What is the reason for the black spots on the glans?

Dark spots on the glans may be related to factors such as pigmentation, trauma, inflammation, melanoma, fixed drug eruption, etc. The diagnosis can be confirmed through dermoscopy, pathological biopsy, etc.

1. Pigmentation

Localized melanin deposition on the glans penis may cause dark spots and is often related to genetics, changes in hormone levels, or chronic frictional irritation. It appears as brown or black patches with clear borders, which are painless and itchy. It is necessary to avoid excessive cleaning or mechanical stimulation on a daily basis. If necessary, laser treatment can be used to improve the appearance.

2. Pigmentation after trauma

Post-inflammatory pigmentation may occur after healing of trauma to the glans, often after impaction, surgery, or instrumentation. Dark spots are often irregular in shape and may be slightly uneven. Generally, no special treatment is required, and most symptoms will fade over time. In severe cases, topical hydroquinone cream can be used as an auxiliary treatment.

3. Chronic inflammation

Repeated balanitis may cause local pigment metabolism abnormalities, such as when fungal balanitis does not heal for a long time. It is characterized by dark spots surrounded by erythema, scaling, or discharge. The primary disease needs to be treated, such as using clotrimazole cream as an antifungal agent, and mupirocin ointment can be combined with bacterial infection.

4. Melanoma

Malignant melanoma appears as rapidly enlarging asymmetric dark spots with irregular edges and uneven color, which may be accompanied by bleeding or ulceration. It needs to be confirmed by dermoscopy and pathology. In the early stage, extended resection is possible. In the late stage, it needs to be combined with immunotherapy such as interferon α2b injection.

5. Fixed drug eruption

Allergy to sulfonamides or antipyretic and analgesic drugs may cause repeated purple-black patches on the glans, leaving behind pigmentation after stopping the drug. It is characterized by round dark red spots with blisters, which will eventually form persistent dark spots. Allergenic drugs need to be stopped immediately, and loratadine tablets can be taken orally to relieve symptoms in the acute stage.

The perineum should be kept clean and dry on a daily basis and avoid using irritating lotions. Wear loose cotton underwear to reduce friction and observe whether the dark spots appear to increase, rupture, or other changes. If it is accompanied by itching, pain or morphological changes, you must promptly go to a dermatology or urology department, and perform histopathological examination to rule out malignant lesions if necessary.