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Dr. Alpana Mohta Ranka, MD, DNB, IFAAD, is a dual-board-certified dermatologist with over 90 research publications in peer-reviewed scientific journals.

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Penile Melanosis: Causes, Symptoms, and Management

Updated: Dec 24, 2023

Penile melanosis, a term that might sound intimidating to many, is a benign condition characterized by diffuse hyperpigmentation, dark spots or patches on the penis.


This comprehensive guide will walk you through all aspects of penile melanosis, ensuring you have the information you need.


What is Penile Melanosis?

Penile melanosis, also known as genital melanosis, refers to hyperpigmented patches or spots that appear on the skin over the shaft of the penis, foreskin, glans, median raphe (a seam-like structure on the underside of the penis) or scrotum. These spots are non-cancerous (benign) and usually have no associated symptoms.


Causes of Penile Melanosis

  1. Natural Pigmentation: Just as people have freckles or moles on other parts of their body, the penis can also have areas of increased pigmentation. People with dark and melanin-rich skin are more likely to have a constitutionally dark skin over the penis and groin. Usually, such pigmentation tends to darken around puberty.

  2. Melanocytic nevus: A congenital or acquired melanocytic nevus on the penis can show up as a darker area of skin, almost like a mole, due to an accumulation of pigment cells. This dark spot can be there from birth or develop later in life.

  3. Friction: Continuous rubbing against clothing can sometimes lead to skin discoloration.

  4. Aging: As with many skin changes, age can play a role in the development of melanosis on the penis.

  5. Post-inflammatory Hyperpigmentation: Previous skin injuries, infections like ringworm, or inflammations like lichen planus can lead to pigmented patches as they heal. At times, penile melanosis may also arise over the site of circumcision.

  6. Drug reaction: Penile melanosis may be a side effect of therapies like anthralin or phototherapy. The pigmentation might also happen secondary to fixed drug eruption (a form of drug reaction) caused by tetracyclines, non-steroidal anti-inflammatory drugs (ibuprofen, naproxen), paracetamol, trimethoprim-sulfamethoxazole, etc.

  7. Skin diseases: At times, penile hypermelanosis may be a manifestation of underlying skin diseases like lichen planus, ringworm, lichen sclerosus et atrophicus, angiokeratoma, acanthosis nigricans, etc.

Symptoms

Typically, penile melanosis presents as:

  • Flat, darkened patches or spots.

  • Smooth and unchanged in texture compared to surrounding skin.

  • Non-painful and without other associated symptoms.

It’s essential to differentiate these benign spots from other potential skin issues or lesions that might require medical attention. In case of moles over your penis, you must keep monitoring these spots for any changes and consult a doctor if you notice any unusual or sudden alterations.


Diagnosis

If you're concerned about any spots or changes on your penis, always consult with a board-certified dermatologist. A dermatologist will typically do the following:

  1. Physical Examination: Evaluate the spots' appearance and characteristics.

  2. Dermoscopy: Use a specialized tool to look closely at the skin's pigmentation patterns.

  3. Skin Biopsy: In rare cases, a small sample might be taken to rule out other conditions.

Management

Penile melanosis is not a disease. As is the case with other parts of the body, people with darker skin tones will experience penile melanosis more than others. In most cases, counseling is the only management option. After all, it's a natural change in color.


However, if the color change deeply concerns you and affects you psychologically, you can discuss the treatment options with your dermatologist. Some dermatologists might suggest the following treatment options:

  1. Laser Therapy: Specific lasers can target and reduce pigmentation.

  2. Surgery: Surgical grafting for penile melanosis involves the removal of dark-pigmented areas on the penis and replacing them with healthy skin grafts from another part of the body. However, the procedure is not routinely carried out due to patient's unrealistic expectations and side effects like scarring, infection, or changes in skin color or texture.

However, these treatments can come with side effects, so always discuss potential risks and benefits with your dermatologist.


Prevention Tips

  • Maintain good genital hygiene.

  • Use gentle, non-irritating soaps.

  • Avoid excessive friction or rubbing.

Conclusion

Penile melanosis is a benign skin condition that doesn't typically pose any health risks. If your partner is suffering from this condition, assuage them and encourage them not to worry about it. An analogous condition that occurs in females is called vulvar melanosis. Any changes to the skin, especially in sensitive areas, can be concerning.


Always consult with a board-certified dermatologist for an accurate diagnosis and peace of mind. Your well-being, both physically and mentally, is paramount, so never hesitate to seek professional advice regarding any skin concerns.

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