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Suggest treatment for fungal infection on the foreskin

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Posted on Sat, 16 May 2015
Question: Hello, I have been having many ongoing problems with my foreskin for the past 4 months now. It's a bit of a long story, but here it goes - it started with warts that appeared on the inside of my foreskin and on my frenulum. A doctor at an STD clinic prescribed me to use Aldara. The warts went away after a couple of weeks, I then had sex (unprotected) with my girlfriend and afterwards I noticed my foreskin was extremely swollen, painful and red. After online research, I suspected I had some sort of yeast/fungal infection, although my girlfriend was not showing any symptoms. So I bought Lotrimin and applied it for a week. After a week, I hadsex again and the same thing happened. I then saw another STD doctor, who did a full STD test, which I tested negative for all across the board. He said maybe it was a reaction to the Aldara cream, and told me to keep applying Lotrimin and a 2.5% hydrocortisone which he prescribed for 2 weeks. It seemed to have helped a bit, but was still getting irritated and swollen after masturbation (I've been avoiding sex ever since, and had to break up with my girlfriend). So I then tried a dermatologist, who said that it's some sort of Psoriasis or contact dermatitis which would just stay under control, which it hasn't, he also kept prescribing me creams that my health insurance couldn't cover. So I gave up on him, and finally saw a urologist a couple days ago who after examining and handling my penis, actually caused my frenulum to tear and bleed for the first time right there in his office. So he quickly diagnosed it as a torn/irritated frenulum, and prescribed me to put Neosporin on it for 3 weeks and avoid any sexual contact. He said if it's not better by then, then he will perform a frenectomy. After a week of Neosporin, it got red and painful, so I stopped using that.
As you can see, this has been a really long, frustrating, and traumatic process for me. It ruined my relationship with my girlfriend, and I'm now depressed and have lost any confidence to talk to girls. I can't even masturbate. I am losing hope and feel like I've permanently ruined my sex life. I'm skeptical if the tearing of my frenulum in his office was just a coincidence due my skin being so irritated or if that's what the underlying issue has been this whole time... Also, all these doctors are always in a rush to get to their next patients and I feel like they never really fully hear me out. Everybody is saying something different and nobody seems to be able to pinpoint what it is.
I'm getting extremely depressed and discouraged, and am dreading the thought of potentially needing to get circumcised, although a frenectomy doesn't sound half as bad if that's all I need.. Do you think a circumcision or frenectomy would even help my situation? It seems like if it is psoriasis, it affects both circumcised and uncircumcised men. Will I ever be able to get my sex life back?
Also, I'm doing all the obvious things (i.e. good hygiene, mild soap, keeping it dry, etc.)
Thank you for your help
I also have pictures if that would help.
R
doctor
Answered by Dr. P. T. Patil (3 hours later)
Brief Answer:
To get circumcised will resolve the issue permanently.

Detailed Answer:
Hello
Thanks for your query,based on the facts and sequence of events that you have posted it appears that you have Fungal Infection of Foreskin (Genital Candidiasis)

I shall be happy if you can post me few more details to help me in making comments on your problem.
1) Are you diabetic?
2)Do you have any urinary symptoms like burning urination,urgency,frequency etc?
3)Do you have any urethral discharge?
4) Is there itching of the foreskin?
5) Is it possible to Upload photographs of penis

Based on the facts I would think your problem to be due to Fungal infection of the Foreskin (Genital Candidiasis) with super added bacterial infection .

Please get following basic tests done to help to establish diagnosis.
1) Swab test and culture of a discharge from urethra or Foreskin .
2) PCR test to rule out Herpes 2 infection.

In the mean while start taking following medicines
1) Antibiotic like Doxicycline twice daily orally
2) Anti Fungal Medicine Fluconazole Twice daily orally.
3)Topical Antifungal jelly Lotrimin.

As regards tear of frenulum I would suggests you take above mentioned drugs for 2 weeks and get circumcised .This will resolve the issue permanently.

Continue to take care of personal hygiene.

Hope I have answered your query ,please feel free to ask if you have more questions I shall be happy to help you
Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. P. T. Patil (22 hours later)
Thank you for your reply.
To answer your questions -

1) I am not diabetic
2) No symptoms when urinating
3) No urethral discharge
4) There is mild itching of the foreskin only when it is irritated (after sex/masturbation). However, when that happens, it's mostly hyper-sensitive rather than itching. Otherwise I don't feel anything from day to day.
5) I do have photographs. How can I upload pictures here?

Also, I've already had a swab test of the foreskin for Chlamydia and the test came out negative. And I also had a blood test for all STD's including Herpes 2 and it came out negative. Is a PCR still necessary?

I'll ask my doctor about those medicines you prescribed and hopefully he can prescribe them to me.

As for the frenelum, would a frenectomy suffice instead of doing a full circumcision?

I should also mention, that the penis is fine if I don't touch it. It's only after sex/masturbation that it gets symptomatic, and then clears up within 1-7 days depending on how severe the contact was. Wouldn't a fungal infection have constant symptoms until it is healed?







doctor
Answered by Dr. P. T. Patil (1 hour later)
Brief Answer:
Doing only Frenulectomy will not resolve the issue.

Detailed Answer:
Hello
Thanks for feedback.

There is link on the home page of Health Care Magic to upload reports and photograph.You may ask for help from HCG .

As regards the the PCR test since you have done almost all necessary tests you may not repeat it again.

You have basically problem of Foreskin hence doing only Frenulectomy will not resolve your problem.

Try the treatment I have suggested in my reply earlier.

Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. P. T. Patil

Urologist

Practicing since :1971

Answered : 10365 Questions

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Suggest treatment for fungal infection on the foreskin

Brief Answer: To get circumcised will resolve the issue permanently. Detailed Answer: Hello Thanks for your query,based on the facts and sequence of events that you have posted it appears that you have Fungal Infection of Foreskin (Genital Candidiasis) I shall be happy if you can post me few more details to help me in making comments on your problem. 1) Are you diabetic? 2)Do you have any urinary symptoms like burning urination,urgency,frequency etc? 3)Do you have any urethral discharge? 4) Is there itching of the foreskin? 5) Is it possible to Upload photographs of penis Based on the facts I would think your problem to be due to Fungal infection of the Foreskin (Genital Candidiasis) with super added bacterial infection . Please get following basic tests done to help to establish diagnosis. 1) Swab test and culture of a discharge from urethra or Foreskin . 2) PCR test to rule out Herpes 2 infection. In the mean while start taking following medicines 1) Antibiotic like Doxicycline twice daily orally 2) Anti Fungal Medicine Fluconazole Twice daily orally. 3)Topical Antifungal jelly Lotrimin. As regards tear of frenulum I would suggests you take above mentioned drugs for 2 weeks and get circumcised .This will resolve the issue permanently. Continue to take care of personal hygiene. Hope I have answered your query ,please feel free to ask if you have more questions I shall be happy to help you Thanks and Regards. Dr.Patil.