How to treat folliculitis on the upper hairy shaft of the penis
May 17, 2014 | 25,00 EUR | answered by Dr. med. Ralf Berg
For a little over 14 days, I have had a hair follicle infection, an ulcer, on the upper, hairy shaft of my penis that does not want to heal because this area rubs against my underwear while walking and moving, preventing it from "resting". Additionally, I am unsure how to hygienically treat the surrounding area, such as cleaning or washing it. My first point of contact was my general practitioner, who prescribed Fucicort cream for application. I then visited a dermatologist, who agreed that the initial prescription was not wrong, but ultimately prescribed something else: InfectoPylyderm 20 mg/g ointment. It appears that the issue lies in needing to clean the infected area first (with what?) and then cover it with the cream/ointment (but how on such a hairy area?), as otherwise, the applied cream or ointment ends up in the underwear after a few steps and not where it should be. How can a bandage be applied and held in place in this area? Is there a special adhesive bandage that would work? Which of the mentioned medications would you prefer?
The situation is quite painful, and I am reaching out to you now because I am struggling to handle this and typically, a hair follicle infection (in a different location) usually heals on its own within about a week, as I have read. Now, onto my questions: Could you please provide me with a step-by-step guide on what I can and should do to get rid of this ulcer infection at this difficult location as soon as possible?
Good morning,
I would like to give you a step-by-step guide:
1. Step: Let the hair grow back first, so please shave about 1-2 cm around the ulcer. This way the ointment will adhere better and you will have a "border" where you can apply fixating plaster.
2. Clean and disinfect: My favorite for open wounds or ulcers is Octenisept (available in small spray cans, burns very little compared to alcohol-based disinfectant sprays, also used for pressure sores). Spray it on, let it sit for about 1 minute, then wipe off with a damp cloth. Apply the ointment afterwards. I recommend using the second ointment prescribed by the dermatologist as it is more effective against bacteria.
3. Cover the ulcer with a Mettaline compress cut slightly larger than the ulcer. Use cuttable adhesive rolls to fixate it. I recommend using "Stretch" versions for a better fit (e.g. Mefix stretch or similar products).
4. Change the dressing 1 or 2 times a day.
Following this regimen, you should see improvement within 3 days and complete healing within 10-14 days at the latest.
If there is no improvement, or if only the bacterial infection stops but the ulcer persists, you should see your local doctors again. This area is particularly prone to venereal diseases, so an ulcer molle can develop there. However, I cannot assess this from here. But do not worry, both doctors have diagnosed your issue as a simple bacterial infection. The severe pain also indicates against the mentioned infectious disease.
I hope you can successfully follow the instructions. For advice on dressing materials, you can consult the pharmacist or simply take this letter with you.
Have a nice weekend, Dr. R. C. Berg
