What causes white spots on the foreskin?

Small white spots on the foreskin may be caused by physiological phenomena and pathological factors, including pearl rash, ectopic sebaceous glands, fungal infection, sebaceous gland blockage, foreskinitis, etc. It is recommended to keep the area clean and dry, and seek medical attention promptly if accompanied by redness, swelling and pain.

1. Pearl rash

Pearly rash is a benign physiological variation, manifesting as small white papules arranged neatly in the coronary sulcus of the foreskin, about 1-3 mm in diameter, without pain or itching. It may be related to local health conditions or physiological development. Most do not require special treatment, just wash the external genitalia with warm water every day. The phenomenon is not contagious and usually does not affect normal function.

2. Ectopia of sebaceous glands

Ectopia sebaceum is a manifestation of abnormal distribution of sebaceous glands on the mucosal surface. It is common in the inner plate of the foreskin and appears as light yellow or milky white granular protrusions. It may be triggered by excessive cleaning or hormonal changes, but generally no treatment is required. If it affects the appearance, laser removal can be considered, but it must be performed after evaluation by a professional doctor in a regular medical institution.

3. Fungal infection

Candida albicans infection can cause white patches on the foreskin with itching and scaling, and is more likely to occur in people with diabetes or low immunity. The diagnosis needs to be confirmed by fungal microscopy, and you can use miconazole nitrate cream or clotrimazole vaginal tablets for external application as directed by your doctor. During the treatment period, sexual intercourse should be avoided, the affected area should be kept ventilated, and the spouse should be checked simultaneously.

4. Blockage of sebaceous glands

Blockage of the sebaceous gland ducts will form miliary-like white spots that feel hard to the touch. It is common in those with strong sebum secretion in adolescence, which may be caused by insufficient local cleaning. When cleaning every day, you can gently massage the foreskin folds and avoid squeezing with your hands. If redness and swelling occur due to secondary infection, antibiotic ointments such as mupirocin ointment need to be used together.

5. Posthitis

In the early stage of bacterial foreshitis, scattered white pus spots may appear, accompanied by redness, swelling and burning pain. Secretion culture needs to be performed to identify the pathogen, and erythromycin ointment or fusidic acid cream can be applied topically. The author recommends circumcision in case of recurrent disease, and post-operative sitz bath diluted with potassium permanganate solution to promote healing.

You should choose cotton breathable underwear every day and avoid using alkaline lotions to clean the perineum. Uncircumcised people need to turn up their foreskin to drain residual urine after each urination. The diet should be light and reduce the intake of spicy and irritating foods. If the white spots continue to enlarge, rupture, or are accompanied by a peculiar smell, you should promptly seek treatment at a dermatology or urology department. If necessary, perform a pathological biopsy to rule out malignant lesions.