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What's normal?

It is common to have skin changes on the penis or vagina that are nothing to do with an STI. However, if you are concerned it is always best to visit your GP or sexual health clinic.

Appearance of sexual organs

We are all different so ‘normal’ is hard to define, for example skin appearance can depend on your type of skin, ethnicity and hygiene habits.

Ask your GP or clinician if you have any concerns or questions about any issue. Remember that early detection and treatment is the best, so don’t embarrassed to ask.

Normal skin appearances that are nothing to worry about

Pearly penile papules (coronal papillae)

Pearly penile papules are small, smooth, white or skin coloured spots that are found at the head of the penis. They are 1mm-3mm across and often appear in small rows. They pose no health risks and don’t cause any pain or irritation. There is no known cause and they aren’t related in any way to personal hygiene or STIs. Do not attempt to pick or squeeze them as this can cause scarring or infection. They can be removed by a dermatologist if they are affecting your self-confidence. Remember that it is still advisable to have any lumps or bumps in your genital area checked by a doctor just in case.

Fordyce spots

Fordyce spots are small yellow-white spots found on the lips and genitalia (both the penis and the vulva). They are completely harmless. They are caused by a kind of overgrowth of the lubricating glands, which keep the skin from drying out and cracking. They can be mistaken for genital warts but they do not change, whereas warts grow bigger if they are left alone. They do not require treatment but remember to go to your GP or sexual health clinic if you are worried.

Skin changes that are not necessarily related to sexually transmitted infection

Epidermoid cysts

An epidermoid cyst is a round, fluid filled bump lying underneath the skin. They are yellow or whiteish, often with a small dark plug through which you might be able to squeeze out pus. It can range in size from smaller than a pea to a few centimetres across, and it will grow slowly. Skin cysts don’t usually hurt, but can become tender, sore and red if they become infected. Foul smelling pus coming out of it is another sign of an infection. They can be found in the skin around the genitals (as well as on the face, neck, chest and shoulders).

Anyone can develop a skin cyst but you’re more likely to have one if you’ve gone through puberty, have a history of acne or have injured the skin. They are harmless and fairly common, and may clear up without treatment. You can hold a cold flannel up to the skin to encourage the cyst to heal and reduce any inflammation. Don’t pop the cyst as it can become infected.

If your cyst does become infected, see your GP as you may need antibiotics. The cyst can be removed by a GP if it is bothering you. Cysts on the scrotum may grow back in the future. It can be hard to tell whether a lump is a cyst or something else that might need treatment. It is best to see your GP if you have any sort of lump so it can be properly diagnosed.

Folliculitis

Folliculitis is an infection of the hair follicles in the skin. It is a common problem and is not usually serious. You will see tiny pus filled spots developing at the base of the hair, often in groups. It usually occurs at sites where hair follicles are damaged by friction or shaving, or where a follicle is blocked. Excessive sweating can be another cause.

Mild cases often disappear within 7-10 days without the need for treatment. You can take some general measures like shaving in the direction of hair growth, taking a break from shaving for a few days, not wearing tight clothing over the affected area, keeping cool and exposing the area to fresh air. If you have folliculitis, do not share razors, flannels and towels. It might also be helpful to use a moisturiser which contains an antibacterial agent. In more severe cases, antibiotic creams or tablets might be needed. If the folliculitis keeps coming back, you can use antiseptic skin washes.

Dermatitis

Dermatitis is an inflammation of the skin that occurs when you come into contact with a particular substance. This can be an irritant (a substance that directly damages the outer layer of skin) or an allergen (a substance the causes the immune system to respond in a way that affects the skin). It is a type of eczema that causes the skin to become blistered, red, scaly, cracked and dry. This will usually occur within a few hours or days after exposure to the irritant or allergen. It can affect any part of the body.

If you have severe, persistent or recurrent symptoms, you should see your GP. They can try to identify the cause and suggest a treatment. They can also refer you for further tests to confirm exactly what is causing your symptoms. Your skin will clear up if you can avoid the cause of your dermatitis. However, if this isn’t possible you are advised to seek treatment. This can be in the form of medicated moisturisers, ointments and creams, or tablets. These will help the symptoms to improve and some cases will clear up completely.

Balanitis

Balanitis is an inflammation of the head of the penis. The foreskin (the loose flap of skin that covers the head of the penis) is also often affected. It is a common condition and it occurs more often in those who have not been circumcised. Symptoms can include redness, swelling and soreness around the head of the penis or foreskin, a thick discharge under the foreskin, a rash on the penis, itchiness, an unpleasant odour and pain when urinating.

Balanitis is not usually serious, but it can be a sign of another condition, such as an STI or thrush. This means that it is important to visit your GP or sexual health clinic if you think you have balanitis. It can be caused by a build-up of a cheesy-looking substance under the foreskin of uncircumcised men called smegma that can irritate the skin if the penis is not kept clean. It can also be caused by irritation from urine, soaps or shower gels, thrush, a bacterial infection, STIs or skin conditions.

Balanitis is easily managed with a combination of creams or ointments, good hygiene and avoiding substances that irritate the penis. It can be prevented by avoiding potential irritants, keeping your penis clean and avoiding STIs.


Remember it is better to visit your GP or sexual health clinic if you’re worried or unsure about any skin changes that you notice.

If you have any questions or need advice, use the “Services Near You” section to find the closest and best service for you.

Other useful resources

Have a lump on your penis? Take a look at this handy guide- it might be able to help you identify it. Many lumps are harmless and don’t need treatment. They can have several possible causes. Remember if you are worried about a lump on your penis, you should see your GP or go to your sexual health clinic.

A guide to penis health, from how to wash a penis to questions on penis size and appearance.

A guide to keeping your vagina clean and healthy, from washing your vagina to cervical screening.

To find more about your closest clinic, GUM or GP please use the "Services Near You" section.

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