Itching of the penis is observed with balanitis and balanoposthitis, scabies, dermatitis and other dermatological diseases. Sometimes provoked by physiological causes. It can be slight, moderate or strong, cover the head, base or the entire penis, spread to the groin, scrotum, and other areas of the skin. The cause of the pathology is established on the basis of the results of the survey and external examination, laboratory data. Itching is treated with antihistamines and corticosteroids. Etiopathogenetic treatment includes antimicrobial agents, insecticide treatment. Operations are rarely required.
Why does the penis itch
Physiological causes
The symptom develops for a short time due to certain external influences. Manifestations do not reach a degree that requires an appeal to a specialist, quickly disappear when the provoking factor is eliminated. Itching of the penis can be observed in the following situations:
- Non-observance of intimate hygiene. Infrequent hygiene procedures and irregular change of linen lead to the accumulation of dirt and skin irritation. Unpleasant sensations are especially disturbing after sexual intercourse, since seminal fluid remains on the penis.
- Irrational choice of underwear. Underwear made of synthetic fabrics or too tight underwear makes it difficult to transfer heat in the intimate area, causes discomfort and increased sweating, followed by itching and burning.
- mechanical impact. Sexual intercourse with insufficient lubrication from a partner can lead to poor gliding of the penis, excessive friction and skin irritation. Along with itching, rapidly disappearing local hyperemia is often observed.
- stressful situations. Psychogenic itching does not have an organic basis, it occurs with nervous tension and intense experiences, and is not accompanied by external changes.
Inflammatory processes
The most common cause of itching in the area of the penis are balanitis and balanoposthitis of various etiologies. Pathology is nonspecific or provoked by specific pathogens. May be seen with the following STIs:
- gonorrhea;
- trichomoniasis;
- mycoplasmosis;
- chlamydia.
In addition, fungi and viruses act as an infectious agent, sexually transmitted. Balanitis is manifested by itching, pain, swelling and redness of the head, the appearance of plaque, plaques and ulcerations, urinary disorders and erectile function. With balanoposthitis, edema and accumulation of secretions in the preputial sac are added to the listed symptoms. The clinical picture depends on the nature of the pathogen and the characteristics of the course of the process:
- catarrhal form. It is more often observed with nonspecific inflammation, occurs with STIs. The most favorable variant of the disease, accompanied by the most striking subjective manifestations. Patients complain of intense pain, excruciating itching, burning sensation during urination.
- Urogenital candidiasis. Patients are concerned about burning and itching in the head area. The coronal sulcus, the head and the inner layer of the foreskin are edematous, inflamed, hyperemic, covered with whitish films. Erosions are possible. Detachable whitish, with the smell of kefir. Urination is normal.
- Genital herpes. Clear blisters appear in the affected area. After a while, the rashes become cloudy, open up, and brownish crusts form in their place. Possible general hyperthermia, regional lymphadenitis, quite pronounced pain.
Along with infectious lesions, inflammation and itching of the head can be non-infectious in nature, develop with diabetes mellitus, urological diseases and some other pathologies. A special form is obliterating xerotic balanitis, which often occurs in the elderly. Itching is moderate. On the inner leaf and head, areas of atrophy, blisters and spots are formed, which subsequently transform into sclerotic plaques.
Itching of the penis
Dermatitis
Itching of the penis is accompanied by dermatitis of the corresponding localization:
- Atopic dermatitis. It often occurs in childhood, but can also manifest in old age. On the face, neck, in the folds of the skin, on the flexion surfaces of the joints and in the groin area, pale pink foci appear with increased dryness and coarsening of the skin, cracks, papules, and peeling. The penis is not a typical localization, but its involvement is possible. Pathology is often complicated by secondary infection with the formation of balanitis.
- Simple contact dermatitis. It develops with the direct action of irritating substances (cosmetics, powder residues on linen). Itching and pain are not intense. The skin is dry, sometimes cracked. It is possible to form bulls with their subsequent opening and erosion. With constant contact with the irritant and the occurrence of chronic dermatitis, the symptoms are smoothed out, itching is slight or absent.
- Allergic contact dermatitis. It is observed with an allergic reaction to washing powders, care products, synthetics, clothing dyes. In the acute form, the affected area has clear boundaries, corresponds to skin contact with the allergen. Against the background of severe itching, swelling and hyperemia, papules appear, which quickly turn into vesicles, open and heal with the formation of crusts. With chronization, changes propagate beyond the contact area. Due to constant itching, scratching appears.
- Orthogenic contact eczema. It is detected in men who abuse hygiene procedures and use irritating care products. Itching and discomfort in the projection of the penis are complemented by erythema, the formation of scabs. With prolonged exposure, lichenification and hyperkeratosis may develop.
Scabies
Typical localization of itching and rashes in scabies are the abdomen, anterointernal surfaces of the thighs, interdigital folds, lateral surfaces of the fingers. In men, the scrotum and penis may be involved in the pathological process. On examination, traces of scratching and scabies are found in the form of lines 5-7 mm long with a vesicle or papule in the ending area.
Other dermatological pathologies
With the listed diseases, damage to the skin of the penis is not a specific symptom, but one of the possible (and often not the most common) localizations:
- Psoriasis. A single focus in the penis area is extremely rare, changes in several zones are more common. On the skin of the penis, small psoriatic plaques and papules are detected, accompanied by mild itching. In the groin, axillary areas, and other places, bright red plaques are often determined.
- Lichen planus. Characterized by intense itching, possibly burning. Skin changes are small smooth purple bumps that often spread from the periphery to the center. The rash may also appear on the ankles and wrists. After resolution, areas of hyperpigmentation remain.
- Lichen scleroderma. A rare disease. Uncircumcised men of mature age are more often affected. The process, as a rule, involves the head, often with the transition to the foreskin. Flat white papules eventually transform into sclerotic and atrophic plaques. Itching, burning, difficulty urinating are noted. Bleeding is possible.
Urologist's consultation
Diagnostics
Patients with inflammatory diseases are examined by a urologist-andrologist. If signs of STIs and dermatological pathologies are detected, patients are referred to a dermatovenereologist. Determination of the nature of the disease is based on complaints, data from an objective examination and laboratory tests:
- Questioning, examination. As part of the conversation, the moment of the onset of the symptom, the presence of other manifestations, the dynamics of their development over time are clarified. In inflammation, the establishment of a causative factor plays a significant role. On examination, the doctor reveals edema, hyperemia, erosion, rashes and other changes, evaluates their localization and prevalence.
- Laboratory tests. Microscopic examination is performed to confirm inflammation. To clarify the nature of the pathogen, PCR is performed, sowing on nutrient media. If scabies is suspected, a scraping is examined. With dermatitis, a general blood test is prescribed to confirm eosinophilia, the concentration of immunoglobulins is determined, and allergy tests are performed.
If there are indications, consultations of doctors of various profiles are prescribed to establish provoking pathologies. Patients can be referred to an endocrinologist, internist, phthisiatrician, and other specialists.
Treatment
Treatment of diseases accompanied by itching of the penis is conservative in the vast majority of cases. Corticosteroids and antihistamines are used to relieve itching. The list of other therapeutic measures depends on the type of pathology:
- Balanitis and balanoposthitis. The patient is advised to strictly observe the rules of hygiene. Taking into account the nature of the pathogen, antibacterial, antifungal or antiviral agents of general and local action are prescribed. Apply irrigation with antiseptics.
- Dermatitis. With common processes, detoxification therapy is carried out. Hormonal ointments are applied locally, wet areas are treated with antiseptics, infusion of oak bark or chamomile. Pustules and vesicles are opened, the exposed surfaces are dried with aniline dyes. With severe itching, it is advised to take sedatives.
- Scabies. Treatment of the whole body with special emulsions, creams or sprays is shown in accordance with the established scheme. Then change the linen, after 2 days the course is repeated. After the treatment is completed, clothes and furniture are wiped with an antiseptic or irradiated with a UV lamp.
Surgical interventions are required for patients with complicated balanoposthitis. With cicatricial phimosis, circumcision is performed. In the presence of a predisposing factor in the form of a narrowing of the foreskin, preputioplasty may be recommended. With the development of precancerous and cancerous diseases, the volume of the operation is determined individually.