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What Causes White Discoloration On The Head Of The Penis?

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Posted on Fri, 14 Oct 2016
Question: The head of my penis has a white discoloration. Dermatologist said it was vitiligo. But itching, burning continued. Urologist said it was scarring from fungal infection(s). Thought maybe it was from rough masturbation and would heal but my GP said no. Shaft seems red and will not heal. Recently have noticed after I shower white areas will crack or peel exposing red skin. Quickly thereafter, thin white tissue covers it over again. Is this normal? Is this a sign of healing? Need to get a more normal color.
doctor
Answered by Dr. Dr. Rahul Kumar (58 minutes later)
Brief Answer:
Not vitiligo

Detailed Answer:
Hello
Thanks for the query.
It doesn't appear to be vitiligo your description is not suggestive of that.
Can you please upload a photograph of the involved area.
This will help me in giving a closer diagnosis and better way of management.
Waiting for your response.
Thank you
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Dr. Rahul Kumar (3 hours later)
At work now, will send photos by tomorrow.

Thank you for your response.

Hope these photos help. I think you can see the cracking and peeling skin.
doctor
Answered by Dr. Dr. Rahul Kumar (25 hours later)
Brief Answer:
Lichen sclerosus

Detailed Answer:
Hello
Thanks for the photographs.
It is looking like lichen sclerosus.
It ia an autoimmune disorder.
There is a possibility of associated fungal infection.
I treat such cases with a mild steroid cream like fluticasone to be applied in night and an antifungal cream like clotrimazole to be applied in morning.
Once the lesions heal you can stop clotrimazole and continue with fluticasone for another month.
Hope this helps you.
Let me know if you have any other doubts.
Thank you.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Dr. Rahul Kumar (54 minutes later)
Do I need to go get a prescription from my doctor? Already using nystatin anti-fungal cream. Is there a definitive test because according to the website it occurs almost exclusively in uncircumcised men - I was circumcised as a baby. Will my skin return to a more natural color?
doctor
Answered by Dr. Dr. Rahul Kumar (15 hours later)
Brief Answer:
nystatin in night and cortisone in morning

Detailed Answer:
Hello
Thanks for the follow up.
Continue with nystatin in night and you can use cortisone cream in morning.
It is available over the counter.
Lichen sclerosus can happen even in non circumcised individuals.
Definitive test is biopsy in which a small bit of your penis mucosa would be cut and sent for histopathological confirmation.
Go ahead with the treatment, you will get relief.
Let me know if you have any other doubts.
Thank you.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Dr. Rahul Kumar (27 hours later)
Is it typical for LS to crack and peel and have thin white tissue recover it? Will these treatments allow the white discoloration to heal? Why would urologist not recognize it and call it scarring from fungal infections? Don't know if you could tell but shaft of penis is also red. Is that also part of LS?
doctor
Answered by Dr. Dr. Rahul Kumar (28 hours later)
Brief Answer:
Its not fungal

Detailed Answer:
Hello
Redness of glans severe itch and white discoloration is typical of lichen sclerosus.
In fungal infection there won't be white discoloration.
In vitiligo there wont be itch and scaling.
Hope you understood.
White discoloration can also be reduced but ot will take time.
Go ahead with treatment and let me know the results.
Let me know if you have any other doubts.
Thank you.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Dr. Rahul Kumar (1 hour later)
Thank you again for your patience. I don't think the urologist is saying it's fungal but rather scarring from fungal infections. Is this not possible? Also, just below the head of the penis where it is red, feels very rough. It also seems wet and itchy after urinating. I will continue with the nystatin and cortisone cream. My GP wants to wait on the biopsy. We will discuss it at my next appointment in Dec. Is it okay to wait that long?

Thank you, will keep you up to date.
doctor
Answered by Dr. Dr. Rahul Kumar (20 hours later)
Brief Answer:
Start with medication

Detailed Answer:
Hello
Yes there is a possibility of super added fungal infection.
That's why I asked you to continue with nystatin.
Biopsy can be delayed as lichen sclerosus is not a dangerous condition.
Use the medicines and let me know about the improvement.
Feel free to ask any other doubts.
Thank you.

Brief Answer:
Welcome

Detailed Answer:
You are most welcome.
Above answer was peer-reviewed by : Dr. Raju A.T
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Dr. Dr. Rahul Kumar

Dermatologist

Practicing since :2010

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What Causes White Discoloration On The Head Of The Penis?

Brief Answer: Not vitiligo Detailed Answer: Hello Thanks for the query. It doesn't appear to be vitiligo your description is not suggestive of that. Can you please upload a photograph of the involved area. This will help me in giving a closer diagnosis and better way of management. Waiting for your response. Thank you