I'm an uncircumsized, sexually active male, 40 years old. About 18 months ago, I developed what seemed like a run-of-mill fungal infection (redness, itchiness, some swelling) on my foreskin. After treating it with some over-the-counter fungal cream, the flare-up died down, but the foreskin area remained red and oversensitive. The crown of the penis head remained a bit purplish and more swollen than normal. I saw a urologist, but he didn't see anything serious. I stopped using the cream, and the flare-up - itchiness, swelling - returned. I went back to my uro who said it looked like a candida infection. He prescribed topical Nizoral.
I applied Nizoral for a month, twice a day, along with taking other precautions - washing the area without soap, drying it throughly after each shower, refraining from sexual activity except for 'gentle' masturbation. But again, while the itchiness, the swelling & worst of the inflammation went away within 3-4 days of application, the red, rash-like conditions remained. When I stopped using the cream, the flare-up sysmptoms consistent with a fungal infection came back within 2-3 weeks.
This has now become a cycle. I would use Nizoral for weeks or even months at a time, the rendness & rash-like condition remains, but no flare-ups. I'd stop using the cream, and at first it appears that the area is healing itself, but the flare-ups return within 2-3 weeks, sometimes a month. Inevitably I'd have to return to Nizoral, and inevitably get frustrated that the chronic rash remains.
During the past year I saw a dermatologist (at least 8-10 visits), who prescribed Elidel and 2 other creams. These only increased the redness & oversensitivity of the area. Canesten is less helpful than Nizoral, I found. I've tried refraining from sexual activity, but it doesn't appear to make any difference (I practice safe sex anyway). I'm not sure if dietary changes are needed - I've asked both the uro & the dermatologist I saw about this, but they have nothing to offer in this regard.
Is this a fungal infection that's partially resistant to anti-fungals? Which is why Nizoral can suppress the worst of the infection but not eradicate it? Neither the uro nor dermatologist appear to know - and neither one thinks I have a serious problem. But it's been a year and a half & I've forgotten what my foreskin used to look like when it was healthy. Honestly, I'm fairly depressed about it. What do I have? And what are potential next steps in treatment here? What haven't I tried?
All & any help are much, much appreciated. Thank you for your time.