Balanitis is an inflammation of the glans penis, also known as the head, which can additionally involve the foreskin in balanoposthitis. There are a number of causes for balanitis, ranging from infection with Candida albicans to irritation caused by laundry soaps. This condition can be diagnosed by a dermatologist or general practitioner with a quick examination of the involved area, although to recommend the best treatment, the doctor will usually need to take a small biopsy sample for examination to determine what is causing the inflammation.
Patients with this condition develop redness and swelling, and may experience foul smelling discharges or pain. In cases of severe swelling, it may become impossible to retract the foreskin. The most common risk factor for developing balanitis is poor hygiene, especially in uncircumcised men, although some studies suggest that washing too much can also lead to inflammation. Men with diabetes are also at increased risk of developing this condition, along with other types of dermatological infections and inflammations.
If the balanitis is caused by a bacterial or fungal colonization, a doctor can provide drugs, usually in the form of a topical cream, to treat the condition. In cases where balanitis is caused by environmental exposure to irritating soaps or rough fabrics, a recommendation to change soaps or use different underpants may be recommended. Anti-inflammatory drugs may also be offered to bring down the pain and swelling.
For an uncircumcised man with a severe case of balanitis, or a case of balanitis which keeps returning, a doctor may recommend circumcision to remove the foreskin. This will ease the pain and swelling during an ongoing inflammation, and reduce the risk of developing an inflammation in the future.
Men can greatly reduce their risks of developing balanitis by observing proper hygiene, taking care to fully wash the glans penis, retracting the foreskin in the case of uncircumcised men, on a regular basis. Balanitis can also develop in infants and boys, making it important for parents to clean properly during diaper changes, and to teach young boys proper hygiene as they develop independence. Young boys and adult males alike should always seek medical attention for inflammation around the glans penis, as it may be a sign of an underlying medical problem which needs to be addressed.
The incubation period varies from 3 days to 1 week. The first signs of involvement may be small red erosions on the glans or undersurface of the prepuce, with concomitant development of much preputial exudation; the purulent discharge may be accompanied by phimosis. If the disease is unchecked, confluent ulcerations will develop along with considerable edema of the penis.
If you or your child has balanitis, the recommended treatment will depend on what is causing your condition. See balanitis – causes for more information.
Treatments for some of the most common causes of balanitis are outlined below.
If your balanitis is the result of skin irritation that is caused by poor hygiene or exposure to a substance that has irritated your penis, you will usually be prescribed a topical corticosteroid (steroid cream or ointment).
Apply the cream to the head of your penis once or twice a day until your symptoms have gone. Do not use the medication for more than 14 days in a row because this could lead to side effects, such as itchy skin and a skin rash.
It is important to avoid using soaps and other potential irritants while symptoms are present (see below). Also make sure that the head of your penis and your foreskin do not come into contact with urine after you urinate.
If you have balanitis, urine is the most important irritant to keep away from the skin of your penis. Other irritants to avoid include:
soap and shower gel
bubble baths
baby wipes
lubricants
antiseptics
hygiene sprays
If your balanitis is the result of a fungal infection, you will be prescribed either an antifungal cream, such as imidazole, or an oral antifungal medication (tablet or capsule), such as fluconazole. Fluconazole is not recommended for children who are under 16 years old. It can also cause side effects. The most common ones are:
headache
skin rash
nausea (feeling sick)
vomiting (being sick)
abdominal pain
diarrhoea
If your symptoms are particularly troublesome, you may also be prescribed a seven-day course of a topical corticosteroid, usually in the form of a cream or ointment.
If your balanitis is the result of a bacterial infection, you will be prescribed a seven-day course of oral antibiotics (antibiotic tablets or capsules).
An antibiotic called amoxicillin is usually recommended. However, if you are allergic to penicillin, erythromycin or clarithromycin may be prescribed.
Again, if your symptoms are particularly troublesome, you may also be prescribed a seven-day course of a topical corticosteroid.
All of the treatments listed above should start working in seven days. Contact your GP if your symptoms do not improve after this time because you may require an alternative treatment.
If your balanitis is not caused by an infection and your GP cannot identify anything that is irritating your penis, you may be referred to a dermatologist (skin specialist) or genito-urinary (GUM) clinic for further investigation.
If you have phimosis (a tight foreskin) and you have repeat episodes of balanitis, circumcision may be viewed as an option.