Pulled back — living with a bare head

Hi Mellon,  you ask us to ignore the white patches at the tip of your penis, visible in the first photograph, dismissing it as dried up urine.  I do not understand why any urine drips were not shaken or wiped off , given that you are retracting your foreskin.  However, if you are correct in attributing the patch to dried urine I strongly suggest testing for diabetes.  Men with untreated diabetes may often notice that inadvertent splashes around the toilet dry white due to the high sugar content in their urine. 

It's interesting you mentioned jock itch! How long have you had it, what have you used to treat it, and is it responding to treatment?

Did the oral itraconazole 400mg daily have any effect on it? May I ask, perchance, do you also have diabetes or problems with blood sugar? You don't have to answer this though, I'm just trying to form a personal picture of this very common problem we all have.

I have a small personal theory about the pain/itches after masturbation and orgasm. I think that when we get invaded and colonized by these bacteria or fungi, they weaken the skin layer where they settle in, so when we use lube and then jack off, the lube first dissolves the very thin and weak keratin layer over the colonised sites, and then the friction from our hands abrades them off, leaving very sore, and very raw spots. When we're healthy no such problems occur and I think it has to do with the health of our skin layers. The bacteria or fungi also prevents normal healing, and as long as they persist the condition may become a chronic problem.

A lot of yeasts and fungi have developed resistance to clotrimazole, so it's a normal thing to switch from one azole to another to see what works for the strain we have. This is a problem of diagnostics - the general population just does not have as much access to lab testing as we like. I think that even for doctors the diagnosis is about likely causes and a process of careful elimination.

Back to your glans: have you noticed any inflammation on your foreskin itself, inner and outer? Have you noticed any "dry" looking skin on your glans or any spot on your penis after pulling back and commencing treatment or at any point of time, or any "scaliness"?

With regards to the terbinafine and antifungal creams, if there is any improvement it might appear visually glacial. Treatment courses are a minimum of two weeks, and perhaps some more for a full cure. Improvement will be visually slow but gradual - but the oral anti-fungals should demonstrate remarkable changes after a single course.

With the antibiotic creams though, I think improvements should be seen within three days. Improvements should be drastic, or the antibiotic is not working. Apart from fucidic acid, you could also use povidone iodine solution, but you have to be careful not to apply it too often on your mucus membranes in case of excessive absorption into the blood stream. I'd say 3 days, twice a day applications max to see if there are any changes.

With regards to the fucidic acid changing your biome and allowing opportunistic fungal infection, the fucidic acid is not as radical as oral azithromycin or doxycycline, so I don't think you have to worry about it so much.

If the anti-bacterials are the ones you haven't tried yet, I'd suggest giving it a shot for a week, making note of any changes or improvements, and then only leaving a two week gap (or maybe 1 week is enough) before your appointment with the dermatologist, who hopefully will perform scrapings for microscope examinations, as well as swabs for various cultures fungal and bacterial. I think it is a good idea to leave enough "lead time" because either the anti-fungals or anti-bacterials could suppress the pathogen to low enough levels to present very light or mild symptoms or presence that it becomes difficult to identify and pinpoint through the lab tests.

I would also recommend taking photographs to note the changes, under similar lighting conditions, to serve as a visual record for the doctor as well as yourself - you do not have to post these here because few of us can help you even if we have that additional personal information. You definitely want to take a photo post orgasm/ejaculation because that would be extremely awkward to show a doctor in person, haha! And otherwise they can only guess how bad it looks like after lol

Quote from: HCheung on 2024-03-18 17:40:18I would still use my foreskin to jerk off before
But recently I've been rubbing my bare glans and shaft directly with my hands, often without lube
And it feels really good 

I'm new to this site. I do enjoy the feel of my foreskin staying all the back which I'm doing now achieving with two O rings. I masturbate using a Lube on just my glans which feels amazing!

QuoteThank you for sharing your photos. I've updated this visual information to my memory banks.

You have no idea how much I appreciate your reply.

QuoteI'm not a doctor, so sadly, I am not qualified to diagnose what I'm looking at

I'm not sure you're at any real disadvantage compared to "real" doctors. Two GP's have looked at it in person. First GP assumed Candida and he's the one that's given me what I've used so far (Clotrimazole/Terbinafine cream, and Itraconazole oral). 2nd GP said he didn't see anything wrong, but listened to my story, and suggested to wait for dermatologist. I asked him if I could try an antibiotic cream, and he gave me Fucidin (I ensured it was the one without the steroid). I have not used this cream yet.

I reached out to specialists thru a work plan I have, but a week and a half later, no reply. I figured I'd try JustAnswer (paid for a membership and spoke with a dermatologist who claims to have 10 years of dermatology). He also listened to my story, and looked at the same pics I attached.
He admitted there was a rash, but told me without testing it, and considering I've tried 3 antifungals, he cannot give me an assessment based on just a visual. He recommended I wait until my in-person Dermatologist to look at it, and hopefully scrape and test the infection. I asked him what I should do with the creams I have now. He said "if you want to use the Fucidin for 1 week like your GP said, you can do that. If you want to keep using Terbinafine, you can do that". Basically a waste of time.

QuoteThere is some redness, but it does not look severe. The redness looks like something I sometimes have when I have completely zero issues - but on the other hand, when I do have issues, I become hypersensitive to how my penis looks

I thought about this, but I remember when I have injured my penis (once, like a decade ago, I masturbated with soap, and that made it look similar to these pics, but that damage healed in 2 days, and was back to normal. This appears to be there even if I leave it alone for 4 days.

QuoteYou mentioned pain after ejaculation/orgasm and I think this is important - everything can look okay but discomfort, pain or itching after orgasm/ejaculation is definitely a sign that you have something and it's not normal.

I have no pain while rubbing my erect penis, or glans. I have no pain when ejaculating. I have tried using coconut oil, and sensitive skin astroglide, and since my glans is very sensitive, I don't have to go hard to climax. Even soft rubbing, afterwards, leaves those red spots you see, twice as red, and my glans then burns at a 3 out of 10 for the next day, all day. It slowly calms down as long as I don't touch it (just wash with water at night).
I wish I could just leave it alone, but my libido is very strong after 4 days. I'm going to try for 2 weeks, if I can make it.

QuoteI also note that you mentioned pain and a burning sensation. If I am not mistaken, fungi/yeast infection is more commonly associated with itching and a crawling sensation. I do not know if fungi can cause pain, but from everything I've read on the internet I've not heard pain mentioned once.

What I've read suggests itching or burning (either one) could be fungal. There is next to zero information on the internet about bacterial infections on the glans, hence, I have no idea what it would look life (except for the extreme cases, which is what seems to pop up when you search any of this stuff).
Bacterial is supposed to have more secretions, and smell foul. Mine has zero smell and zero secretions. No itching either, just the constant mild burning.

QuoteOral terbinafine tends to have worse side effects than Itraconazole, and is usually used to treat nail fungus. If I'm not mistaken, terbinafine works really well on the dendrophytes, but not so much on the yeasts that cause balanitis.

Ironic that you mention this. I have a mild jock itch that I am treating successfully right now. The sex worker started fondling my scrotum and right under. I told her to stop, but she was already touching my glans again. I suspect this transferred dermatophytes from my groin to my glans.
Not a single doctor has given me the opportunity to explain this theory. It would make sense that Terbinafine cream helped a little. I also bought a Miconazole cream but have not used it yet. I have about 1 month of not using any antifungals at all.

QuoteDid the doctor give you instructions on how to use the Fucidic acid?

Yes, twice a day for 7 days. If issue is bacterial, I would expect to start seeing results within 2-3 days of use. I asked the doctor if it could aggravate it if it was fungal. He said "there's a small possibility that if it's fungal, changing the flora by killing some good bacteria could aggravate it". So this is where I am stuck. I don't want to make things worse.

Anyway, yeah, that's pretty much it for the moment. I think I'm going to try and wait for dermatologist, and hopefully get a scraping done and find out what the hell it is. I'm betting 80% it's a dermatophyte transferred from my jock itch. Or it could be E. Coli transferred from the area of my anus...........or the girl just didn't wash her hands properly. Either way, I'm not really sure at this moment what to do.

I really enjoy using one of those sleeve toys for a bit more fun. For the day to to day, I would usually just slide the foreskin up and down the shaft over the head. Lately I've been edging by rubbing the head while pulled back, I find that can give a really different sensation than other methods.

Quote from: PossibleMagician130 on 2024-04-01 19:14:51That sounds terrible. In children the adhesions to the glans may not have loosened sufficiently and this could cause internal scarring that makes the phimosis worse, potentially even causing a life-threatening condition.

I absolutely do not recommend acts that cause terror and potential injury in children

it was painful my mom tired so many time to strech it but I didn't let her so she told my aunt to do so she did it ...

But I'm happy also cuz of that I started keeping my glan exposed and now it pullback  by itself

That sounds terrible. In children the adhesions to the glans may not have loosened sufficiently and this could cause internal scarring that makes the phimosis worse, potentially even causing a life-threatening condition.

I absolutely do not recommend acts that cause terror and potential injury in children

Quote from: Alex07 on 2024-04-01 14:18:54I still remember that day I was 7 or 8 and had tight foreskin my aunt is nurse she told me not to move and grab my foreskin and try to pull back but It was tight ....then next day after bath my aunt and her 2 junior told me to lay down on bed and both of them grab my both leg and hand so I don't move and my aunt garb my foreskin and forcefully pull my foreskin and keep pulling until it open I took like 5 min I was crying after that that I can easily open my foreskin then she told me to keep open ur foreskin after that I started keeping my glan exposed not regularly but after 11 i started doing regularly now I have short foreskin and fully dry glan this is my story frm tight foreskin to short skin

Thank you for sharing your photos. I've updated this visual information to my memory banks.

I'm not a doctor, so sadly, I am not qualified to diagnose what I'm looking at. There is some redness, but it does not look severe. The redness looks like something I sometimes have when I have completely zero issues - but on the other hand, when I do have issues, I become hypersensitive to how my penis looks, and I definitely do remember having symptoms while having redness less than this.

You mentioned pain after ejaculation/orgasm and I think this is important - everything can look okay but discomfort, pain or itching after orgasm/ejaculation is definitely a sign that you have something and it's not normal.

I also note that you mentioned pain and a burning sensation. If I am not mistaken, fungi/yeast infection is more commonly associated with itching and a crawling sensation. I do not know if fungi can cause pain, but from everything I've read on the internet I've not heard pain mentioned once.

I think you can't rule out some kind of bacterial infection. Not being a doctor, I don't know what could have been transmitted via a hand job, but on the other hand this would not be impossible. Hands are very rough surfaces compared to pussy or ass. You could have suffered a lot of micro-tears in the skin and subsequently this allowed bacteria or fungi to penetrate deeper than they would have.

Oral terbinafine tends to have worse side effects than Itraconazole, and is usually used to treat nail fungus. If I'm not mistaken, terbinafine works really well on the dendrophytes, but not so much on the yeasts that cause balanitis.

Did the doctor give you instructions on how to use the Fucidic acid? If my memory is correct, you should not use it for longer than 7 days, because if it would have worked, it should have worked by then, and if it doesn't, you might contribute to antibiotic resistance on your own biome. I've used fucidic acid to clear up some really stubborn, follicular spots before, and it worked with just two applications. In general fucidic acid prevents bacterial replication, and only for gram positive bacteria, not gram negative ones. At low doses found in topical creams it may not help against the more serious or stubborn bacterial infections.

P.S: By the way make sure the fucidic acid cream does not also include a steroid in it

Quote from: Mellon on 2024-04-01 14:14:22I got Itraconazole for 7 days, but at the 5th day, started to get side effects (burning in my legs) so I stopped it. I wanted to try Oral Terbinafine, but the GP's said "best for a dermatologist to look at you at this point".

Here it takes forever to get to see one. I have an appointment with dermatologist at the end of this month. I went to a 2nd GP for a 2nd opinion because I got scared about the issue possibly being bacterial and not fungal? I have the Fucidin cream here, but have not used it yet.

Here's some pics, see attachments. Ignore the white patches on the tip, that's just dried up urine.

I slept with glans exposed last night, and what's interesting is that it looks better when the glans is dry, and I think the past 7 days of exposure have actually improved it. Originally the rash was twice as bad as what you are seeing there. The Lamisil cream improved it by maybe 20%, and so far, the pulling back seems to have improved it another 10%.

At least it's not getting any worse. As I understand it, a bacterial infection would create blisters, or "canker" looking sores, and possibly different secretions. Other than the redness and the burning sensation, I have no other symptoms. If I leave it alone for a few days, the pain is almost gone. I've had days where I completely forget it's there. But when I jerk it, that's the worst. It doesn't hurt at all while doing it, but the next day I am in 3 out of 10 pain, and the rash is flared up.

I haven't taken any pics after masturbation, and I plan on not touching myself this whole week, while pulling back as much as I can (only because it seems to be helping at least a little bit)

Pulling back has definitely reduced the pain at least. Based on all this, what do you think?

Quote from: Mellon on 2024-04-01 14:31:19Guys, for some reason I can no longer look at any posts. After I attached the pics, any post on the board just give me "Wrong value type sent to the database. Array of integers expected. (preview_attachments)"

I was able to go to my profile and look at my own posts and reply to one of my posts (how I was able to post this). Could it be because I need to get picture access? How do I get that access?

I'll look at the logs sometime and see if I can make head or tails of it.

You already have picture access so that's not the problem.

Ok looks like I can see posts again. Weird, but ok you have the pics, that's what it looks like right now.