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How can white raised patches over the penis be treated?

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Hi. I wonder if you could kindly help me with some thing that has worried me for a long time. I'm now 33 and at the age of 20 I developed white areas of skin discoloration, two patches either side of the frenulum on my penis, which were probably about 5cms in diameter each. One side was a raised white plaque. I went to see a couple of sexual health docs, although I was a virgin at that times, and it was suggested I had lichen sclerosis by two and another said it was normal. I tried steroid cream which made no difference. It has not worsened over time and I dont think I have been given the right diagnosis. I have tried months of keeping area very dry then moisturizing it. In the end because I had enough of it about six months ago, I wondered if one plaque was raised because my body was trying to get rid of it, so I decided to remove it over a few days and was surprised that it has not returned. However the skin on either side still appears white to me in a small area similar in size as above but not raised as before. I wish it was the same color as the rest of the glans. I keep wondering what to do as the doctors I have seen dont seem to know. Also my foreskin has white thin skin sometimes on the inner surface, and sometimes I have to pull it off which seems to improve for a while and my foreskin generally feels more comfortable. I can retract it quite well but its probably a little tight. Any advice would be so helpful! I asked for men's health category so hopefully I've come through to right section unless you think this should be more for dermatologist?
Thanks so much
Posted Sat, 5 May 2012 in Penis Problems
Answered by Dr. Bharat Chawda 14 hours later

Thank you for the query.

White patch over the penis which is slightly raised would possibly be lichen sclerosus et atrophicus (balanitis xerotica obliterans).

And if the white patch is not raised and is de-pigmented then there is a possibility of it being a vitiligo (leucoderma).

You have provided with good information but I would like to know a few more things as this would help me in suggesting you better.
1) Is there any other patch on the body?
2) Is the patch de-pigmented (milky white)?
3) Any symptoms (like itching)?

You can also consider sending me a picture of the lesion.

You have a feature to upload the images by yourself at the right side of the query page, please utilize it so that I can answer your queries better.

Perhaps a visit to competent Dermatologist can also confirm the diagnosis.

As far as treatment of the lichen sclerosus is concerned, potent topical steroid is the drug of choice, but the results are not very satisfactory.

You can confirm the diagnosis by doing a skin biopsy, that also help to rule out any malignancy.

At times patient develops phimosis and would need to undergo circumcision.

For Vitiligo, I would prefer a mild topical steroid only.

Please reply back with the above answers and a picture of the lesion as this will help me in answering you better.


Dr.Bharat chawda
Above answer was peer-reviewed by
Follow-up: How can white raised patches over the penis be treated? 3 days later
Hello. Thanks for your initial answer. I'm keen to try to find out what the definite diagnosis is so thanks for your help. There are no other patches on my body at all. There are no longer any raised areas except maybe for some small raised whitish pimples within the area and sometimes elsewhere on the penis but I understand that these may be quite common. I find it difficult to describe the colour, they do not seem to be as white as a milky colour. There are not any other associated symptoms I think to what I have already described. The areas are not itchy really, but occasionally uncomfortable but I think this is more when there is there is a thin layer of skin, a small amount which sometimes seems to develop on the inner layer if the fores I, but I have found recently I can gentle pull this off and although uncomfortable then for a few days this then seems to improve the whole situation for a while. I thought for a long time that trying to remove bits if it would make it worse, especially as I had read that if its lichen sclerosis then trauma can sometimes make it worse, but this definitely doesn't seem to be in the case. In fact the two main lesions I have described now look better, less prominent than what they have for a long time. I'm just hoping they will somehow go. I did try to add photos but I will try to do this again, I'm not sure if you will be able see clearly with the maximum resolution that is allowed to upload to the website. Some more information action that may be helpful, is that in my late teens and early 20s, I suppose I was shy about masturbation, and I tended not to retract my foreskin as much as usual I think during masturbation and as a result put pressure in the areas where the lesions are now. I remember that more pressure was on the left side where my thumb was, and this is the side that was worse and where the plaque was. Maybe this is a red herring but I wonder if this will help. The final thing is my frenulum appears to pull down a little more on one side when the fireskin is retracted, it seems to be attached to a little more skin on one side and I wonder if this is normal or maybe part of some pathological process. It does feel a little firmer than I guess it should and I wonder if it didn't then the whole area would feel more comfortable. I can retract my foreskin when erect, but the frenulum feels a little uncomfortable. Hope the photos are now attached, I know I've given you quite a bit of information but hopefully its may be helpful. Thanks for your help. It really will put my mind at rest if I can get to the bottom of this.
Answered by Dr. Bharat Chawda 11 hours later

Thank you for the reply,

I have gone through the photos and you were right regarding the pics, they are not very clear, except one where I could make out some de-pigmented lesions. And yes even the frenulum stretching on one side. This should not be of worry at all and should be regarded as normal.
I wish the picture were more clear .

As you said that the lesions are not milky white, then the possibility of pre-vitiligo is more likely.

Pre-vitiligo is a condition in which the color is not exactly milky white but has other feature that of vitiligo(leucoderma). Lichen scleroses is also a condition where we see milky white patches. In lichen scleroses the skin is not so smooth and the skin should not come out.

Since you said that you feel better when you remove the top layer of skin, I was wondering whether we are dealing with candidiasis(fungal infection). This is the only condition where you can remove the top whitish layer. But such a long history does not favor this.

I would appreciate if you can send a more clear picture if possible.

I would advise you to discuss all the three possibilities with a competent dermatologist & come to a conclusion.

Wish you good health.

Dr.Bharat chawda.
Above answer was peer-reviewed by
Follow-up: How can white raised patches over the penis be treated? 36 hours later
Thanks. The areas are definitely nw completely smooth. The pics seem to make the lesions more obvious than what there are, but hopefully that helps. To be honest my feeling is after having these for a while, if they were removed somehow, just the small areas of skin, I don't think they would return, but of course I suppose I can't be definite about that but think it is likely, I would be interested to know if u think the frenulum appears normal. I'm sure that should answer my questions really well. I do wonder if lichen sclerosis is now the least likely. Thanks
Answered by Dr. Bharat Chawda 6 hours later

Thank you for the query,

I feel the frenulum is slightly shifted to one side ,but that should not be a problem at all.I hope you don't face any problem like pain while erection.If there are no such symptoms I think you can leave it as it is.

I am sorry to say ,but the picture was still not clear.

Regarding lichen sclerosus you should rule it out by consulting any good dermatologist.There are times when lichen sclerosus can lead to urethreal meatus stenosis (narrowing of urethral lumen).Lichen sclerosus looks like ivory white in color .

I hope this answers your query.

Wish you good health.

Above answer was peer-reviewed by
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