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The spotted dick

“I just noticed a spot on my penis… I’m freaking out! What could it be?”

This is probably one of the most common questions I get in the clinic and the ER — so definitely worth a revisit.

We men highly value our “members” and therefore are usually very well acquainted with what should or shouldn’t be present on them. It is good health practice to become intimately familiar with your goods — as is understanding that the skin on your junk is very uneven and bumpy on its best day.

The colour of the spot helps you figure out what it is. If you notice a new bump it is still possible it was there before and you didn’t notice — guys often come in because they have what’s called “pearly penile papules” or PPP, which are colourless little bumps situated around the head of the penis.

These are normal, and can even grow or disappear.

Spots with pigment in them are almost always freckles, moles or, if you have a had a recent irritation to your pecker, post-inflammatory hyperpigmentation. If it’s growing quickly, has an irregular border/shape or colour, show it to a medical professional because, although very uncommon on the penis, melanoma (skin cancer) can occur anywhere.

If your spot is red it’s probably not supposed to be there. If it looks like a pimple then it probably is, and will go away by itself. Red bumps where you shaved recently are also likely simple razor burn and also go away with time. Red splotchy spotty rashes on uncircumcised guys (but sometimes on cut guys as well) may be your run-of-the-mill yeast infection (yes, guys get them too). In guys with dark skin this may look pink as the skin loses pigment. Try a topical antifungal cream, which are available without prescription, several times a day for a week to see if this fixes it.

Painful red spots that ulcerate (cause a hole in) the skin are usually an infected scratch or cut. Put polysporin on it frequently, abstain from sex, and watch it to make sure it resolves. If not, it could be a more bothersome infection like herpes.

Painless red ulcerated lesions are worrisome for syphilis, a sexually transmitted infection spread by genital to genital contact, as well as oral and anal sex. A blood test will tell you if this is what you have and is always worth doing if you are sexually active and have any kind of spot that should not be there, since untreated it can cause serious illness.

If your spots are small, shiny and many, it may be a common infection called molluscum spread by physical contact. While harmless, it’s a nuisance and infectious, so see your health care person to have them removed. Larger, rough lesions that grow quickly are most likely warts caused by the HPV virus, and need to be removed by a medical professional.

So hopefully you now have a better idea what your little friend’s little friend is. Seek a medical opinion to confirm, especially if you think it’s a sexually transmitted infection and it’s not going away.

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