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Genital skin lesions and burning during urination
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Sexual Health & Wellness
Question #21703
135 days ago
347

Genital skin lesions and burning during urination - #21703

Hazzel

Hello Doctor, I am a male patient seeking advice for a genital problem. For the past few days, I have been experiencing: Itching around the genital skin Multiple small boil-like bumps on the skin, which are increasing in number No pus discharge at present Mild burning sensation during urination, which is worse at the beginning of urination No penile discharge (no white or yellow fluid) I previously used Luliconazole cream, but the bumps increased instead of improving. Currently, I am using Mupirocin ointment on the skin lesions. There is no severe pain or fever. The area sometimes feels irritated and dry. I would like to know: What could be the possible diagnosis? Do I need any tests (urine test or others)? Do I need oral antibiotics, and if yes, which type would be appropriate? Thank you for your time and guidance.

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Doctors' responses

Dr. Nikhil Chauhan
I am currently working as a urologist and kidney transplant surgeon at Graphic Era Medical College & Hospital, Dehradun. It's a role that keeps me on my toes, honestly. I handle a pretty wide range of urology cases—stones, prostate issues, urinary tract obstructions, infections, you name it. Some are straightforward, others way more complex than you expect at first glance. Every patient walks in with a different story and that’s what keeps the work real for me. Kidney transplant surgery, though, that’s a whole different zone. You’re not just working on anatomy—you’re dealing with timelines, matching, medications, family dynamics, emotional pressure... and yeah, very precise coordination. I’m part of a team that manages the entire transplant process—from evaluation to surgery to post-op care. Not gonna lie, it’s intense. But seeing someone who’s been on dialysis for years finally get a new shot at life—there’s nothing really like that feeling. In the OR, I’m detail-focused. Outside of it, I try to stay accessible—patients don’t always need answers right away, sometimes they just need to feel heard. I believe in walking them through what’s going on rather than just giving reports and instructions. Especially in transplant cases, trust matters. And clear, honest conversation helps build that. Urology itself is such a misunderstood field sometimes. People ignore symptoms for years because it feels “awkward” or they think it’s not serious until it becomes unmanageable. I’ve had patients who came in late just because they were embarassed to talk about urine flow or testicular pain. That’s why I also try to make the space judgment-free—like whatever it is, we’ll figure it out. At the end of the day, whether I’m scrubbing in for surgery or doing OPD rounds, I just want to make sure what I do *actually* helps. That the effort’s not wasted. And yeah, some days are frustrating—some procedures don’t go clean, some recoveries take longer than they should—but I keep showing up, cause the work’s worth doing. Always is.
134 days ago
5

Hi Hazzel,

Here is a concise, point-wise breakdown of your concerns:

Possible Diagnosis:

· Herpes Simplex Virus (HSV) is a strong possibility given the painful bumps, itching, and urethral burning. · Other considerations include a bacterial skin infection (folliculitis) or a different sexually transmitted infection (STI). · The worsening with antifungal cream (Luliconazole) suggests it is likely not a simple fungal infection.

Required Tests:

· Yes, testing is essential. · STI Panel: Specifically request tests for HSV (swab of a bump), Gonorrhea, and Chlamydia (urine test). · Urine Routine & Culture to check for urinary tract infection.

Medication Advice:

· Stop using Mupirocin. It is for bacterial skin infections and is not the correct treatment for likely causes here. · Do not take random oral antibiotics. The correct treatment depends entirely on the diagnosis. · If confirmed as HSV, specific antiviral tablets (e.g., Acyclovir) are required. You need a prescription.

Immediate Action Plan:

1. Consult a doctor (Physician, Dermatologist, or Urologist) immediately. Do not delay. 2. Get the recommended tests done to confirm the diagnosis. 3. Start targeted prescription medication only after consultation.

For accurate diagnosis and treatment of such conditions,

Dr. Nikhil Chauhan, Urologist

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Given the symptoms you’ve described, such as itching around the genital skin, the presence of small boil-like bumps, and the burning sensation during urination, a few conditions come to mind. One possibility is a herpes simplex virus infection, particularly given the presentation of multiple small lesions. Another consideration could be folliculitis, since boil-like bumps may sometimes occur due to bacterial infection of hair follicles. It’s also worth considering a fungal infection, although it seems less likely if you’ve already tried an antifungal cream without improvement.

In terms of diagnostics, it’d be prudent to perform a few tests. A urine analysis can help identify any urinary tract infections that might explain the burning sensation. Testing for sexually transmitted infections (STIs) such as herpes and possibly syphilis is also recommended, considering the genital location and lesions. A swab of the lesions could be taken to culture bacteria or viral PCR testing for HSV.

As for antibiotics, I wouldn’t recommend starting oral antibiotics without more concrete evidence of a bacterial infection. Misuse of antibiotics can lead to resistance and doesn’t address viral or fungal causes. If herpes is suspected, an antiviral medication like acyclovir might be prescribed. But it’s really important to have these symptoms evaluated by a healthcare professional who can perform an appropriate exam and follow-up on lab results. Until a more definitive diagnosis is made, avoid using mupirocin if it’s ineffective and consult a doctor for proper guidance. Your immediate next step should be scheduling a visit with a healthcare provider to ensure you receive a precise diagnosis and appropriate treatment.

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Dr. Alan Reji
I'm Dr. Alan Reji, a general dentist with a deep-rooted passion for helping people achieve lasting oral health while making dental visits feel less intimidating. I graduated from Pushpagiri College of Dental Sciences (batch of 2018), and ever since, I've been committed to offering high-quality care that balances both advanced clinical knowledge and genuine compassion for my patients. Starting Dent To Smile here in Palakkad wasn’t just about opening a clinic—it was really about creating a space where people feel relaxed the moment they walk in. Dental care can feel cold or overly clinical, and I’ve always wanted to change that. So I focused on making it warm, easygoing, and centered completely around you. I mix new-age tech with some good old-fashioned values—really listening, explaining stuff without jargon, and making sure you feel involved, not just treated. From regular cleanings to fillings or even cosmetic work, I try my best to keep things smooth and stress-free. No hidden steps. No last-minute surprises. I have a strong interest in patient education and preventive dentistry. I genuinely believe most dental issues can be caught early—or even avoided—when patients are given the right information at the right time. That’s why I take time to talk, not just treat. Helping people understand why something’s happening is as important to me as treating what’s happening. At my practice, I’ve made it a point to stay current with the latest innovations—digital diagnostics, minimally invasive techniques, and smart scheduling that respects people’s time. I also try to make my services accessible and affordable, because good dental care shouldn’t be out of reach for anyone.
133 days ago
5

Your symptoms are most suggestive of folliculitis or irritant/contact dermatitis, sometimes mixed with a fungal or bacterial infection, and luliconazole can worsen irritation if fungus isn’t the main cause; mild burning at the start of urination may be from local skin inflammation rather than a urinary infection. A urine routine test (to rule out UTI) and, if bumps persist, a dermatology exam ± swab is reasonable; STI testing is only needed if there’s risk exposure. Do not start oral antibiotics on your own—continue gentle hygiene, avoid soaps/friction, keep the area dry, and please consult a dermatologist or urologist to confirm the diagnosis and prescribe targeted treatment if needed.

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Dr. Shayeque Reza
I completed my medical degree in 2023, but honestly, my journey in healthcare started way before that. Since 2018, I’ve been actively involved in clinical practice—getting hands-on exposure across multiple departments like ENT, pediatrics, dermatology, ophthalmology, medicine, and emergency care. One of the most intense and defining phases of my training was working at a District Government Hospital for a full year during the COVID pandemic. It was chaotic, unpredictable, and exhausting—but it also grounded me in real-world medicine like no textbook ever could. Over time, I’ve worked in both OPD and IPD setups, handling everything from mild viral fevers to more stubborn, long-term conditions. These day-to-day experiences really built my base and taught me how to stay calm when things get hectic—and how to adjust fast when plans don’t go as expected. What I’ve learned most is that care isn't only about writing the right medicine. It’s about being fully there, listening properly, and making sure the person feels seen—not just treated. Alongside clinical work, I’ve also been exposed to preventive health, health education, and community outreach. These areas really matter to me because I believe real impact begins outside the hospital, with awareness and early intervention. My approach is always centered around clarity, empathy, and clinical logic—I like to make sure every patient knows exactly what’s going on and why we’re doing what we’re doing. I’ve always felt a pull towards general medicine and internal care, and honestly, I’m still learning every single day—each patient brings a new lesson. Medicine never really sits still, it keeps shifting, and I try to shift with it. Not just in terms of what I know, but also in how I listen and respond. For me, it’s always been about giving real care. Genuine, respectful, and the kind that actually helps a person heal—inside and out.
135 days ago
5

Based on your symptoms genital itching, multiple small boil-like bumps increasing in number, irritation and dryness, mild burning at the start of urination, no pus, no penile discharge, and no fever the most likely diagnosis is superficial bacterial folliculitis or irritant/contact dermatitis, possibly with secondary bacterial infection from scratching or friction. The fact that luliconazole (antifungal) worsened the bumps suggests this is not a fungal infection. Improvement focus should be on skin healing and bacterial control, which makes mupirocin a more appropriate choice. The burning at the beginning of urination is most likely due to local skin irritation near the urethral opening, not a deep urinary tract infection or STI.

Keep the area clean, dry, and well-ventilated Avoid scratching, shaving, or tight clothing Avoid all creams unless prescribed Use only plain water for washing

Physical examination is most important.

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Dr. Arsha K Isac
I am a general dentist with 3+ years of working in real-world setups, and lemme say—every single patient teaches me something diff. It’s not just teeth honestly, it’s people… and how they feel walking into the chair. I try really hard to not make it just a “procedure thing.” I explain stuff in plain words—no confusing dental jargon, just straight talk—coz I feel like when ppl *get* what's going on, they feel safer n that makes all the difference. Worked with all ages—like, little kids who need that gentle nudge about brushing, to older folks who come in with long histories and sometimes just need someone to really sit n listen. It’s weirdly rewarding to see someone walk out lighter, not just 'coz their toothache's gone but coz they felt seen during the whole thing. A lot of ppl come in scared or just unsure, and I honestly take that seriously. I keep the vibe calm. Try to read their mood, don’t rush. I always tell myself—every smile’s got a story, even the broken ones. My thing is: comfort first, then precision. I want the outcome to last, not just look good for a week. Not tryna claim perfection or magic solutions—just consistent, clear, hands-on care where patients feel heard. I think dentistry should *fit* the person, not push them into a box. That's kinda been my philosophy from day one. And yeah, maybe sometimes I overexplain or spend a bit too long checking alignment again but hey, if it means someone eats pain-free or finally smiles wide in pics again? Worth it. Every time.
135 days ago
5

Hello,

Your symptoms most likely suggest genital folliculitis or bacterial skin infection, possibly with local irritation/urethral inflammation. It is less likely to be an STD based on your description

Luliconazole can worsen non-fungal infections → explains why bumps increased

Mupirocin is appropriate for bacterial skin infection

Urine routine test → helpful if burning continues

STD tests not mandatory unless there was risky sexual exposure

Continue Mupirocin 2–3× daily for 5–7 days Keep area clean, dry, loose clothing Avoid shaving, scratching, or sexual activity until healed Drink plenty of water

This condition is common and usually treatable with local care.

Thank you!

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Dr. Bharat Joshi
I’m a periodontist and academician with a strong clinical and teaching background. Over the last 4 years and 8 months, I’ve been actively involved in dental education, guiding students at multiple levels including dental hygienist, BDS, and MDS programs. Currently, I serve as a Reader at MMCDSR in Ambala, Haryana—a role that allows me to merge my academic passion with hands-on experience. Clinically, I’ve been practicing dentistry for the past 12 years. From routine procedures like scaling and root planing to more advanced cases involving grafts, biopsies, and implant surgeries. Honestly, I still find joy in doing a simple RCT when it’s needed. It’s not just about the procedure but making sure the patient feels comfortable and safe. Academically, I have 26 research publications to my credit. I’m on the editorial boards of the Archives of Dental Research and Journal of Dental Research and Oral Health, and I’ve spent a lot of time reviewing manuscripts—from case reports to meta-analyses and even book reviews. I was honored to receive the “Best Editor” award by Innovative Publications, and Athena Publications recognized me as an “excellent reviewer,” which honestly came as a bit of a surprise! In 2025, I had the opportunity to present a guest lecture in Italy on traumatic oral lesions. Sharing my work and learning from peers globally has been incredibly fulfilling. Outside academics and clinics, I’ve also worked in the pharmaceutical sector as a Drug Safety Associate for about 3 years, focusing on pharmacovigilance. That role really sharpened my attention to detail and deepened my understanding of drug interactions and adverse effects. My goal is to keep learning, and give every patient and student my absolute best.
135 days ago
5

Hello dear See you already taken a lot of topical medication I suggest you to please get following tests done for confirmation of exact diagnosis and best treatment Esr CBC Allergy test Blood allergy test Intradermal skin test Rft Lft Culture Urine analysis if recommended by gynecologist Please share the result with gynaecologist or sexologist for confirmation and for safety please donot take any medication without consulting the concerned physician Regards

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Dr. Prasannajeet Singh Shekhawat
I am a 2023 batch passout and working as a general physician right now, based in Hanumangarh, Rajasthan. Still kinda new in the bigger picture maybe, but honestly—every single day in this line teaches you more than textbooks ever could. I’ve had the chance to work under some pretty respected doctors during and after my graduation, not just for the clinical part but also to see how they handle people, real people, in pain, in panic, and sometimes just confused about their own health. General medicine covers a lot, right? Like from the smallest complaints to those random, vague symptoms that no one really understands at first—those are kinda my zone now. I don’t really rush to label things, I try to spend time actually listening. Feels weird to say it but ya, I do take that part seriously. Some patients just need someone to hear the whole story instead of jumping to prescription pads after 30 seconds. Right now, my practice includes everything from managing common infections, blood pressure issues, sugar problems to more layered cases where symptoms overlap and you gotta just... piece things together. It's not glamorous all the time, but it's real. I’ve handled a bunch of seasonal disease waves too, like dengue surges and viral fevers that hit rural belts hard—Hanumangarh doesn’t get much spotlight but there’s plenty happening out here. Also, I do rely on basics—thorough history, solid clinical exam and yeah when needed, investigations. But not over-prescribing things just cz they’re there. One thing I picked up from the senior consultants I worked with—they used to say “don’t chase labs, chase the patient’s story”... stuck with me till now. Anyway, still learning every single day tbh. But I like that. Keeps me grounded and kind of obsessed with trying to get better.
134 days ago
5

Hello Hazzel Thank you for describing your symptoms in detail. Based on what you’ve shared—itching, multiple small boil-like bumps increasing in number, mild burning at the start of urination, no pus or penile discharge, and irritation/dryness—the most likely causes are:

Possible Diagnosis - Folliculitis: This is a common skin infection of the hair follicles, often caused by bacteria (like Staphylococcus) or sometimes by fungi. It can appear as itchy, boil-like bumps. - Fungal Infection (Tinea/Yeast): Sometimes, fungal infections can worsen or change appearance with certain creams, especially if the skin barrier is irritated. - Irritant or Allergic Reaction: Sometimes, repeated use of creams or ointments can irritate sensitive skin, leading to bumps and itching.

What You Can Do - Continue Good Hygiene: Keep the area clean and dry. Avoid tight clothing and harsh soaps. - Stop Using Multiple Creams: Using too many creams can irritate the skin further.

Do You Need Tests? - Urine Test: If burning during urination continues or worsens, a urine routine and culture can help rule out a urinary tract infection. - Skin Swab: If the bumps keep increasing or become pus-filled, a doctor may take a swab to check for bacteria or fungus.

Rx- ointment Mupirocin - apply on affected area Tab Ciprofloxacin 500 mg - one in morning, one at night after food for 7 days Tab Flucanazole 150 mg - once a week after food for 7 days Tab Montac lc - once at night after food

Thank you

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Dr. Nirav Jain
I am a qualified medical doctor with MBBS and DNB Diploma in Family Medicine from NBEMS, and my work has always been centered on treating patients in a complete, not just symptom based way. During my DNB training I rotated through almost every core department—Internal medicine, Pediatrics, Obstetrics & Gynecology, Surgery, Orthopedics, ENT, Dermatology, Psychiatry, Emergency medicine. That mix gave me the skill to manage acute illness, long term disease and preventive care together, something I find very important in family practice. In psychiatry I worked closely with patients who struggled with depression, anxiety, stress related problems, insomnia or substance use. I learned not just about medication but also about simple psychotherapy tools, psycho education and how to talk openly without judgement. I still use that exp in family medicine, specially when chronic disease patients also face mental health issues. My time in General surgery included assisting in minor and major procedures, managing wounds, abscess, sutures and emergencies. While I am not a surgeon, this gave me confidence to recognize surgical cases early, provide first line care and refer fast when needed, which makes a big difference in online or OPD settings. Now I work as a consultant in General medicine and Family practice, with focus on both in-person and online consultation. I treat conditions like fever, infections, gastrointestinal complaints, respiratory illness, and also manage diabetes, hypertension, thyroid disorders, and lifestyle related chronic diseases. I see women for PCOS, contraception counseling, menstrual health, and children for common pediatric issues. I also dedicate time to preventive health, lifestyle counseling and diet-sleep-exercise advice, since these small changes affect long term wellness more than we often realize. My key skills include holistic diagnosis, evidence based treatment, chronic disease management, mental health support, preventive medicine and telemedicine communiation. At the center of all this is one thing—patients should feel heard, safe, and guided with care that is both professional and personal.
131 days ago
5

Hello Hazzel, thank you for sharing your concern. It is pretty much impossible to make a diagnosis without a visual inspection of your skin lesion. Kindly show it to a certified dermatologist or a family physician for proper diagnosis, appropriate tests and treatment.

Do not go ahead with online prescriptions without showing a photo of your lesions. It might cause more harm than benefit.

Feel free to reach out again.

Regards, Dr. Nirav Jain MBBS, D.Fam.Medicine

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