Penile erosion describes the breakdown or loss of the superficial layer of skin, or epithelium, on the penis. This condition results in a raw, open sore or lesion that can be painful and concerning. Erosion is not a diagnosis in itself but a physical manifestation of an underlying issue, such as infection, inflammation, or trauma. Because the skin barrier has been compromised, a medical evaluation is required to identify the specific cause and prevent complications like secondary infection or scarring.
Recognizing Penile Erosion
Penile erosion typically presents as a well-defined area of shallow ulceration where the skin surface has been stripped away. The exposed tissue often appears intensely red, moist, and tender to the touch, lacking the defined edges of a deeper ulcer. This raw appearance is distinct from simple redness, or erythema, because the top layer of skin is visibly missing.
Lesions frequently appear on the glans penis, or the head of the organ, or on the inner surface of the foreskin. Patients commonly report localized symptoms that include burning, itching, or significant pain, especially during urination or sexual activity.
Primary Causes
The breakdown of the skin barrier that leads to erosion is categorized into infectious, inflammatory, and physical causes. Fungal infections are a frequent culprit, particularly Candida balanitis, an overgrowth of yeast that thrives in the warm, moist environment. Uncontrolled diabetes is a systemic factor that significantly increases the risk of this fungal overgrowth.
Bacterial infections, often secondary to poor hygiene, can cause inflammation that progresses to erosion. Viral infections, such as Herpes Simplex Virus (HSV), typically present as small, painful blisters that rupture, leaving behind shallow erosions. These infectious causes require targeted treatment to resolve the skin damage.
Inflammatory and immunological skin conditions can manifest as penile erosion. Zoon’s balanitis, or plasma cell balanitis, is a chronic inflammatory disorder that presents as persistent, reddish-orange patches on the glans, which often become eroded. Other dermatoses like lichen planus or psoriasis may also lead to erosive lesions.
Physical trauma and irritation represent another major category. This includes chemical irritants from harsh soaps, detergents, or certain lubricants that trigger contact dermatitis. Severe erosion can also result from mechanical pressure, such as chronic friction from medical devices like indwelling urinary catheters.
Medical Treatment and Management
The initial step in managing penile erosion involves a professional diagnosis to determine the underlying cause. This process may include taking a swab of the lesion to test for infectious agents like fungi or bacteria. If the erosion is persistent or the appearance is unusual, a small skin biopsy might be necessary to rule out inflammatory conditions or precancerous changes.
Treatment is tailored to the identified cause. If a fungal infection like candidiasis is confirmed, the physician will prescribe a topical antifungal cream. For erosions caused by a bacterial infection, a course of topical or oral antibiotics is the appropriate intervention to clear the pathogen.
Inflammatory causes like Zoon’s balanitis or lichen planus are managed with potent topical corticosteroids to suppress the immune response and reduce inflammation. Topical calcineurin inhibitors may be used as an alternative to steroids. Wound management, including gentle cleansing with lukewarm water and non-adherent dressings, is used concurrently to promote healing.
Strategies for Prevention
Preventing the recurrence of penile erosion centers on maintaining a healthy local environment and reducing exposure to known triggers. Proper hygiene is fundamental and involves gently washing the area daily with lukewarm water. If uncircumcised, the foreskin should be carefully retracted and the glans dried thoroughly to prevent moisture build-up.
Avoid using perfumed soaps, bubble baths, and harsh laundry detergents that can trigger contact dermatitis. Choosing breathable undergarments, such as cotton, helps to reduce heat and moisture, minimizing the risk of maceration and fungal overgrowth. For individuals with systemic conditions, such as diabetes, strict control of blood sugar levels is important because poor management increases susceptibility to candidal infections.