When the Cream is not enough !

[eddy5]

I am a 29 year old male who suffers from chronic Balanitis.  My story goes as follows, 3 years ago, after receiving oral sex I developed a mid redness on the tip of my penis.  I visited my doctor who tested me for the majority of STD

[eddy5]

Dr Rockoff,

Thank you for the further comments.

It appears that my redness & discomfort is the disease that has no name.  Therefore like all newly found comets, I would like to name this condition the "Eddy5's disease", and hope I am the only one afflicted with it.   ;)

However in more seriousness, I fully accept the fact that worry increases the discomfort of any condition.  Although in my case, I only wish that I could heal the redness / inflammation, so that there is no visual stimulus to worry me.  I hate these Catch 22's.

Thanks again, and looking forward to hearing on scientific developments for the cure to Eddy5's disease.

[eddy5]

Dr Rockoff,

Thank you (I think) for your comments

Further to your response I would like to make a couple of comments.  I agree that I probably exacerbate my discomfort with the constant worry that I am going through.  It is extremely difficult ignore a problem when you are constantly reminded by an uncomfortable move or twitch, and therefore I would suspect that if you were put in my situation and your mind would be working overtime aswell.

However, the bottom line is I have an inflammation on the tip of my penis which won't go away, and it is uncomfortable.  Therefore, I find it incredulous that you state "no physical disease which explains your symptoms", as the conditions & symptoms appear to be crystal clear.  What is not clear is the cure, which I was hoping for your help?  It is very easy to state "if the cause for your pain can't be found, it must be in your head", however I believe this to be misguided and outdated.

Best.

[Alan Rockoff, MD]

As you wish.

There are a number of diseases which affect the penis: eczema, psoriasis, yeast infection, and so forth.  None of these produces the sypmtoms you describe, or fails to respond to the treatments you have, at least temporarily.  I did not say you don't have redness, only that no disease I know of explains it.

In my experience, worry about redness or other symptoms can cause discomfort.  Many patients are reluctant to accept this.  I understand their reluctance, but I cannot counter it.  Of course physical disease must be ruled out before one entertains psychological explanations.  But you have, it seems, ruled out physical disease many times over.  To suggest that you move on to other approaches does not seem, at least to me, to be either misguided or outdated.

Good luck and take care.

Dr. Rockoff

[Alan Rockoff, MD]

It's really hard to answer your question.

One things seems clear: there is nothing "Draconian" you should consider.  You don't get rid of inflammation with a knife.  (Yes, circumcision can help in some respects, but you already did that.)

I find it hard to believe that the redness around your penile opening is now a yeast infection, even if it once was--the cream would have taken care of yeast, long since.

Moreover, no matter how much what you perceive as swelling "continues to push my darkened lips together," it cannot be actually blocking the opening, since you obviously can urinate, or you wouldn't be around to write me your question.

It must therefore be that your skin looks inflamed only.  In that case, I don't know what, or where, your "continuous discomfort" is.  In the penis?  In the groin?

In short, I know of no physical disease which explains your symptoms.  I know you see redness, but redness does not cause the symptoms you have.

If you can't ignore the problem, you need help to do so.

I therefore advise you to see your dermatologist one more time.  Ask for an evaluation and the consideration of a sigle oral dose of Diflucan (fluconazole) to put paid once and for all to the theoretical existence of yeast.  If the dermatologist cannot think of any other somatic possibility, please do yourself a favor and seek out the psychological help you seem so clearly (to me) to need.

Good luck.

Dr. Rockoff