Sprucing up where the sun don’t shine

Man’s total anno-genital rejuvenation

Let’s face it, when the boxer-briefs are off, who doesn’t want to look their best? Well, there are a number of great procedures to make your member stand out. Lets break it down to categories:

  1. Can’t see the member?
    1. If you have a large abdominal flap that hangs over and prevents you from seeing your genitals, consider liposuction or a mini tummy tuck to remove the excess skin. With liposuction, the fat is suctioned out through small incisions and the area heals over a few months. If there is an excess skin issue, the can be removed by a mini abdominoplasty, which will take longer to heal than liposuction alone.
  2. Extending penile length
    1. There are two major techniques in penile length enhancement. The first is liposuction of the fat pad (or happy pillow, aka, FUPA) above the penis. This makes a grower into a shower. The procedure is done under local anesthesia, and takes less than one hour to do. The results can take a few months to fully show. The cost is $2500. The Second method is cutting the suspensory ligament of the penis. The problem with this is that most studies find patients who have the latter procedure have less sex after the procedure, even though the penis is longer.
  3. Penis girth
    1. The thickness of the penis can be enhanced with ones’ own fat. In fact, a combination of liposuction of fat from the FUPA and transfer into the penis gives more length and thickness to the penis.
  4. Too little pubic hair
    1. Hair can be transplanted with Follicular Unit Extraction (FUE), where individual hair grafts are harvested from similar looking hairs and transplanted in a natural looking pattern into the area without hair. This procedure is not only used for the scalp. It can be used for the pubic area, the buttocks, the peri-anal skin, and the happy trail.
  5. Too much pubic hair
    1. You can get rid of dark hairs in the pubic area with laser technology. You can design the perfect permanent outline. The process takes numerous sessions, The pain is like a rubber band sting. If you have grey hairs, the laser does not work. Electrolysis is an alternative for grey hairs.
  6. The skin color is different
    1. If an area is darker than the surrounding area, show it to your dermatologist.

If it is a benign process, there are numerous ways of reducing the darkness.  Anal bleaching has gained popularity in recent years. Anal bleaching has garnered mainstream media attention with adult film stars and erotic entertainers visiting Dr. 90210 to lighten this particular area of the body which may be exposed during the course of their workday. Even gay icon Margaret Cho went side-by-side anal bleaching with one of her best gays on her reality television show, The Cho Show. An L.A. area salon seems to have pioneered this phenomenon a few years ago. With the popularity of total waxing of the genital region, clients were discovering areas of darker pigmentation, especially around the anus that were otherwise camouflaged by hair. Apparently, hundreds of clients have used their services with about one third being men. Although many people routinely bleach their teeth or hair, when it comes to bleaching the delicate skin of the anal area it is important to understand the causes of skin darkening and the medical and safety concerns associated with the procedure. So, let’s explore the ins and outs of anal bleaching…  Causes of darkening:  Skin darkening around the outer anus can be due to at least two main causes: increase in pigment or thickening of irritated skin. In order to have effective treatment, i.e., lightening, the diagnosis must be determined. Increased pigment can be due to prior irritation or genetics. Thickening of skin, i.e.,  lichenification, may present as darkening, however it is truly increase in thickness of the top layer of the skin (epidermis). This irritation can be caused by many factors, including irritation from lack of hygiene, excessive rubbing of the area, chronic itch of the anus, pin worms, food allergy, over-aggressive anal sex, skin allergy to items coming in contact with the area. There are a number of preparations for anal bleaching. After your physician has ruled out irritation causing anal skin darkening, I recommend the following treatments. Here are the main treatments, from mild to deep:

Creams that lighten:

  1. Hydroquinone (HQ) 2% HQ is readily available over the counter in various cosmetic preparations. Evidence of improvement with HQ alone is usually observed at 4-6 weeks, with improvement appearing to plateau at approximately 4 months. For better efficacy, HQ is also compounded into various mixtures for the treatment of hyperpigmentation. Tri-Luma is a popular, prescription skin-lightening agent that combines 4% HQ, a mild topical steroid and retinoid in a cream formulation.  Although it is not FDA approved for use in the anal skin area, under close physician supervision, it is safe and effective.
  2. Azelaic acid A naturally occurring acid, it has been formulated in topical preparations used to lighten skin. It is safer than hydroquinones and hydrocortisones.
  3. Kojic acid Kojic acid lightens skin and is safe in the anal area. It is usually mixed with a combination of the above two products. It can, however, cause irritation when used over a long period of time.

Procedures that cause anal bleaching:

Application of up to 20% hydroquinone and glycolic acid: I do not recommend this because there is a concern with hydroquinone cancer-causing potential at does this high.

  1. Glycolic, salicylic or trichloroacetic acid (TCA) peel. These are very effective in lightening; however they are met with at least a week of irritation and redness, followed by a pink regrowth of skin. This should be only be performed by a licensed medical provider such as a physician or nurse practitioner.
  2. Light based skin lightening:
    1. Intense pulsed light (IPL) is an effective device to lighten skin. The procedure is widely-available and takes about 15 minutes and usually requires about 4 to 6 treatments. There is some discomfort involved as the procedure feels like getting snapped with a rubber band. The area may blister or scale for several days.
    2. For deeper pigment around the anus, a Q-switched Alex laser, which is used for tattoo removal can address the deeper pigment. This  may be painful and needs topical and/or injected local anesthetic.
  • Skin resurfacing lasers, like fractionated Er-YAG or CO2 lasers. These require local anesthesia and the recovery is up to 2 weeks.

My best advice in seeking anal bleaching is to find a medical provider with whom you are comfortable discussing this issue and approach it cautiously and safely with clinically-proven treatments and procedures.


  1. If the area has less pigment than the surrounding area. The area can be darkened with phototherapy (narrow band-UVB) or if the area is devoid of pigment cells, micro-pigmentation can be used to match the surrounding skin. Yes, a tattoo to make the skin look like the surrounding skin!
  1. Skin tags
    1. Skin tags are polyps in the folds of the groin. They can age the groin and they are easy to remove in the office.


  1. Wrinkly scrotum
    1. You can iron out your junk like George Clooney. He has a laser treatment to tighten the skin. Others use Botox® to smooth out the muscles of the scrotum giving a smooth and low hanging look.


  1. Bent Penis
    1. Its called Peyronie’s disease and develops with scar formation on one side of the penis, creating a curvature and pain during sex. Surgery can remove the scar tissue but risks nerve damage and loss of sexual function. Injection of cortisone or Platelet Rich Plasma (PRP), where your own blood products are used to inject into the curvature and restoring function and looks. PRP is also used to enhance sexual sensation and some call it the “priapus shot”.

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