The name makes it hard to know what it is, but balanitis is a very common condition among male children and adult men1. Despite being uncomfortable, it does not cause more serious harm and can be treated with topical medication.

What Is Balanitis?

Balanitis is an inflammation of the glans, or the head, of the penis, due to infection or other causes. Balanitis can be uncomfortable and sometimes painful, but it is usually not serious. It is a common condition, affecting approximately 1 in every 25 boys and 1 in 30 uncircumcised men at some point in their lives. Boys under 4 years old and uncircumcised men are at higher risk, but it can happen at any age. It may also be more frequent in individuals who have phimosis (a condition where the penile foreskin is too tight)2. When boys reach age 5, the foreskin becomes easy to retract and the risk of balanitis decreases significantly.

Types of Balanitis

Although balanitis is an inflammation and looks similar, the types are different: Zoon’s Balanitis – Inflammation of the head of the penis and the foreskin. It usually affects middle-aged and older men who have not been circumcised. Circinate Balanitis – Usually occurs as a result of reactive arthritis. Micaceous and Keratotic Pseudoepitheliomatous Balanitis of Civatte – Characterized by scaly, wart-like skin lesions on the head of the penis.

Causes of Balanitis

The most common cause is infection by Candida albicans. Candida is the fungus that causes thrush. Other infections that can cause balanitis include:

  • Bacteria: these can multiply rapidly in the moist and warm conditions under the foreskin
  • Sexually transmitted infections (STIs): Examples include Herpes simplex virus, Chlamydia, and syphilis.
  • Skin conditions can also trigger the condition.

Examples include:

  • Lichen planus – a skin disease with small, itchy, pink or purple patches on the arms or legs
  • Eczema – a chronic or long-term skin condition that can cause itching, redness, cracked or dry skin
  • Psoriasis – a disorder of dry and scaly skin
  • Dermatitis – inflammation of the skin due to direct contact with an irritant or an allergic reaction
  • In very rare cases, balanitis has been associated with skin cancer.
  • Irritation – Irritation of the skin of the glans can lead to inflammation.

And include:

  • Chemicals used in condoms, lubricants, and spermicides
  • Detergents or laundry soap and fabric softeners that are not completely rinsed out
  • Scented soaps and bath salts
  • Diabetes: Increases the risk of infections, especially if blood sugar levels are poorly controlled. If glucose is present in urine, some may remain under the foreskin. Glucose helps bacteria multiply faster.
  • Phimosis: This is when the foreskin is too tight, making it difficult or impossible to retract it, or pull it back, completely over the glans. Sweat, urine and other substances can accumulate under the foreskin, causing irritation and allowing germs to multiply. Phimosis is uncommon in teenage and adult men. Symptoms

Symptoms of Balanitis

Signs and symptoms of balanitis include:

  • Tight and shiny skin on the glans
  • Redness around the glans
  • Inflammation, pain, itching, or irritation of the glans
  • Thick and pungent discharge under the foreskin
  • Unpleasant odor
  • Tight foreskin that cannot be pulled back
  • Pain when urinating
  • Swollen glands near the penis
  • Sores on the glans

For men who are sexually active, pain, irritation, and discharge under the foreskin may often occur 2 to 3 days after sexual intercourse. Some of the signs and symptoms of balanitis are similar to those of an STI.

How Is the Diagnosis Made?

Balanitis can be diagnosed by a clinical examination. The doctor will observe the redness and inflammation of the glans. They might examine the skin for any dermatosis or skin disease that could involve the genital area. If the balanitis doesn’t resolve after avoiding potential irritants, practicing good hygiene, or treatment for a fungal infection, the doctor may order diagnostic tests. Possible tests include:

  • Swab test of the glans, for laboratory detection of infection
  • Urine test, if diabetes is suspected
  • A blood test to determine glucose levels
  • Rarely, a biopsy may be performed, in which a sample of the inflamed skin is taken and sent to the laboratory for testing.

Treatment of Balanitis

Balanitis treatment depends on the cause. In most cases, the doctor will advise which substances to avoid and provide the patient with hygiene information. Allergic reaction – Antifungal creams can treat balanitis caused by Candida. If the inflammation appears to be due to an allergic or irritant reaction, the doctor may prescribe a mild steroid cream, such as 1% hydrocortisone, for swelling. An antifungal or antibiotic medication may also be prescribed. If there’s an infection, the patient should not use a steroid cream on their own. All soaps and other potential irritants should be avoided during treatment, and until signs and symptoms have fully disappeared. Candida – Candida is a fungal infection3. The doctor will prescribe an antifungal cream. The patient’s sexual partner should also receive treatment. While treatment is ongoing, the patient should abstain from sex. Bacterial infection – If there is a bacterial infection, the doctor will prescribe an antibiotic. If there is no infection and no irritant is identified, the patient may be referred to a dermatologist, a skin condition specialist, or a urologist.

Are There Any Home Treatments?

There are no real home remedies for balanitis besides good hygiene:

  • Clean the penis every day.
  • Do not use soap or bath salts or anything that might act as an irritant.
  • After urinating, gently dry under the foreskin.
  • Instead of regular soap, it’s better to use an intimate soap.
  • A sitz bath can help manage symptoms, as warm water can reduce discomfort.

Washing and carefully drying the penis every day so that moisture does not remain under the foreskin helps reduce the risk, although excessive genital washing with soap can worsen the condition. Unprotected sex, poor hygiene, and urinary catheters also increase the risk. A woman with vaginal problems can infect a man, increasing the risk of developing balanitis.

How Can Balanitis Be Prevented?

To prevent infections, the head of the penis and the foreskin must be kept clean and dry. Daily washing, with special attention to cleaning the penis, is essential. Here are some hygiene tips:

  • The foreskin should be retracted so the glans is exposed.
  • The area should be washed carefully and gently with warm water. Soap can irritate, so it should be avoided.
  • An intimate or another mild liquid soap can be used, but it should be rinsed off completely.
  • Before pulling the foreskin back in place, the glans should be completely dry.
  • Men who tend to develop balanitis after sex should wash the penis after finishing their sexual activity.

Avoiding Irritations

If symptoms seem to be linked to substances in condoms or lubricants, there are condoms available for sensitive skin. Men who work with chemicals or have traces of potential irritants on their hands should wash them before using the bathroom. See Also: Vaginal Synechia – How Do I Know if My Daughter Has It? Photos: derneuemann