Updated 06 January 2016

Penis bumps

What are those bumps around my penis shaft? I’ve never had sex.

We all have embarrassing questions that we’re too afraid to ask. Have no fear. In this weekly series Dr Rakesh Newaj and Dr Elna McIntosh tackle penile bumps.

Fear not! Sometimes a bump is just a bump, particularly if you’re at low risk for sexually transmitted infections (STIs). Bumps on the lower part of your penis shaft or around the scrotum are likely sebaceous glands and the hair follicles they are associated with. Since these bumps are quite small and easy to overlook, it’s only natural to wonder if they have always been there once you happen to notice them. Bottom line: they are 100% normal and everyone has them.

Irritation or injury is another very common issue that can affect the skin around the penis. Most minor abrasions or skin inflammations will go away on their own or with the help of a lubricant such as Vaseline to help minimize the irritation.

Some men may also have small, benign (non-cancerous) growths around the head of the penis, called pearly penile papules. These are also perfectly normal and pose no problems for the men who have them. If you become sexually active (and even if you don’t), it’s a good idea to keep looking over “the equipment” to know what’s normal for you. That way, you’ll be more likely to notice any potential changes soon after they show up.

There are many other lumps and bumps that can be unsightly on such an important tool, leading to a lot of distress. This can lead to severe psychological issues, low confidence and “no power” when it needs to perform. Some of them are due to infections which are rarely sexually transmitted.

Folliculitis is a common eruption which results from the inflammation or infection of the superficial portion of the hair follicles. It can look like a small bump from which a hair may be seen to be coming out from the middle. It can be caused by bacteria, fungus or simply due to an irritation. It can be very painful and needs proper treatment.

Furunculosis is a “boil” in layman’s term. It is due to an infection of the deeper portion of the hair follicles of the penile shaft. It presents as a red, painful nodule that sometimes drains pus. If left untreated, this can heal on its own and reappear at other places. It is rarely ever sexually transmitted.

A median raphe cyst is quite commonly seen in men. This is a lump (rarely several cysts) which can occur at the base of the penis and is present at birth. Usually asymptomatic  and rarely inflamed due to friction, it can be left alone.

Prominent sebaceous glands are common, skin-coloured to yellow, grouped papules on the shaft. One can mistake them for small warts and seek help. However, this is just a common variation and must be left alone.

Pyogenic granulomas, epidermal cysts, millia, lichen nitidus and nodular scabies are other conditions that are not associated with sexual intercourse. These conditions need to be excluded or treated by the skin specialist.

Common signs and symptoms of STIs include pain, itching, sores, redness, smelly or unusual discharge, rash, lesions, painful urination, unusual bleeding, and, yes, bumps. If you have any of these, get checked out by a health care provider (HCP) as soon as possible.

After all, one in two people who are sexually active will get an STI by age 25. Do you know your status? If not, stop by the HCP for a HIV, chlamydia, syphilis and gonorrhoea screening. However, bear in mind that many of the bumps can be due to skin disease, unrelated to sexual intercourse. In brief, you do not need to suffer in silence pondering on what to tell your girlfriend. You can just ask you mother to take you to see a dermatologist and get checked out.

This and other embarrassing questions will be answered weekly by sexologist, Elna McIntosh and dermatologist, Dr Rakesh Newaj.

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