When spots, lumps or rashes appear on the penis one of the first concerns many men have is whether they have a sexually transmitted disease. In most cases most spots are both common and harmless. It is the size, shape and color of the spot that helps to determine whether there is something to be concerned about.
Tiny nodules beneath the skin which appear over the scrotum and the base of the shaft of the penis are normal hair follicles.
Small pearly spots around the crown of the glans affect about 10% of all men around the ages of 20-40. These ‘pearly penile papules’ if diagnosed, are not infectious and require no treatment.
Small red or purple spots on the penis can appear on the glans, shaft or scrotum and usually affect younger men. Known as Fordyce spots they may appear in one’s or two’s but they frequently occur in patches of up to 100. These spots come about as a result of dilated blood vessels. They can look a little unsightly but they are completely harmless. No easy way is known of removing this type of spot.
A small-medium sized raised spot on the scrotum, sometimes filled with pus, is most likely just a spot or a boil.
Thick red patches with a well defined edge could spell psoriasis. Psoriasis can be inherited but is rarely serious. Typically, psoriasis of the penis will be treated by a steroid cream.
Pink-brown or skin-colored lumps with a moist surface could suggest genital warts.
A single, round and painless ulcer of the penis or scrotum could be primary syphilis.
A painless irregular genital ulcer could be penile cancer.
A single, painless but foul-smelling ulcer could be the result of a tropical disease and may be a sexually transmitted disease if sexual contact has occurred in the tropics.
Small blisters forming painful ulcers sounds like herpes simplex. This is the commonest form of genital ulceration. This is highly infectious and usually transmitted sexually. The first episode is often associated with a feverish illness.
Small gray ulcers with a red halo could be apthous ulcers. These occur in crops and can get better by themselves. However, because they are easily confused with herpes simplex a lab test is needed to determine a proper diagnosis.
Small raised papules often with a central depression could be molloscum contagiosum. This is a harmless and common viral disease in children most commonly spread through sexual contact in adults.
Irritating and burning red rash could be a condition know as balanitis.
The list above is not exhaustive. Self diagnosis of spots, lumps or rashes is not a good idea and sometimes a proper diagnosis can only be made with clinical tests. As with all genital signs and symptoms seek medical advice and practice safe sex.