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Pimple-like Bumps on Penis and Testicles

Everyone is familiar with pimples, condition that effects the oil glands of the skin. We are not worried if pimple occurs on our nose or cheeks, but what if pimple pops up on penis or testicle? Is that still normal? What to do then? Call a doctor or wait until the pimple subsides? 

What are Pimples?

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Pimple is actually a result of a blockage of the skin's pore and it can happen anywhere on the body: face, back, legs, even genitals and elsewhere. Pimples is a common and frequent condition that effects the oil glands of the skin. Oil glands are found in every hair follicle and when they become clogged or inflamed, they can lead to pimples breakouts.   

Are Pimples on Penis & Testicles Normal?

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Yes and no. Some types of so-called pimples (bumps,...) are normal and represent very common condition, but in some cases those bumps can be dangerous and demand prompt medical attention.

Pimples on penis or testicles typically occur in teenage years, but it is also possible men will experience pimples at some time later in their life. Statistics claim that eight out of ten men will experience pimples on penis and/ or testicles at some time in their life. Most of the time penis and testicle pimples go away as person grows, or if they occur later in life, they subside in a matter of week or two. But

the fact is that if they don't, it is not wise to sit at home miserable, hoping they will go away.

If you notice any new lumps or bumps,

Ask your doctor to check, or go to a genitourinary medicine clinic. I know it can be suffering, not to mention the psychological effect pimples on genitals can cause.    

What Spots are Normal on Penis?

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So called (and looking like) pimples are normal. They are pearly penile papules, small in size (approximately 1-2 mm) and they look just like pimples, but are not pimples. They are actually tinny glands, and you shouldn't pick on them. They occur around the margin of the penis head, and can be seen when foreskin is pulled back. They usually develop in teenage years, but may occur up to the age of 40. They are visible in some men, while in others are less noticeable. Around 10% of men is affected by pearly penile papules.    

After masturbation or sexual intercourse hard swelling might appear near the foreskin, in the shaft of the head of the penis. This swelling is called lymphocele, and is caused by temporary blockage of the lymphatic channels at the area described. This condition is also normal and goes away on its own without any after-effects.   

What Spots on Penis are not Normal?

Ulcers

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Ulcers. If ulcer develops, you must immediately visit your doctor. Ulcers appear as craters on the skin and represent a full-thickness loss of skin (epidermis). Typically of ulcer is crust, clear liquid (serum) or pus in the crater. Ulcers may occur due to genital herpes, infection, virus or may even be form of skin cancer. 

Papules

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Papules are small lumps (less than than 1 cm), raised above the skin surface. Most penile papules do not have a serious cause (pearly penile papules for example), but some are infectious and may lead to more serious conditions.

Types of Papules:

Molluscum contagiosum is form of papules, which is very common, but must be supervised by doctor. They are pinkish-white round lumps, each about 1–5 mm in diameter, and are caused by a virus.

Hair follicles are a normal and are usually found on the underside of penile shaft. They may be visible or only felt as small lumps in the skin. They are recognized by having a hair arising from them.Pearly penile papules (described above as very normal condition)

Fordyce spots are small (1-5mm) bright red or purple papules that can appear on the penis or testicles. They usually affect younger men, and appear in crops. They are painless and not itchy, but are embarrassing because of their appearance. 

Genital warts are very common and are caused by a virus. In case of genital warts seek medical help.

Plaques

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Plaques are raised, flat-topped lesions, greater than 1cm in diameter. Usually they do not have a serious cause, but some are infectious and others may develop into more serious conditions, such as Erythroplasia of Queyrat, lichen sclerosis and balanitis xerotica obliterans, which may lead to the development of penile cancer 

Erythroplasia of Queyrat appears as a sharply demarcated bright red plaque with a velvety surface. Disease is not infectious, but needs prompt medical attention since it represents an early manifestation of penile cancer. Treatment usually involves excision of the affected area.  

Lichen sclerosis looks like white plaques on the glans, foreskin or shaft of the penis. The severe form of lichen sclerosis is balanitis xerotica obliterans, and it occurs on the opening of the foreskin, which becomes white and firm. Both conditions may lead to penile cancer, but rarely. Medical care is necessary.        

What Spots are Normal on Testicles?

Chicken-skin: it is normal that the skin on testicles looks similar to the skin of plucked chicken.  

Sebaceous cysts: they are swollen, blocked grease glands that look like yellowish pimples. They occur  in dozens or more. If they become infected, they can be treated.    

Angiokeratoma of Fordyce: tiny, bright-red blood-blisters; can be itchy, but are otherwise harmless.

What Spots are not Normal on Testicles?

Genital Warts

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Varicoceles, which are caused by the swelling of veins; are more noticeable when standing. Approximately 15% men have this condition, and usually occurs on left side. 

Lump(s) in the testicles, which usually isn't visible, but can be felt through the skin. In most cases these lumps are armless cysts, but they may develop into testis cancer. Consult your doctor if you find a lump in your testicle.

In Conclusion

Men are understandably concerned when they notice spots on the penis. So, what is best to do in this case?

First of all- do not make the situation worse! For that reason do not try to squeeze anything! Squeezing might cause an additional inflammation, which can spread the bacteria that caused pimple, which leads to spreading pimples and possible scarring. Clean your skin several times daily with pH neutral soap, but do not exaggerate, since this could lead to other problems. If you suffer from swelling, apply ice pack, which should reduce swelling, redness and pain.

However, if you feel your condition isn't just pimples, it is highly recommended to see doctor or dermatologist as soon as possible

Red Spots on the penis 

 

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Men are understandably concerned when they notice spots on the penis. They are frequently worried they may have a sexually transmitted disease or some form of cancer. They may equally be worried about the appearance of their penis and what their sexual partner might think of it.

Are They Common?

Spots on the penis are very common and most do not have a serious cause. However, some do and it is important to seek prompt medical advice if you are concerned.

This article describes some of the causes of spots on the penis, but reading it and examining your own penis is no substitute for examination by a doctor!

What Should I Do?

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Unless you think you have a sexually transmitted disease (STD), the first place to seek advice about spots on the penis is from your GP.

If you are too embarrassed to discuss it with your family doctor, or think you might have an STD, you can seek confidential advice from your local genito-urinary medicine (GUM) clinic. You don't need a referral letter from your GP, but it is advisable to first telephone the clinic for more information.

In the UK, they are usually listed in the telephone directory under 'Health Service' or 'Hospitals'.

Types of Spots

Spots on the penis can be divided into groups according to their appearance.

Ulcers: ulcers appear as craters on the skin and represent a full-thickness loss of skin (epidermis). There is frequently a crust, clear liquid (serum) or pus in the crater.

Papules: papules are small (less than 1cm diameter) lesions (lumps) raised above the skin surface.

Plaques: plaques are raised, flat-topped lesions, greater than 1cm in diameter.  

Ulcers

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Single penile ulcers frequently have a serious cause and it's important to seek prompt medical advice.

Possible causes:

  • primary syphilis: a single, round, painless ulcer on the penis or scrotum is characteristic of the first attack of (or primary) syphilis. It is caused by a spirochaete (spiral-shaped) bacterium called Treponema pallidum. The diagnosis must be confirmed by laboratory tests. It is an infectious STD.
  • chancroid, granuloma inguinale, lymphogranuloma venereum: these are tropical diseases that cause a single, painless, foul-smelling ulcer. The diagnosis must be confirmed by laboratory tests. They should be suspected in men with a history of sexual contact in tropical areas. They are all infectious STDs.
  • penile cancer (squamous cell carcinoma): may appear as a painless, irregular genital ulcer. Early diagnosis and treatment is essential and may be life-saving.

Multiple penile ulcers are more common and may have a less serious cause. However, seeking prompt medical attention is still important. They can be divided into two groups: acute - present for less than two weeks - and chronic - present for more than two weeks.

Acute

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  • Herpes simplex: this is the commonest cause of genital ulceration. It is caused by Herpesvirus hominis type two, or sometimes type one - the virus usually associated with oral herpes or cold sores. Herpes is characterised by recurrent bouts of genital vesicles, like small blisters, which rapidly break down to form small, painful ulcers. It is highly infectious and usually sexually transmitted. The first episode is usually associated with an acute feverish illness, which may be quite severe. The diagnosis must be confirmed by laboratory tests. Acute episodes can be effectively treated with antiviral medicines, such as aciclovir, although recurrences are common. Stress or other feverish illnesses may precipitate such recurrences.
  • Secondary syphilis: multiple irregular, shallow, painless grey ulcers, sometimes described as 'serpiginous', like a snail track on the penis, are characteristic of secondary syphilis. It is caused by a spirochaete bacterium called Treponema pallidum. A flu-like illness and a blotchy, red rash usually accompany it over the body. As with primary syphilis, the diagnosis must be confirmed by laboratory tests. It is an infectious STD.
  • Apthous ulcers: these are small, shallow, painful ulcers that most commonly appear in the mouth, but can also affect the penis. Typically, they have a grey centre surrounded by a bright red halo. They occur in crops and resolve without treatment. They can easily be confused with herpes simplex ulcers, so laboratory tests are necessary to reliably distinguish the two. They are not infectious and their cause is unknown.

Chronic

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Pemphigus: this usually affects other parts of the body, frequently starting in the mouth, but may be restricted to the penis. It appears as fragile, thin-walled blisters that break down to form ulcers. These are often painful and may itch. There are a variety of different forms; the most severe type may affect the whole body and is life threatening. It is caused by a breakdown in the adhesion between different layers of the skin. Prompt diagnosis and treatment is essential.
  • Behçet's disease: an inflammatory disorder affecting the skin, joints, nerves, eyes and other body systems.Symptoms may include large, deep and painful ulcers on the penis and scrotum, but is always accompanied by mouth ulcers. It is a potentially serious condition and prompt diagnosis and treatment is essential. It is not infectious.
  • Reiter's syndrome: an inflammatory condition that occurs with generalised arthritis. About a quarter of affected men have small, ulcerated plaques around the glans and foreskin. It can also affect muscles, the eyes and nails. It is caused by an abnormal immune response to a gut or genital infection. It may follow a prolonged, relapsing course, but can be treated. Reiter's syndrome is not itself infectious, but the germs that might cause it are. Some of them can be sexually transmitted.

Papules

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Most penile papules do not have a serious cause, but some are infectious and may lead to more serious conditions. An early penile cancer may also appear as a papule before ulcerating. It is important to seek prompt medical advice about penile papules.

  • Molluscum contagiosum: a common, benign, infectious viral disease affecting the skin and mucous membranes. It is a common skin condition in childhood when it is transmitted through ordinary peer contact. In adults it may be sexually transmitted and this is probably the commonest cause of penile molluscum in adult men. It appears as multiple, small, dome-shaped papules, often with a central depression or plug. A curd-like discharge can be squeezed from them. It may disappear without treatment, but freezing or cautery will usually get rid of it. Molluscum contagiosum is a marker for 'unsafe' sexual practices in adulthood and those affected should be screened for HIV
  • Hair follicles and sebaceous (sweat) glands: these are a normal part of the skin's anatomy and are commonly found on the penile shaft, particularly on the ventral surface (underside). They may be visible as small nodules or might only be felt as small lumps in the skin. They will have a hair arising from them that reveals their true nature. They are quite normal.
  • Pearly penile papules: multiple, small (about 1-3mm) papules running around the circumference of the crown of the glans penis. They typically develop in men aged 20 to 40, and around 10 per cent of all men are affected. They may be mistaken for warts, are not infectious and require no treatment.

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  • Fordyce spots: small (1-5mm) bright red or purple papules that can appear on the glans, shaft or scrotum and usually affect younger men. They may occur as a solitary lesion, but frequently appear in crops of 50 to 100. They are painless and not itchy, but may cause embarrassment because of their appearance, or a fear that they might be sexually transmitted. They are abnormally dilated blood vessels, covered by thickened skin. They may bleed if injured or even during intercourse. They are not infectious and their cause is unknown. Although a number of approaches have been tried, there is no simple, reliable treatment to remove them. Troublesome bleeding spots can be sealed with a device that uses a small electric current (electrocautery).
  • Psoriasis: most commonly affects other parts of the body, particularly the knees, elbows and scalp, but occasionally first appears on the penis, usually on the glans or inner surface of the foreskin. Psoriasis appears as thickened red papules or plaques with a well-defined edge. In uncircumcised men, and at other sites, it has a scaly surface. It rarely causes irritation. It is caused by an abnormality of skin production and can be inherited. It is unsightly, but rarely serious. There are a number of effective treatments available, such as steroid creams and calcipotriol cream (Dovonex).
  • Warts: a number of different types of wart may appear on the penis. Genital warts are caused by human papilloma virus (HPV) and are infectious. They may be single or multiple, skin-coloured, pink or brown, with a moist surface. HPV infection is associated with the development of cervical and anal cancer, so it is important that sexual partners are screened for evidence of infection. They can be treated in a variety of ways, from skin paints to cautery, but are sometimes very difficult to eradicate.

Plaques

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Penile plaques do not usually have a serious cause, but some are infectious and others may develop into more serious conditions: Erythroplasia of Queyrat, lichen sclerosis and balanitis xerotica obliterans may lead to the development of penile cancer.Make sure you seek prompt medical advice about penile plaques.

  • Balanitis and posthitis: balanitis is an inflammatory condition of the glans penis. Posthitis is an inflammatory condition of the foreskin. Symptoms include local irritation, burning and a red rash. Sometimes the skin appears to be peeling off as if scalded. Bacteria and yeasts such as candida can cause it. It is more common in older men and those with diabetes. Balanitis is infectious and may be sexually transmitted. It can be treated with appropriate antimicrobial creams.
  • Erythroplasia of Queyrat: appears as a sharply demarcated bright red plaque with a velvety surface. It is usually painless, and not itchy. It is an early manifestation of penile cancer and needs prompt diagnosis and treatment. Excision of the affected area is usually curative. It is not infectious.
  • Zoon's plasma cell balanitis: Zoon's balanitis appears as a bright red, shiny-surfaced plaque on the glans or inner surface of the foreskin. It is usually painless but may be accompanied by itching. The cause is unknown. It may respond to application of steroid cream, but frequently recurs. Circumcision is curative, but not essential. It is a harmless condition but can be confused with the much more serious condition of Erythroplasia of Queyrat. It is not infectious.
  • Lichen sclerosis and balanitis xerotica obliterans: lichen sclerosis appears as white plaques on the glans, foreskin or shaft of the penis. It usually has no symptoms, although burning and irritation have been reported. Balanitis xerotica obliterans is a severe form of lichen sclerosis affecting the foreskin of uncircumcised men. The opening or edge of the foreskin is firm and has a white scarred appearance. It is quite inelastic and will not pucker open as it is retracted. This may interfere with passing urine or sex. Both conditions may, rarely, lead to penile cancer and circumcision may be necessary. They are not infectious.
  • Psoriasis: See Above, Under Papules.

 Eczema: most commonly affects other parts of the body, but occasionally it may first appear on the penis. In such cases, it may be a skin reaction to an irritant that is better be described as dermatitis. Eczema appears as diffuse red plaques with a poorly defined edge and finely scaled surface. It frequently causes quite severe irritation. It can be caused by infection or local reaction to skin injury from chemicals or radiation. There are a number of effective treatments available, such as steroid creams. It is not infectious.

Treatmnet

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