken pox.)  And I could see them clearly.  Is there any concern with the fact that these red spots became so pronounced on this one particular day?

I checked my penis again the next day and the subsequent two days, and the red spots have again become way less prominent and seem like they are present underneath skin. I can't notice any of these spots unless through very close examination and exposure to bright light.

Do you recommend that I visit a primary care practitioner back in Seattle for a personal inspection?  Do you suggest that I take any tests? I appreciate your patience in dealing with my anxiety. Your advice is certainly very helpful. Thanks. 
Edward W. Hook M.D.
Edward W. Hook M.D.
47 months ago

Sorry about misreading the time frame.  That said, six weeks is still far too long for this to suggest that it is an STI of ANY sort. 

Day to day change in color or the intensity of the lesions is not unexpected and may be, in part, a result of repeated manipulation and self examination or, alternatively just day-to-day variation.

You state you anxious and a bit hypochondriacal about STIs,  If seeing wa well informed clinician will be helpful, my advice is to go to the Seattle King County STD Clinic at Harborview Medical Center. Both Dr. Handsfield and, many years ago, I have worked there and we will vouch for their accuracy and excellence at an affordable cost.  Doing this however will only help you if you can commit to believing them and their assessment.  If you see them and are still worried about this, then my advice would be to talk this through with a trained counselor who can help you address your (most probably) unwarranted concerns.  EWH

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47 months ago
Thanks Dr.Hook. Your assessment is certainly helpful. I have indeed been obsessing about these red spots for quite sometime. They are hardly visible until this one particular day unless I do some very very close examination. 

The obsession to self-inspect seem to come and go. And every time I go through that phase, anxiety sets in. In addition to your assessment that these red spots don't seem like STIs, I'll also take your advice to visit Harborview as well one of these days.

Appreciate your advice.
Edward W. Hook M.D.
Edward W. Hook M.D.
47 months ago
Glad to help, take care. EWH---