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White spots on foreskin, no itching, no pain, tight foreskin. Ointment?

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Practicing since : 1996
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Hi Doctor,
I am 32 years old male, 5 feet,6 inches tall, 73 kgs and healthy. I am married and have a 4 yr child. I've white spots at the tip of foreskin, which I've been seeing from last 2-3 years, no itching or pain, but it looks ugly when I see them and worries me a lot. Also, my foreskin is tighten a bit from before, is there any ointment that I can use to come out of these problems. Thanks
Posted Fri, 27 Apr 2012 in Pigmentation Problems
Answered by Dr. Bharat Chawda 1 hour later

Thank you for posting the query,

It is very important to see the lesions clinically here .
But with history what you have submitted ,there seems to be two possibilities.
One which we very commonly come across is the de-pigmented(milky white) patch called VITILIGO.
The second thing is a condition which is not very commonly seen and can cause difficulty in retracting the foreskin and difficulty in urinating also.This is called as Balanitis xerotica obliterans (BXO) .This condition manifests as atrophic de-pigmented patch(white) involving the foreskin .

To differentiate between the two you may need to get a skin biopsy done or consult a competent dermatologist who can diagnose it clinically.

As far as treatment is concerned both would require topical steroid .This would also help in retraction of foreskin.

If diagnosed as BXO ,then you may need to go for circumcision,as medical therapy may not help much.

Treatment of vitiligo is also depressing when such areas areas involved.

So,I would advise you to consult a dermatologist who can guide you regarding the diagnosis and treatment best.

Hope I have answered your query.Should you have additional concerns regarding this issue I would be happy to address them.

Dr.Bharat chawda
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