Various abnormalities can affect the skin of the penis. Some are bodywide skin disorders that affect the penis as well as other parts of the skin. Examples can include psoriasis, lichen planus, and seborrheic dermatitis. Some affect only the penis or affect the penis before they affect other areas.
Growths on the penis are sometimes caused by infections. One example is syphilis (see Syphilis), which may cause flat pink or gray growths (condylomata lata). Also, certain viral infections can cause one or more small, firm, raised skin growths (genital warts, or condylomata acuminata) or small, firm, dimpled growths (molluscum contagiosum). Scabies can cause small, itchy bumps.
Lichen planus can cause small flat or raised spots on the head or shaft of the penis. They often itch. Occasionally, painful sores develop on the penis and in the gums (called penogingival syndrome). Lichen planus usually resolves on its own. No treatment is required unless itching is bothersome. Corticosteroid creams can relieve itching.
Pearly penile papules:
Pearly penile papules are abnormal growths originating in the blood vessels of the penis. They appear as small, usually skin-colored growths shaped like domes or hairs on the shaft of the penis. They are harmless, normal, and common, occurring in as many as 10% of men. No treatment is required.
Balanitis xerotica obliterans:
Balanitis xerotica obliterans (also called lichen sclerosus et atrophicus) occurs when chronic inflammation causes the skin near the tip of the penis to harden and turn white. The opening of the urethra is often surrounded by this hard white tissue, which eventually blocks the flow of urine and semen. Antibacterial, corticosteroid, or anti-inflammatory creams may relieve the inflammation, but if the urethra must be reopened, it is done surgically.
Contact dermatitis is often caused by use of a latex condom in a man who is allergic to latex. Usually red, itchy spots appear. Sometimes the skin is broken or fluid leaks from around the spots. Affected men should instead use a synthetic non-latex condom. Natural condoms do not protect adequately against human immunodeficiency virus infection. If necessary, symptoms can be relieved by a corticosteroid cream, such as 1% hydrocortisone cream (available over-the-counter).
Last full review/revision June 2013 by Patrick J. Shenot, MD