Itchy Penis – What You Need To know

Written by Dr Chester Lan

Itchy Penis – Is it normal?

Itching on/around your genitals is something that most people would have experienced at least a few times in their lives. In Singapore’s hot and humid weather, it is not an uncommon symptom for us doctors to see. There are a variety of conditions that can result in your nether regions itching.

For the purposes of this article, we can identify a few distinct areas.

1. The pubic area (hair bearing area above the penis)
2. The shaft of the penis
3. Scrotum
4. Foreskin and glans penis (head of penis)
5. Itchy along the length of the urethra (pee-tube)

Common Causes of Itchy Penis

Itchy Penis Cause #1 – Fungal Infection

One of the more common conditions we see is a fungal infection. A fungal infection can affect areas 1,2,3 and 4. Fungal infections can occur on any part of the body, but the groin region is particularly susceptible to such infections as the area is covered most of the time, making the environment moist and warm. Fungal infections thrive in such conditions. This can usually be identified with a physical examination. Occasionally, the doctor may do a swab or skin scraping to aid the diagnosis. We can use topical and oral antifungals to treat such infections.

Itchy Penis Cause #2 – Balanitis

Another common condition we see is balanitis, an infection of the head of the penis. If the foreskin is affected as well, it is termed balanoposthitis. Such infections are less commonly seen in patients who are circumcised. In uncircumcised patients, the overlap of the foreskin and head of penis creates an environment where both fungal and bacterial infections can thrive. A history of diabetes is also a risk factor. We usually treat these with antifungals and antibiotics in the form of creams or oral medication. Hygiene advice to keep the area clean and dry is necessary to reduce the chance of recurrence. If the issue is recurrent, we may even recommend a circumcision.

Itchy Penis Cause #3 – Pubic lice

Another skin condition that can affect the pubic area (area 1) is pubic lice (crabs). Pubic lice are commonly seen in institutionalised people (old folks homes, incarceration), but they can also be seen in sexually active adults. The lice are spread through direct physical contact. We can usually see burrow marks and tracks on the skin in established cases of lice. We can use anti-parasitic medications to treat lice.

Itchy Penis Cause #4 – Folliculitis

Folliculitis is another skin condition that can affect the hair bearing areas. This is caused by inflammation and infection of the hair follicle. The spots may be itchy and painful at the same time. The appearance of it is usually pimple-like, sometimes with a pus filled center. We usually treat severe cases with antibiotics.

Cause #5 – Genital Warts

Warts and molluscum are two conditions that result in skin growths in the affected areas. Warts can even grow on the head of the penis itself. These two conditions are skin infections caused by human papillomavirus (HPV) and molluscum contagiosum virus (MCV) respectively. They can be asymptomatic, but they can occasionally be mildly itchy as well. The best way to treat them is with destruction of the infected skin, either with lasering, burning or freezing them off. There are some topical medications that can be used as well. Speak to your doctor on the best form as every doctor practises differently and there may be other considerations before choosing the most appropriate method to treat these conditions.

Cause #6 – Genital Herpes Simplex (HSV)

Genital Herpes Simplex (HSV) is another condition that can cause pain and itching during an outbreak. This is usually considered a sexually transmitted infection. An outbreak of HSV usually starts off with a fluid-filled blister that breaks and crusts up eventually. Unfortunately, this is a condition that cannot be cured. But if you do have an outbreak, it can be easily managed with antiviral medications.

Other Potential Causes

Other skin conditions such as psoriasis, eczema and lichen planus can also affect the pubic region, shaft and scrotum. These are diagnosed based on physical examination and can be treated with topical medications.

Cancer

A condition that can be potentially serious is Extramammary Paget’s disease. This is an uncommon cancer (intraepithelial adenocarcinoma) usually of the anogenital or axillary skin. Extramammary Paget disease is classified into primary and secondary disease where Primary extramammary Paget disease of skin is of cutaneous origin and Secondary extramammary Paget disease of skin is associated with a primary adenocarcinoma elsewhere in the body. This rash may be mildly itchy. It may appear to look like eczema. If an eczematous rash does not respond to treatment, this more serious condition is suspected.

When Is A Test Needed?

Some patients may also report itching along the shaft of the penis, and may be associated with urinary symptoms such as pain on passing urine, urinary frequency and urgency. Some patients may also report penile discharge. In such cases, a seuxally transmitted disease such as chlamydia or gonorrhea will be suspected. A urine test will usually be done and the patient treated with antibiotics.

Better Safe

While scratching may provide temporary relief, it is important to see a doctor to get the correct diagnosis and treatment. Scratching the affected area can worsen the condition and introduce another bacterial infection.

For more questions, please email them at hello@dtapclinic.com.sg to make an appointment today or visit them at www.dtapclinic.com.

Also See: Circumcision Singapore