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Noticed small bumps under foreskin. Diagnosed fox fordyce spots. Cure?

Dec 2013
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Practicing since : 2002
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A few months back I found small bumps on the underside of my foreskin (not the penis. I'm not circumcised). I went to see a dermatologist, who said it was genital warts. I thought it was possible, since my girlfriend has had sex with another guy before me (although we used condoms). So the doctor had them burned off.

After a couple of weeks, i noticed bumps in the same area. I went to the doctor again and he said it looked like cysts. He burned them off again.

Now its been almost two months and the bumps are back. They are tiny, skin coloured and sometimes form semi circles.The doctor this time said they are fox fordyce spots.
I got myself checked for HIV and VDRL, both of which came negative. Im generally healthy, no big issues so far -if it helps, I even have a strong HB count of 18.

But I'm clueless about what to do next, see another doctor or wait it out? Any advise would be appreciated.
Posted Sun, 14 Jul 2013 in Skin Hair and Nails
Answered by Dr. Sanjay Kumar Kanodia 16 hours later
Hello XXXXX,

Welcome and thanks for posting your query to XXXXXXX

I can understand your concern for the bumps over the penile area. It is really distressing for a man to have anything unusual on genital area.

Now according to your query you have the problem of recurring small bumps over undersurface of penis. These were diagnosed as genital warts and then as cysts and then as Fordyce spots. Presently you are stressed and confused about the exact nature of the problem.

To begin with let me reassure you by the most important thing that you are totally clean form the status of any major disease like HIV or syphilis. So any how what ever the thing might be on penis it is not at all XXXXXXX So what is the possibility of the problem then..!!

Most commonly the spots on the undersurface of penis are Fordyce spots. These are pinhead size or slightly larger bumps present over mainly the under surface of the penis i.e. on the frenulum area. Basically these are proliferation of the normal oil glands which are present over this area. These are totally asymptomatic (without any problem) and are most commonly confused with genital warts in there initial course of appearance. A close examination is the must to differentiate one from another. There is no need of any treatment in this condition as it is totally normal condition. If at all some person are panicky then we do remove these with radiofrequency ablation.

Now there is second possibility is of genital warts. As you must be knowing these are simple viral infection which appears as acuminate or thorn like or pointed projections from the surface of the skin. These are small at first and then in few weeks of period increase in size as well as number over the genital area. These are most commonly present on the ring of glans penis (where there is maximum friction and trauma during sexual act) or at any site over genital area. This is also totally asymptomatic condition.

For the close possibility of the problem it would be better if you can upload a close picture of the area. For that you have a feature to upload images by yourself at the right side of the query page, please utilize that so that I can answer your further queries. Or else, you can send as an attachment to YYYY@YYYY with the subject as "Attn: Dr. Sanjay Kumar Kanodia). I hope this feature will help us better in resolving you r problem.
One important thing to ask at this juncture is that – Have you seen any sort of genital warts like condition at her genital area. I think this would also be guiding way to relieve us from the tension of warts. If she is not having anything like that then also is a point of relaxation for us.

Anyhow, as per your history you used condoms every time during sexual act with your girlfriend. Therefore this along with any other protected sexual act with condoms is the best way to protect you form any kind of sexually transmitted diseases including HIV, syphilis or from genital warts too. So the possibility of any sexually transmitted diseases including warts is unlikely.
Lastly, even if we consider them as genital warts then can be easily removed by radiofrequency ablation.

As you have got recurrence of the problem so I would guide you to wait for atleast 6-8 weeks of period. If you feel that the bumps are increasing in number and size and becoming pointed or thorn like then we will proceed in the direction of warts. Else if the condition is stagnant without any point of interference then is in favor of Fordyce spots.

I hope these information's will help you. If you have further queries I will be happy to help.

"Wish you good health"

Dr Sanjay Kumar Kanodia
MD (Dermatology and Sexually Transmitted Diseases)
Above answer was peer-reviewed by
Follow-up: Noticed small bumps under foreskin. Diagnosed fox fordyce spots. Cure? 16 minutes later
Well, the problem is that the bumps are so small and skin coloured that they dont show up on the photographs much. so i cant really upload them.

And one thing I have to clarify is that they are not on the penis - they are on the underside of the foreskin (seen only when i pull back the foreskin and look on the inner side of it). My penis is clear. And my girlfriend has so far not reported any GW, but she had hand warts about a year ago.
Answered by Dr. Sanjay Kumar Kanodia 51 minutes later
Welcome again to the forum young fellow.

Thanks for your prompt reply.

Well your description of the problem is enough to guide you further regarding your problem and there is no need to upload any picture for the same.

Taking your description in detail, the closest possibility is of Fordyce spots only. As per your description the bumps are visible only when you pull back your skin. This puling of skin makes the foreskin stretched and therefore the Fordyce spots become more prominent on stretching of the skin.

To tell you further, foreskin is also a part of penis which we medically take from the root of penis up to glans and skin covering this. So any thing in relation to it, is actually in relation to penis only. So as I can get that you are telling about clear glans part is also a good supportive thing in your favor for Fordyce spots.

Lastly the good news of “No genital warts” in your girl friend is the best supportive thing of the bumps as Fordyce spots. History of hand warts one year ago doesn’t make any sense presently. The most important reason being, that genital warts can only be transmitted sexually. Therefore if your partner is free and you haven’t had any incidence of unprotected sexual intercourse makes the things totally clear.

I request you to relieve your tension regarding any sexually transmitted disease including genital warts. The bumps will persist as a normal phenomenon of the body so no need to do any active intervention for the same.

Hope these information's will help you. If you have further queries I will be happy to help.

"Wish you good health and productive life ahead"

Dr Sanjay Kumar Kanodia
MD (Dermatology and Sexually Transmitted Diseases)
Above answer was peer-reviewed by
Follow-up: Noticed small bumps under foreskin. Diagnosed fox fordyce spots. Cure? 2 days later
Hello doctor,

I am attaching two photos of my initial outbreak. Could u check these and tell me if they were warts?
Answered by Dr. Sanjay Kumar Kanodia 8 hours later
Welcome again to the forum gentleman.

I have gone through both the pictures thoroughly and the good news for you is these pictures further confirms the diagnosis of Fordyce spots in your case.

You can very well see the skin colored, dome shaped smooth surfaced papules (beads or bumps in common term) over the area which are totally different from the rough surface, acuminate or thorn like projections of the warts.

The pictures are the classical example of the same (thanks for good resolution of the pictures taken by yourself). So you should relieve your tension regarding the possibility of any kind of sexually transmitted disease including viral warts.

I request you to stay happy and tension free. I personally suggest you to do nothing for the same and therefore no active intervention is required. These will never ever would be going to cause any problem through out life.

I now hope that these informations will help you. If you have further queries I will be happy to help or else you can close the discussion and rate the answer.

"Wish you healthy and productive life ahead"


Dr Sanjay Kumar Kanodia
MD (Dermatology and Sexually Transmitted Diseases)
Above answer was peer-reviewed by
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