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Noticed white dots on penile shaft. Could it be fordyce spots, epidermal nevus, hair follicle or STD?

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Dermatologist
Practicing since : 2005
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Hi there. I wanted to get a second opinion on a skin question on my penile shaft. I have lots of little white dots on the upper portion of my penile shaft. Most are only noticeable in direct light and if the skin is stretched, and a couple are raised enough to be felt. I have been told they're either Fordyce spots, epidermoid nevus, or a hair follicle as most do have a small clear hair coming from them like a penile hair follicle would. I have NEVER had sexual intercourse before and have no reason to suspect I could have an STD unless it was from oral, but I have only had that occasionally and by other careful, safe females. But I am mentioning it in the interest of total disclosure.

The spots don't grow, hurt or otherwise interrupt anything. I have been asked about them before but other than that, they do not bother me. My urologist today said they are papules or hair follicles and did NOT see them to be HPV. But, I would like your opinion as well.

I have always had rough penile skin and have gotten ingrown hairs easily, etc, so it would not be alarming or unusual for this to be part of my normal penile landscape. Interested in hearing your thoughts. PS - these bumps are a little harder than a Fordyce and are more "above" the skin than a Fordyce, but still have a "root" underneath the skin, like a hair follicle, and again, most of these spots do have a small clear hair coming out of them. Just wanted to add that detail.
Thank you!
Posted Thu, 18 Oct 2012 in Penis Problems
 
 
Answered by Dr. Sudarshan 20 hours later
Hi XXXXXX

Thanks for the details and the photograph.

I really appreciate the detailed information provided by you. It makes clear picture before answering your query. Also you seem to be quite a health conscious and observer person.


After going through the photos I do not find any abnormal findings.

All the skin bumps and lesions indicated by you are normal findings.

There are no warts or any other infective pathology.

White bumps near the head are Fordyce spots; others are just hair follicle prominences.

These Fordyce spots are believed to be caused by sebum which is the natural oil of the skin. This oil gets trapped in a sebaceous gland that does not have hair.

In most cases, sebaceous glands open into a hair follicle and its oil is secreted up the hair shaft. But in the case of Fordyce spots, no hair means there is no way to discharge the natural body oil secretions. Therefore, the cause of the bumps.

Hope this clears the confusion.

There is nothing to be worried about and no treatment or investigation is needed in your case.

Also I would be available for any further clarification.

Wishing you good health.

Regards
DrSudarshan
Above answer was peer-reviewed by
 
Follow-up: Noticed white dots on penile shaft. Could it be fordyce spots, epidermal nevus, hair follicle or STD? 2 hours later
Thank you for the very reassuring diagnosis doctor. Are you certain this is not warts? Also, what would the odds be of contracting HPV from occasional oral sex? I hear the risk is low but I just want to know for my own education. As you stated, I try to be very informed and make good decisions.

Also, I just wanted to make sure you did indeed see the most recent photo I posted in my report labeled 2012-09-27_03-50-37_31.jpg. This shows the most prominent bumps. Thank you for easing my troubled mind. Blessings to you.
 
 
Answered by Dr. Sudarshan 9 hours later
Hi again XXXXXX

Ive gone through your recent pics also.

I can reassure you these are not warts.They are no pathology at all.

I am 100% certain these are not warts.


Warts are caused by HPV or human pappiloma virus.

HPV is primarily transmitted through genital skin-to-genital skin sexual contact.
Penetrative intercourse is not required. Oral and anal HPV infections occur, and oral and anal intercourse may not be required.


The exact risk of developing genital warts after having one episode of sexual intercourse with someone who has genital warts is not known, but several studies would appear to establish a risk in the range of 65% or more.


Likewise, most studies of women with cervical HPV disease indicate that approximately 64-70% of their partners will have HPV penile lesions if evaluated clinically. Most often, these are so small that neither partner is aware of their presence.

Most couples practice oral sex, yet HPV lesions are very uncommon in the mouth. However, recent studies report high-risk HPV in approximately 1/4 of squamous cell carcinomas of the head and neck worldwide, so oral HPV transmission does occur but only very rarely causes serious problems.


So to summarize oral sex has small but definite risk of acquiring HPV infection.

Hope this helps.

If you need any future asistance for skin and STD related problems I will be available.

If you are satisfied by the answer please accept it and rate it at the end.


Regards
DrSudarshan
Above answer was peer-reviewed by
 
Follow-up: Noticed white dots on penile shaft. Could it be fordyce spots, epidermal nevus, hair follicle or STD? 2 hours later
THANK YOU VERY MUCH!! Your words have eased my troubled mind.

I would like to ask you one more thing because it seems you are extremely in tune with these kind of troubles.

I have an inflammation type friction on my right side of my penis. I feel it when clothing rubs against it but I cannot duplicate the pain by touching with my hand to try to find where it is. It's a non-specific pain that is hard to pinpoint but it happens every day so there is concern. On that same side near where I feel the pain, there is a brown mole/freckle and a couple of the white spots we mentioned earlier. There is one right on the border between the foreskin and the shaft skin that is adjacent to the mole/freckle. I cannot figure out where this pain is coming from. Any ideas of what it could be?

Also, does the freckle/other areas look healthy as well? The mole is not raised over the skin. It is perfectly flat with the skin and has been there from years. I do not feel like this is the source of the pain but it is from this area.

Just in total disclosure in case this to do with it...I am also being treated for prostatitis at the moment.

Thanks!
 
 
Answered by Dr. Sudarshan 3 hours later
Hi XXXXXX

The photos dont show anything which can cause pain.

Mole/freckle cannot cause pain.

Prostatitis may rarely cause referred pain here.

Further examination and woek up may be required for pain.

Hope this helps.

Regards.
DrSudarshan
Above answer was peer-reviewed by
 
Follow-up: Noticed white dots on penile shaft. Could it be fordyce spots, epidermal nevus, hair follicle or STD? 41 hours later
Thank you doctor.

One additional followup...

I have noticed a couple additional Fordyce spots on my foreskin in the past 48 hours. Obviously since these are new it scares me a little. They are in the same area you saw before, just a few more prominent ones. Just wanted to make sure these are still healthy and safe
Also, what could cause them to be popping up randomly at this time?

New photo attached.

Thank you so much once again. You'll never know how much assurance you have given me.
 
 
Answered by Dr. Sudarshan 40 minutes later
Hi again XXXXXX

Ive gone through new images.

These are the same bumps.

Popping them may cause small scarring and occasional hypo pigmentation.

Otherwise you can pop a large one causing discomfort.

If you are satisfied with the answer please accept it and rate it at the end.

Regards
DrSudarshan
Above answer was peer-reviewed by
 
Follow-up: Noticed white dots on penile shaft. Could it be fordyce spots, epidermal nevus, hair follicle or STD? 2 minutes later
Thank you again. They do not pop like a pimple. They just kinda retract into the skin when squeezed. Any ideas?
 
 
Answered by Dr. Sudarshan 35 minutes later
Hi again,

Yes they tend to retract in skin but may cause hypopigmentation in some cases.

Squeezing may cause retraction and hypopigmentation.

Hope this helps .

Regards.
Above answer was peer-reviewed by
 
Follow-up: Noticed white dots on penile shaft. Could it be fordyce spots, epidermal nevus, hair follicle or STD? 47 hours later
Thank you so much as always. I have decided I would like to ask you about one additional irregularity I have down there. I will ask it here since we have been on the subject but I will also ask it as a private inquiry so that you may be paid for it accordingly since this is a little off subject from what we originally talked about.

I have what I believe to be an in grown hair on my scrotum skin. It has hardened and has not healed any further in months. I have had similar before and they lasted for a long time. It is inside the skin but gives an unattractive outside appearance. It has a head like a pimple but will not pop. Any ideas on what it is or how to get rid of it?

Thank you. You are a friend for life.
 
 
Answered by Dr. Sudarshan 1 hour later
Hi again XXXXXX

Thanks for writing in.

Ingrown hair is a common problem. The best way to deal with it is to remove the hair using a sterile needle. You can get a sterile needle from pharmacy shop.

Wash the scrotal area with antiseptic wash or soap and water.

Pass the needle from upper open end of the hair. Pull it out. If it’s not viable, you can pop it with needle.
Apply over the counter antibiotic like neomycin or mupirocin over the area for 7days.

Keep your hair trimmed at the area to avoid recurrence of same problem.
Hope this helps.
It is always a pleasure talking to you.

Regards.
Above answer was peer-reviewed by
 
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