I am in Japan for 2 more weeks and I would really like to understand what I have, because here speaking in English with Japanese people is impo
24 -year-old man
My penis has had a rash for about a month. I was in Indonesia with my girlfriend when my symptoms started. At the beginning, I had micro tears on my foreskin (I thought it was due to the humidity, the sea). Then I started to have a strange sensation, as if a drop was running all the time, and therefore the sensation of always going to the toilet. I never felt any burning when I urinated. A pharmacist prescribed me an antifungal, but it didn't really work. I started to get red spots on my glans and my foreskin seems to be all irritated (but it doesn't hurt). Two weeks ago I arrived in Japan and bought a balanitis cream. Not too much result and I'm starting to be afraid that my foreskin will "tighten" again, because the skin is dry. Also noted that I went to do a urine test and that I had no STI.
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David Maurier · a year ago
Hello!
I would like to know more about the treatments you tried. Could you tell me the name of the 2 creams used, and what dosage was followed?
If you have access to other medications at this time, could you please tell me what they are?
I would also like to ask you some additional questions:
- Do you have any lesions elsewhere on your body?
- Are you using any new body products (soap, shower gel, etc.)?
- Do you remember using condoms recently (some people are allergic to the latex in them)?
- Do you use any new products during sex, such as gels or lubricants?
- Do you have any other known health problems?
- Did you notice a slight improvement after the 2 treatments you tried, or not at all?
Thanks in advance for the clarification!
24 -year-old man · a year ago
Hello !
So the first cream I tried was Nizoral ketoconazole 20mg/g. I had to use it for 6 days, once a day. At that time it was small cracks that heated up when I put soap or even water on them like a cut on a finger for example.
Afterwards I really felt that the treatment had worked because everything returned to normal for 2-3 days and I stopped using the cream.
Then it started to be really uncomfortable as if I always had a drop on the end. I also felt like going to the bathroom a lot. So I went to the pharmacy and tried to explain my problem (just an exercise here in Japan) and finally I was advised to buy a betamethasone 1.2mg/g cream, which I applied for 12 days once a day.
Now I don't have the feeling of having this drop or the urge to urinate but I have like patches and red spots on the foreskin and the glans. It's not really painful though.
As for your questions, I've used a lot of different soaps in the last few weeks (in hotels), I don't have any lesions on my body and I haven't used condoms or lubricants.
Thank you very much for following up!
David Maurier · a year ago
Thanks for the clarification!
The symptoms you describe really remind me of balanitis (fungal infection). To treat it, you usually have to use antifungals like the ketoconazole you tried. It is therefore normal that you noticed an improvement in the lesions after using it! However, the recommended treatment time is usually 2-4 weeks, not just 6 days. The problem with this type of infection is that even if the lesions are no longer visible on the skin, there may still be lesions under the skin that cannot be seen. If the treatment is stopped too soon, then these invisible lesions can start to reoccur, probably what you experienced.
The problem with betamethasone (or any other corticosteroid cream) is that it decreases the effectiveness of the immune system where it is applied. The body is therefore less able to protect itself from infections, including fungal infections. Applying betamethasone to an infection that was probably not fully healed most likely contributed to the reappearance of the plaques.
So, here's my advice to you:
- Continue to maintain proper hygiene, preferably using a mild, fragrance-free soap and dry the area well after showering or bathing
- Stop using betamethasone
- Repeat the application of ketoconazole twice a day for a minimum of 2 weeks, and up to 4 weeks if you have enough. I would also recommend applying it to the healthy skin around the visible lesions, as there may be infection under the skin beyond the plaques.
Your betamethasone can still be useful if you want to keep it! You can use it if you have irritation or inflammation (e.g. reaction on the skin after touching a plant, eczema, itching etc.)
24 -year-old man · a year ago
Thank you so much for the advice I really appreciate it. I will start the ketoconazole application again.
Have a nice day!
David Maurier · a year ago
Have a great day and a great rest of your trip!
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