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What causes itchy skin on tip of penis?

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Posted on Fri, 2 Jan 2015
Question: i have itching in skin of tip of penis.but.not in inside head of penis but tip of penis...it where urine passes it it itch more there..and i have pain in inside tube of penis..i have no std ..i tested urine and fluid of penis i m negative..but the pain and itch never go wat ist .i used to masturbate too..and last time i encountered ngu..but nowits clear and negative but also the pain and itch never go why??.i had fungul infection too i used mycoban cream and it was okey..but still i have problems..help me pls
doctor
Answered by Dr. Rahul Tawde (3 hours later)
Brief Answer:
Treatment for genital candidiasis

Detailed Answer:
Hi, thanks for posting the concern in the HCM.
Firstly, we need to rule out urethritis. Urethritis can be diagnosed by presence of one or more of the following-
1. Mucopurulent or purulent urethral discharge
2. At least 5 white cells/ oil immersion field on urethral smear microscopy
3. At least 10 white cells/hpf on first morning urine sample/ positive leucocyte esterase spot test
So, you need to tell me whether you have such discharge.
If you have undergone the tests mentioned in 2 and 3, you need to send me reports or you can do the tests now and send me the report.
This is considering your pain in penile shaft, h/o recurrent genital infection and particularly past h/o NGU.

Now, considering the itch, I would say there seems to be a concurrent candida infection. I need to know whether you have any rash, ulcer or white dots in the skin fold or glans of penis. Candida infection might have also spread inside and if left untreated it can cause UTI. KOH mount of urethral smear would help in diagnosis.
So, you should immediately consult a venereal disease specialist. Now, more importantly, you have recurrent genital infection. Therefore, the following should be important-
1. Avoiding multiple sexual partner
2. Use condoms during intercourse
3. Maintain good local hygiene
4. You need to visit the nearest VCTC center or STI clinic also for HIV testing
5. You should also have the following blood tests done-
Complete blood count, urea, creatinine, electrolytes, HbA1c

You may need to take tab Fluconazole 150mg single dose after consulting your venereal disease specialist. If Urethritis is diagnosed, adequate treatment with antibiotic should be done for complete cure.

If you find this answer helpful, please rate it with thanks.
Regards,
Dr. Kaushik Sarkar

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Rahul Tawde (2 hours later)
thank u sir..as u mention i have no discharge like that.i went to clinic they told me stop urine for 4 hours so i stop and went and from tip of my penis smear was taken and little urine in bottle.my penis use to itch so from tip of my penis little tissue my taken by scrubbing they tested result came it was ngu and fungul infection.they gave medicine and cream .i took all in time went again tested same as before.the result came negative.my red rashes white spot on penis dscharge was gone but pain and little itch was alwas there.they said to rest drink plenty of water and no sex and masturbation.but problem same.i went 3rd time same test as before and result too.they said u r free std its nothing all clear ..rest for 1 month still pain itch we will refer to neurologist.i have checked for my blood test after 3 month as they said and hiv and syphilips both negative.and as u say reports they keep all rports in computers for reference they dont give..they say everything which disease wat is it everything .and if i have anyproblems i go there they look past reports saved in computer and do furthur treatment..so wat is it..its already 4 months ..i m tensed and paniced .help me plz.
doctor
Answered by Dr. Rahul Tawde (9 hours later)
Brief Answer:
Evaluation by Urologist and Cystoscopy may be needed.

Detailed Answer:
Hi, thanks for providing the detailed history.
As you have told, you were diagnosed with NGU and fungal genital infection. You complied to the treatment offered. Most of the symptoms were gone except for itching and pain in urethra.
Now, they have decided to send you to a neurologist.
My understanding is, as reports of blood and urine don't show anything suggestive after treatment, but there are some symptoms present, clinical evaluation by a urosurgeon is needed. You may need Ultrasound scan of the lower abdomen and if necessary CT scan of KUB region. This will help to find out any stone or any other pathology in the kidney, ureter, prostate and urinary bladder region. Alongwith them direct visualization of the urethra and urinary bladder are also needed to rule out ant pathology and that can be done by cystoscopic visualization. If urogenital problems are ruled out completely, then only you need to visit some neurologist for evaluation of pain.
Therefore, you can consult your treating doctor regarding the above mentioned management plan now. You should also continue to follow the advices given-
1. Take plenty of oral fluid
2. Avoid masturbation and intercourse
3. Maintain good local hygiene
If you find this answer helpful, please close the thread and rate my answer.
Regards,
Dr. Kaushik Sarkar
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Rahul Tawde (1 hour later)
so in as your view it is not std.right??
its other like stone kidney problems like u mentioned above..so first urologist and after then neurologist..

thank u for your advice..
doctor
Answered by Dr. Rahul Tawde (11 hours later)
Brief Answer:
Evaluation by Urologist and then neurologist

Detailed Answer:
Hi, thanks for posting again.
I think I should explain to you in simpler terms again for better understanding.

As you have said, you had NGU and genital fungal infection. The former belongs to STD group. Then you were treated. The line of treatment was rational. You were cured of most of the symptoms and now you only have itching and pain. But, the tests which gave relevant results before are giving repeated negative result. So, this is never like, "it is not STD, it is kidney stone". Rather, this is a continuous process.

You may not have the urethra infection now. But, there may be some other pathology of the urogenital organ systems inside, which initially presented as one urethral infection.

May be there are calculi or any other pathology inside. So, we need to investigate and rule out all the possible diseases that can cause such symptoms. Once it is confirmed that there is no urogenital problem, we need to evaluate whether the cause of pain is simply neurological.

I hope now you can understand what I was trying to explain.
If you find this answer helpful, please close the thread and rate my answer.
Regards
Dr Kaushik Sarkar
Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
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Dr. Rahul Tawde

General & Family Physician

Practicing since :1980

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What causes itchy skin on tip of penis?

Brief Answer: Treatment for genital candidiasis Detailed Answer: Hi, thanks for posting the concern in the HCM. Firstly, we need to rule out urethritis. Urethritis can be diagnosed by presence of one or more of the following- 1. Mucopurulent or purulent urethral discharge 2. At least 5 white cells/ oil immersion field on urethral smear microscopy 3. At least 10 white cells/hpf on first morning urine sample/ positive leucocyte esterase spot test So, you need to tell me whether you have such discharge. If you have undergone the tests mentioned in 2 and 3, you need to send me reports or you can do the tests now and send me the report. This is considering your pain in penile shaft, h/o recurrent genital infection and particularly past h/o NGU. Now, considering the itch, I would say there seems to be a concurrent candida infection. I need to know whether you have any rash, ulcer or white dots in the skin fold or glans of penis. Candida infection might have also spread inside and if left untreated it can cause UTI. KOH mount of urethral smear would help in diagnosis. So, you should immediately consult a venereal disease specialist. Now, more importantly, you have recurrent genital infection. Therefore, the following should be important- 1. Avoiding multiple sexual partner 2. Use condoms during intercourse 3. Maintain good local hygiene 4. You need to visit the nearest VCTC center or STI clinic also for HIV testing 5. You should also have the following blood tests done- Complete blood count, urea, creatinine, electrolytes, HbA1c You may need to take tab Fluconazole 150mg single dose after consulting your venereal disease specialist. If Urethritis is diagnosed, adequate treatment with antibiotic should be done for complete cure. If you find this answer helpful, please rate it with thanks. Regards, Dr. Kaushik Sarkar