Balanitis is an inflammation of the glans, or the head, of the penis, due to infection or another cause. Balanitis can be uncomfortable and sometimes painful, but it is not usually serious. It can be relieved with topical medication.
It is a common condition, affecting approximately 1 in every 25 boys and 1 in 30 uncircumcised males at some time in their life. Boys under the age of 4 years and uncircumcised men are at the highest risk, but it can happen at any age.
It is more likely if there is phimosis, a condition where the foreskin of the penis is too tight. When boys reach the age of 5 years, the foreskin becomes easy to retract, and the risk of balanitis falls.
Women can also have balanitis, as the term is used to describe an inflammation of the clitoris. However, this article will focus on the glans of the penis.
Treatment for balanitis depends on the cause. In most cases, the doctor will advise on what substances to avoid, and give the patient information on hygiene.
Antifungal creams can treat balanitis caused by Candida.
If the inflammation appears to be due to an allergic reaction or irritant, the doctor may prescribe a mild steroid cream, such as one percent hydrocortisone, for the swelling.
An antifungal or antibiotic medication may also be prescribed. These may be available over-the-counter, or can be purchased online.
If there is an infection, the patient should not use a steroid cream on its own.
All soaps and other potential irritants should be avoided during treatment, and until signs and symptoms have completely gone.
Candida is a yeast infection. The doctor will prescribe an antifungal cream, such as clotrimazole or miconazole. The patient’s sex partner should also be treated. While treatment is underway, he should either abstain from sex or use a condom.
If there is a bacterial infection, the doctor will prescribe an antibiotic, such as erythromycin or penicillin.
If there is no infection and no irritant has been identified, the patient may be referred to a dermatologist, who specializes in skin conditions, or a genitourinary clinic.
If the patient has a tight foreskin and the balanitis keeps coming back, the doctor might suggest circumcision.
Alternatively, a slit may be cut along the top of the foreskin to separate it from the penis.
A sitz bath may help to manage symptoms, as the warm water can reduce discomfort.
Balanitis is easy to treat, but complications can occur in some cases.
These may include:
Scarring of the opening of the penis
Inadequate blood supply to the penis
Retracting the foreskin is painful
A foreskin that does not retract can be the result of long-term, untreated balanitis.
The earlier treatment is sought, the better the outlook will be.
Signs and symptoms of balanitis include:
Tight, shiny skin on the glans
Redness around the glans
Inflammation, soreness, itchiness, or irritation of the glans
A thick, lumpy discharge under the foreskin
An unpleasant smell
Tight foreskin that cannot be pulled back
Swollen glands near the penis
Sores on the glans
Soreness, irritation, and discharge may occur under the foreskin 2 to 3 days after sexual intercourse.
Some of the signs and symptoms of balanitis are similar to those of an STI or thrush.
Types of balanitis
There are three types of balanitis:
Zoon’s balanitis: inflammation of the head of the penis and the foreskin. Usually affects middle-aged to older men who have not been circumcised.
Circinate balanitis: normally occurs as a result of reactive arthritis.