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Forum Name: Male Sexual Disorders

Question: Small, solid, dry white spots above the head of penis.


 thatguy - Sat Oct 11, 2008 11:09 am

I am 24 year old male with no outstanding medical diagnosis or condition and am on no medication.

I have a couple of small (`1/3 cm and ~ 3 mm respectively), hard, white, dry spots right where the head (circumcised) meets the shaft of the penis. It is right where my thumb is when I hold it with my left hand to urinate. It started many years ago (perhaps before initiating sexual activity, though not 100% sure of this) as one tiny (few millimeters) dry scale that I would always pick (sometimes causing bleeding when nearby skin was torn). Over the last year or two, it has gotten a little bigger (very slow growth, likely due to me picking at it). It gets dry and forms a scale when I leave it alone and don't pick at it for a week or so. However, I always pick it off, it bleeds, and it returns. It is solid and slightly raised (almost like scar tissue), and is deeper than the epidermis.

Because it is on an area that is softer skin (where foreskin would have been) is this likely to be scarring from years of picking at it? Keratosis? A wart (it doesn't look like a textbook genital wart, but I hear they can be sneaky little guys)? For some reason, not doctor has taken notice of this during checkups.

I have no unrealistic expectation that you can deliver an exact diagnosis over a forum without seeing it, but a most likely explanation would be appreciated.
 John Kenyon, CNA - Sun Oct 12, 2008 9:04 pm

User avatar Hello -

It actually does sound like it could be a keratosis, but that's fairly unusual. The chronic picking at it has no doubt caused some scarring and chonic irritation, but this still needs to be looked at, probably by a dermatologist, to make certain it isn't a skin cancer (this actually can happen on the penis). Even if it's something completely benign it still sounds like something that needs a look, and if your doctor pays no attention to it, either point it out directly (I know, this is easier said than done, but trust me, the doctor isn't interested, which is probably why he hasn't noticed it). I wouldn't let it just go on like this.

I hope this is helpful. Please let us know how things turn out. Good luck to you.
 thatguy - Thu Nov 27, 2008 11:15 pm

There is no discoloration, protrusions, etc that point to skin cancer (or at least the skin cancer that we laypeople are told to look out for). The recent (over the past year or so) slight growth that has occurred has been a result of me creating an open wound by tearing it off resulting is the smaller secondary bump on the underside of the head and when I tried removing it with salicylic acid (I had some left over from a plantar on my foot that I was treating, so I gave it a go). Wouldn't being circumcised at birth further reduce the probability of cancer? I am not trying to be doubtful, rather just clarify as to be absolutely certain as to how urgent it is for me to eat some deductible payments.
 John Kenyon, CNA - Fri Nov 28, 2008 11:49 am

User avatar Hello again -

The bottom line here is whether or not circumcision might reduce the risk of cancer (and other problems). While this has been a controversial issue over the years, the last time I checked the preponderance of agreement lay with it not being a big factor. I personally find that a little hard to believe, but I have no scientific basis for my notions about it. It certainly would make the area more easily maintained, kept clean and probably less prone to irritation and certain problems, which seems to me would only help reduce the risk of at least certain cancers that occur secondary to chronic irritation. If it were me I'd probably have it done. However, again, that's just an opinion, and not one held by a majority lately.

Hope this is helpful. Best of luck to you.
 thatguy - Sat Nov 29, 2008 10:08 pm

I was circumcised at birth. I was wondering how this plays into the probabilities of this irregularity being serious (in context with the other facts mentioned).
 John Kenyon, CNA - Sun Nov 30, 2008 12:20 pm

User avatar Hi -

That part (being circumcised already) wasn't clear to me. If that's the case there is a slightly greater risk of the lesion being of some concern. At any rate it's not something you want or need going on, and for that reason alone, plus the small but discrete risk of a skin cancer, it would defintely be wise to have this looked at by an MD, preferably a dermatologist.

Sorry for the confusion. I hope this clears things up.
 thatguy - Sat Dec 13, 2008 8:41 pm

I went in for a checkup to day and showed the spot to the PA. She said that it was not an STD, did not appear cancerous, and most likely some sort of sclerosis. She advised me to stop picking at it.

She offered to refer me to a dermatologist if I wished, but said that it was up to me. The dermatologist would possibly cut it out and run tests, however she said that he/she would likely just repeat the same advice and tell me to stop picking at it. I could also return early next year when her boss (internal medicine) is in and he may perform the same procedure (or maybe not).

Being the nature of the skin under the head of the penis is a soft sensitive type skin (what would have been covered by foreskin if I wasn't circumcised). What is the likelihood that a doctor would remove it? Would the risk of scarring and making it worse be high enough that they wouldn't touch it?
 John Kenyon, CNA - Sun Dec 14, 2008 1:17 pm

User avatar The bottom line here seems to be a concern as to the advisability of having anything done surgically. I would suggest you see the dermatologist, first of all, and second that you trust his (or her) judgement about the advisability of removing the affected tissue. Dermatologists are acutely aware of the cosmetic and practical aspects of what they do, so there's not much chance you would be scarred unecessarily. Besides, if removal is suggested, you will still have the final say as to whether or not to go ahead with it.

I'd say go for the consult, listen, and if removal of the tissue is suggested, discuss your concerns, then make a decision based on that.

Best of luck to you, and please keep us updated.

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