What's wrong with the itchy red spots on the glans?

Patient's question:

[Condition Description: There are red bumps and spots on the head of the penis with a bit of itching, but my foreskin is a bit long. Another issue is that during sex at night, the first time is short, but the second time is normal. Why is this? I hope for a detailed explanation. Thank you.
History of Treatment and Effect: No treatment has been administered!
What kind of help do you want: Medication or topical medication?]

Doctor's answer:

Considering it may be symptoms of balanitis, balanitis requires treatment based on the underlying cause. The basic principles of Western medicine for treating balanitis are anti-inflammatory and antibacterial, with both internal and external treatments.
1. Symptomatic treatment: Keep the affected area clean and avoid various irritants. Those with excessive foreskin should undergo circumcision.
2. Local treatment: If the affected area shows erosion, exudation, or purulent discharge, medication or ointment can be applied to alleviate symptoms.
3. Etiological treatment: If the cause is identified, corresponding medication should be administered. For example, for candidal balanitis, topical treatments such as nystatin cream, clotrimazole, econazole, or miconazole cream can be used, or oral antifungal drugs may be prescribed. For trichomoniasis balanitis, metronidazole, tinidazole, or griseofulvin can be selected. For amoebic balanitis, emetine, metronidazole, or tinidazole should be given. If the partner also has candidal or trichomonal vaginitis, both should receive treatment simultaneously.

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