Written by Yeva Margaryan, MD | Published on March 26, 2024

Reviewed by Slava Fuzayloff

Scabies

Scabies is an infection caused by the mite Sarcoptesscabiei var hominis. These mites burrow tunnels into the skin, forming linear or wavy lines about 4–6mm long. As the body reacts to the infestation, patients develop red papules and nodules, often accompanied by local redness and swelling. These burrows and lesions are commonly found on the glans penis, scrotum, and shaft. Itching, notably exacerbated at night or after hot baths, is the primary symptom. 1 Common skin disorders of the penis. BMJ International. https://sci-hub.se/10.1046/j.1464-410x.2002.02962.x

The infection is spread through skin-to-skin contact and rarely through sharing bedding or underwear. 1 Common skin disorders of the penis. BMJ International. https://sci-hub.se/10.1046/j.1464-410x.2002.02962.x

Syphilis is an STI caused by the bacteria Treponema pallidum. It isprimarilytransmitted through direct (usually sexual) contact with syphilitic sore(s). 2 Syphilis. The British medical journal (BMJ). https://www.bmj.com/content/365/bmj.l4159

In primary syphilis infection, a distinctive rash known as a chancre appears. This rash is a localized, painless skin lesion that develops at the site of infection. The chancre typically presents as a 1-2 centimeters (0.4-0.8 inches) ulcer with raised, indurated margins and a clean base. The swelling of nearby lymph nodes often accompanies these lesions. 2, 3 Syphilis. The British medical journal (BMJ).https://www.bmj.com/content/365/bmj.l4159 Chancre of Primary Syphilis. Journal of Education and Teaching in Emergency Medicine (JETem)https://jetem.org/syphillis_chancre/#:~:text=Primary%20syphilis%20infection%20manifests%20as,with%20associated%20moderate%20regional%20lymphadenopathy.

Syphilis rash on the penis

Penile herpes infection is caused by the Herpes simplex virus (predominantly HSV type 2)and is transmitted through sexual contact, even when visible sores are absent. The herpes-associated rash manifests as clusters of shallow, small, and painful fluid-filled blisters on a red base (the redness is less pronounced on brown or black skin). These blisters rupture, leading to the formation of sores and ulcers that typically heal on their own. People may also experience fever, muscle pain, fatigue, and tender enlarged lymph nodes. Recurrent male genital infections may present as 3-5 blisters on the penile shaft. 1 Common skin disorders of the penis. BMJ International. https://sci-hub.se/10.1046/j.1464-410x.2002.02962.x

Patients may experience local pain, tingling, itching, or burning at the exposure site several hours or days before the blisters appear. 4 Genital Herpes: A Review. American Family Physician (AFP) Journal. https://www.aafp.org/pubs/afp/issues/2016/0601/p928.html

Herpes rash on the penis

Genital warts caused by the human papillomavirus (HPV), typically stem from types 6 and 11. The virus spreads through skin-to-skin contact, including during protected sex, though condom users might still develop warts in the lower abdomen and groin area. In others, warts commonly appear in the subpreputial region, on the penis head, shaft, and scrotum. 1 Common skin disorders of the penis. BMJ International. https://sci-hub.se/10.1046/j.1464-410x.2002.02962.x

Penile warts can present as:

• Bumpy, cauliflower-like, flesh-colored to reddish warts that are most commonly found in areas with increased friction

• Dome-shaped, as a rule, flesh-colored papules (small, well-defined bumps)

• Flat papules that are pink-red to reddish-brown

Penile warts photo

Molluscum contagiosum is a viral disease that causes flesh-colored, dome-shaped bumps with a central indentation, typically 2-5 mm (about 0.08-0.2 inches) in diameter (occasionally up to 1.5cm (about 0.6 inches)). Immunocompetent adults usually have fewer than 20 lesions, often appearing in clusters or widely scattered. 5 Molluscum Contagiosum Clinical Presentation. Medspace. https://emedicine.medscape.com/article/910570-clinical?form=fpf

The infection spreads through direct skin-to-skin contact or contaminated objects like towels, clothing, or sex toys. 5 Molluscum Contagiosum Clinical Presentation. Medspace. https://emedicine.medscape.com/article/910570-clinical?form=fpf

Molluscum contagiosum rash on the penis

Balanitis, or inflammation of the glans penis, is a common condition in uncircumcised men, people with diabetes or HIV, and those with poor hygiene.It can result from various fungal or bacterial infections. Symptoms include itching, burning sensation, redness, and occasionally curd-like accumulations.

The balanitis-associated rash can appear as: 6 Penile Inflammatory Skin Disorders and the Preventive Role of Circumcision. PubMed Central. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5439293/

• Reddish or white patches, plaques, and/or bullae (large, fluid-filled blister)

• Pustules (small, raised lesion that contains pus)

• Ulcers (in severe cases)

Balanitis rash

3: Yeast infection

A penile yeast infection (candidal balanitis) is mostly caused by an overgrowth of the fungus Candida albicans. The penile rash usually appears as red spots on the head of the penis. Other symptoms include itching, pain, swelling, and irritation of the head of the penis and under the foreskin. As the infection progresses, white patches may appear and merge into a flat white coating (thrush). 7 Candida Balanitis. Altmeyers encyclopedia. https://www.altmeyers.org/en/dermatology/candida-balanitis-118722

Penile yeast infection photo

4: Allergic reaction

Allergic contact dermatitis typically presents with redness and swelling, which can progress to blistering over time. It’s often triggered by various substances like medicated creams, hygiene products, contraceptives, lubricants, feminine hygienedeodorant sprays, local anesthetics like benzocaine, and spermicides or other agents that come into contact with the skin, including those transferred by hand.People with latex allergycan experiencehives or even life-threatening allergic reactions shortly after using a condom. 1 Common skin disorders of the penis. BMJ International. https://sci-hub.se/10.1046/j.1464-410x.2002.02962.x

Contact dermatitis rash photo

5: Friction burn

A friction burn on the penis typically appears as redness and irritation, resembling a heat burn. In more severe cases, it may develop into blistering and peeling. The affected area often feels sore, swollen, and tender to the touch. Friction burns occur when the skin is rubbed vigorously against a surface, such as during aggressive or prolonged masturbation, sexual activity, or due to friction from tight clothing. 8 How to Treat a Friction Burn on a Penis. Manual. https://www.manual.co/health-centre/penis-health/how-to-treat-a-friction-burn-on-a-penis#:~:text=Penis%20friction%20burn%20is%20a,fragrance%2Dfree%20moisturiser%20or%20gel

Friction burn photo

6: Genital psoriasis

Psoriasis is the most common autoimmune disease affecting the male genital organs. It appears as red plaques in the groin and buttocks area. Sometimes the entire scrotum and penis may be affected, although it may only occur on the penis. In circumcised males, red scaly patches are often found on the penile head and corona. For others, non-scaling plaques are common under the foreskin and on the nearby area of the head of the penis. Often, this rash is present on the elbows, knees and scalp. 1 Common skin disorders of the penis. BMJ International. https://sci-hub.se/10.1046/j.1464-410x.2002.02962.x

Psoriasis rash on the penis

7: Penile eczema

Eczema can affect various parts of the skin, including the penis. Symptoms of penile eczema often include red, inflamed, scaly patches, bumps, thickened, dry, and itchy skin. In severe cases, the skin may crack or leak a thick, yellow, or white fluid, indicating a potential infection. 9 Eczema on Penis. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/24314-eczema-on-penis

Penile eczema results from a combination of factors, including immune system activation, genetic predisposition, and environmental triggers such as stress, certain soaps, skin care products, and desensitizing gels or lubricants that delay orgasm. 9 Eczema on Penis. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/24314-eczema-on-penis

Eczema on penis

8: Lichen sclerosus

Lichen sclerosus is a chronic progressive anogenital skin disease. It typically affects the glans, penis, and foreskin and appears as reddish bumps or plaques that develop into atrophic, whitish, flat-topped lesions. This condition is very characterized by a sclerotic white ring at the tip of the foreskin. 1 Common skin disorders of the penis. BMJ International. https://sci-hub.se/10.1046/j.1464-410x.2002.02962.x

Some individuals may experience localized itching, burning sensations, bleeding, scratching, tearing of the foreskin, and discomfort during intercourse and urination. 10 Penile Lichen Sclerosis: A Surgical Perspective of its Aetiology and Treatment. PubMed Central. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9509524/

Lichtensclerosus photo

9: Ingrown hair

Ingrown hair rashes are red, bumpy, painful lesions resembling pimples. They may also contain clear or yellowish pus. They usually occur in shaved or waxed areas when growing hair curls and grow back into the skin, causing local inflammation, but can appear anywhere hair grows. 11 How to Tell If You Have an Ingrown Hair on Your Penis — and What to Do About It. Healthline. https://www.healthline.com/health/mens-health/ingrown-hair-on-penile-shaft#_noHeaderPrefixedContent

Ingrown hair rash

10: Fixed drug eruption

Fixed drug eruption is an adverse reaction to a drug characterized by the appearance of a single or multiple red patch reoccurring on that exact site of the body when exposed to that drug. This disease can affect any part of the body, but it often appears on the hands, lips, and genital area. 12 A case of fixed drug eruption caused by loxoprofen sodium hydrate. Allergology International. https://sci-hub.se/10.1016/j.alit.2015.04.007

Fixed drug eruption rash on the penis

Treatment for genital rash depends on the condition. The rash caused by STDs should be treated with special medications, while allergies can be avoided by changing your diet or avoiding allergens.

STDs can be prevented by practicing safe sex or abstaining from it. Allergic reactions, psoriasis, and eczema can be controlled by avoiding triggers. Additionally, maintaining good hygiene (keeping the genital area clean and dry) will help prevent penile irritation.

It is recommended to seek medical care in case of a severe rash on the genitals that does not go away and interferes with your everyday lifestyle.

A rash on the penis can be the result of various infectious and non-infectious diseases. Timely diagnosis of these conditions can help in their early resolution and prevent further outbreaks.

82. Common skin disorders of the penis. BMJ International.https://sci-hub.se/10.1046/j.1464-410x.2002.02962.x
83. Syphilis. The British medical journal (BMJ).https://www.bmj.com/content/365/bmj.l4159
84. Chancre of Primary Syphilis. Journal of Education and Teaching in Emergency Medicine (JETem)https://jetem.org/syphillis_chancre/#:~:text=Primary%20syphilis%20infection%20manifests%20as,with%20associated%20moderate%20regional%20lymphadenopathy.
85. Genital Herpes: A Review. American Family Physician (AFP) Journal.https://www.aafp.org/pubs/afp/issues/2016/0601/p928.html
86. Molluscum Contagiosum Clinical Presentation. Medspace.https://emedicine.medscape.com/article/910570-clinical?form=fpf
87. Penile Inflammatory Skin Disorders and the Preventive Role of Circumcision. PubMed Central.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5439293/
88. Candida Balanitis. Altmeyers encyclopedia.https://www.altmeyers.org/en/dermatology/candida-balanitis-118722
89. How to Treat a Friction Burn on a Penis. Manual.https://www.manual.co/health-centre/penis-health/how-to-treat-a-friction-burn-on-a-penis#:~:text=Penis%20friction%20burn%20is%20a,fragrance%2Dfree%20moisturiser%20or%20gel
90. Eczema on Penis. Cleveland Clinic.https://my.clevelandclinic.org/health/diseases/24314-eczema-on-penis
91. Penile Lichen Sclerosis: A Surgical Perspective of its Aetiology and Treatment. PubMed Central.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9509524/
92. How to Tell If You Have an Ingrown Hair on Your Penis — and What to Do About It. Healthline.https://www.healthline.com/health/mens-health/ingrown-hair-on-penile-shaft#_noHeaderPrefixedContent
93. A case of fixed drug eruption caused by loxoprofen sodium hydrate. Allergology International.https://sci-hub.se/10.1016/j.alit.2015.04.007 Dr. Yeva Margaryan is a public health specialist specialized in population health promotion and research.

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