Red spots? Fleshy bumps? When to worry about spots on the penis

The news that men are extremely attached to their penises, literally and emotionally, will come as no surprise to either gender.

A man's sense of masculinity is often linked to his sexual organ. Unsightly blemishes down there - particularly those that are sexually transmitted - can not only be damaging to a guy's vanity but, for the unlucky few, their long-term health.

Lumps and bumps

The good news is the majority of lumps that appear on the penis are both normal and harmless.

"Men often worry about spots, pimples, rashes, lumps or bumps, but remember, spots and pimples can be a normal part of a person's anatomy," says Karin O'Sullivan, clinical lead at the sexual health charity fpa.

Among the most common are the wonderfully alliterative pearly penile papules, small flesh-coloured lumps that tend to circle the head of the penis in one or two rows - these are just a normal part of your penis and can't be caught or passed on.

Occasionally, similar-looking papules may have a belly button-like dimple in the top and be scattered across the penis - these are more likely to be molluscum contagiosum instead.

Most prevalent in young boys, these are caused by a relative of the wart virus and your body will get rid of them on its own. However, be sure to wash your hands after touching them as they could be passed on to other parts of the body or to other people.

Fordyce Spots are sebaceous glands - they make a thick moisturiser-like substance for the skin but without hairs coming out of them as on other parts of the body - and manifest as small yellowish or white spots on the head or shaft of the penis.

They may appear more alarming, but, again, fret not - up to 95% of adult men have them and they don't generally require any treatment.

A lymphocele - a hard lump that appears after sex or masturbating - can seem even more worrying, not least because it's usually self-inflicted.

No worries; this swelling caused by a temporary blockage of lymph channels that drain away clear lymph fluid (important in immunity) usually goes away in no time at all and won't cause any permanent problems.

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A spot of bother

Chlamydia, warts and gonorrhoea are the most common sexually transmitted infections (STIs) and, of these, genital warts are the most common in the UK. They look like small fleshy lumps, sometimes with a cauliflower-shaped surface, and appear on their own or in crops.

Genital warts usually disappear on their own in time but you can pass them on to others,via sexual contact so, guys, be responsible and use a condom to prevent transmission. They can also be treated with special creams or paints, or even 'burned' off with a laser/liquid nitrogen - nerve-wracking, sure, but relatively painless.

Long-term, doctors hope that the human papillomavirus (HPV) vaccination being given to girls will be extended to boys, which will not only reduce cervical cancer rates but also genital warts.

Sometimes a crop of painful blisters or red spots can appear on the penis or groin, which could be indicative of genital herpes. Be proactive and seek medical advice as early as you can - doctors will most likely prescribe tablets to reduce the length of the flare and advise about how to prevent passing the herpes simplex virus on.

Peyronie's disease describes a hard lump (called a plaque) that develops on one side of the penis shaft, causing it to bend when erect and interfering with penetration or achieving an erection.

Peyronie's can be caused by aggressive sex or masturbation and is often more difficult to treat - shockwave therapy or even an operation are two options.

"Guys often come to me with pearly penile papules, but more commonly I'm getting more and more young men coming to me with Peyronie's," says Dr Anand Patel, a specialist in sexual function. "This may be related to more aggressive sex and/or masturbating since pornography has been around."

What types of spots and pimples on the penis can be a sign of something more serious?

"Ulcers or lumps - other than pearly penile papules - that won't go away should be checked out," advises Patel. "A single painless ulcer, or chancre, can be the first presentation of early syphilis and will require antibiotics. If you've got a lump (usually on the head of the penis) that's not going away or is getting bigger, please do get it checked out, as penile cancer is an uncommon possibility."

If in doubt, get it checked out

So guys, if you are worried about spots or pimples on your penis, don't waste time worrying unnecessarily - make an appointment with a GP or sexual health clinic and put your mind at rest.

"People sometimes avoid getting checked because they're embarrassed, or just hope any problem will go away," says O'Sullivan. "But it's often easier to treat a problem if it's identified early, and if it's something more serious it means you can be referred urgently.

"And if it isn't anything to worry about, at least then you'll know for sure!"

Patel concurs: "If you've read this and you're still not clear, then please go and get checked out either at your GP or genitourinary medicine (GUM) clinic, where you'll see doctors and nurses who see this sort of problem many times a day!" he says.

"The earlier you see us, the sooner we can ease your concerns or get you some treatment."