What is balanitis?
Poor hygiene of the penis is one of the most common causes of balanitis. It can be treated with antibiotic cream and pills and usually clears up within three to five days of starting treatment.
Balanitis is a condition where a man’s glans penis, or head of the penis, becomes inflamed. Balanitis generally appears only in men or boys who are not circumcised and affects one in 30 uncircumcised males. Balanitis occurs when yeast and bacteria form in the folds of skin around the foreskin and develop into an infection. The infection then causes redness, swelling, and pain.
Uncircumcised men 45 and older may develop balanitis due to skin conditions, weight issues, diabetes, or sexual activity. Boys ages 4 and younger who are uncircumcised might develop balanitis if their genital areas are not adequately cleaned.
Balanitis generally is not a serious condition and can be treated with antibiotic creams and pills. Most occurrences of balanitis clear up within three to five days of starting treatment. Left untreated, however, it can become more painful or cause other health problems.
If you or your child is uncircumcised, it is essential to recognize the symptoms and causes of balanitis so that you can help prevent it.
Signs and symptoms of balanitis
There are many signs that you might have balanitis. You might experience:
- Swelling of the glans (the head of your penis)
- Pain in the glans and surrounding area
- Itching around the affected area
- An unnatural smell
- Sores on your glans penis
- Problems pulling back your foreskin
- Bleeding and cracking on your foreskin
Left untreated, balanitis can cause painful complications. You might experience a backflow of urine toward one of your kidneys due to a narrowing of the tube (the distal urethra) that carries urine out of your penis. You may also begin to retain urine or experience a lack of blood flow to your penis, both of which can cause pain and other health problems
Types of balanitis
Balanitis has three known types:
- The most common type of balanitis, Zoon’s generally affects middle-aged men who were not circumcised.
- This is the result of a type of arthritis and is characterized by sores, swelling, or redness on the head of your penis.
- Pseudoepitheliomatous keratotic and micaceous balanitis
- This is a rare type of balanitis that affects men over 60 and is identified by scaly warts that form on the glans.
Causes of balanitis
Poor hygiene is one of the most common causes of balanitis. The foreskin on uncircumcised men is a warm and damp area. If the skin is not washed correctly, yeast and bacteria may form between the layers of skin. These microorganisms can cause an infection, which leads to inflammation of the foreskin and glans.
You might also be at risk of developing balanitis if you:
Some prescription drugs can cause balanitis as a side effect, specifically medicines used to treat Type 2 diabetes.
When to see the doctor for balanitis
When it comes to your most sensitive areas, it helps to be cautious. If you experience any symptoms of balanitis, you might want to see your doctor immediately. If you see your doctor in the early stages of balanitis, they can help you eliminate it before it develops into a more painful problem.
A few other conditions cause symptoms similar to balanitis, so it can be difficult to diagnose. A trip to your doctor is the only way to know for sure that you have balanitis. Your doctor will conduct a physical exam and run some tests to determine if you have it, as well as noting the type and cause of it.
To figure out whether you have balanitis, your doctor will collect samples from any discharge, test you for STDs, and take blood samples to screen you for diabetes or other medical conditions that might be causing it.
Treatments for balanitis
To treat balanitis, your doctor will most likely prescribe antibiotics (as a pill or cream) or an antifungal lotion. If a skin condition or allergic reaction is causing balanitis, they might give you a steroid cream.
Sometimes, balanitis can continue coming back, which is known as recurring balanitis. As a last resort, your doctor might decide you need a circumcision to alleviate the condition.
Prevention is always better than treatment. If you’re uncircumcised, take extra care to thoroughly clean your genital area with mild soap and warm water. Make sure you dry the area completely. Work to make cleaning and drying your foreskin and penis a daily routine.
When having sex, use a condom, and wash thoroughly when you finish and make sure everything is dry. If you have any symptoms of balanitis, try not to engage in sexual activity. Adding the friction and fluid exchanges of sex can make the condition worse.
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Will circumcision get rid of balanitis?
If you have recurrent balanitis, your doctor may suggest circumcision as a treatment. Circumcision, which is the surgical removal of the foreskin, is a relatively simple procedure. It is effective at preventing future episodes of the swelling and inflammation associated with balanitis.
Balanitis is a painful inflammation of the head of the penis. It’s usually a symptom of some other problem, such as an infection or allergic reaction. Pain, swelling, and discoloration around the glans of the penis are the main signs. Balanitis is more common in people who have an intact foreskin.
Symptoms of balanitis include:
- Redness, swelling, and itching
- Bleeding around foreskin
- Difficulty pulling back the foreskin
- Foul smell
- Pain when urinating
- Shiny or white appearance of the skin on the glans
- Sores on the glans
- White discharge under the foreskin
Causes of balanitis
Inadequate hygiene is often the reason for balanitis. The area under the foreskin of an uncircumcised penis can trap bacteria or fungi. These microorganisms begin to flourish there if the area isn’t cleaned thoroughly. That leads to skin irritation and pain.
Other causes of balanitis include:
Children and teens who don’t take the time to carefully clean under their foreskin and around the glans are the most at-risk for balanitis. Older adults, people with disabilities, and babies who rely on other people to clean them can also be at higher risk if their caregivers neglect proper hygiene.
In some cases, a tight foreskin that is difficult to retract complicates cleansing the penis. This is called phimosis, and it’s common in babies and toddlers. It can occur in older children and adults as well. Sometimes, it happens as a result of scarring or other damage to the foreskin and penis.
If you have balanitis, your doctor needs to figure out the cause so they can treat it. They will do a physical examination and ask questions about your health, sexual history, and possible allergies. Once they know what is causing the pain and swelling, they will prescribe appropriate medicine.
If medicine doesn’t clear the problem up, or if balanitis comes back repeatedly, your doctor might suggest circumcision. Removing the foreskin reduces the risk of dirt and microorganisms being trapped under the skin of the penis. This, in turn, reduces the risk of infection or irritation.
Circumcision for balanitis
Circumcision is the surgical removal of the foreskin. It’s most commonly performed on infants for religious or cultural reasons. It can be done on older children or adults as well.
The procedure for circumcision is usually performed as outpatient surgery, so you can go home the same day. Discuss your options for anesthesia with your doctor. They can use local anesthesia so that you are awake for the circumcision, but you may prefer sedation or general anesthesia, so ask your doctor if that is an option for you.
The procedure itself is straightforward. Your doctor will remove the foreskin and use dissolvable stitches to close the wound. You’ll go home with compression bandages to keep the wound clean. Your doctor will tell you what medicines you can use for pain relief.
You will need to restrict activities for about ten days after the circumcision. You will need to care for your penis by keeping the incision site clean. Your doctor may suggest using petroleum jelly to protect the incision. You will need to refrain from sexual activity, including masturbation, for about six weeks.
The risks of circumcision include bleeding, infection of the incision, and a need for a repeat procedure to remove additional skin.
Circumcision is effective for preventing most future cases of balanitis, as, in general, balanitis is far less common in people who don’t have a foreskin. There are cases of balanitis after circumcision, however. You will need to continue to use good hygiene after the procedure. You should also avoid potential allergens and practice safe sex to reduce the risk of sexually transmitted infections.
If you have questions about balanitis or circumcision, you can talk to your doctor. They will help you choose the right treatment.
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Medically Reviewed on 2/25/2022
American Family Physician: “Adult Circumcision.”
Harvard Medical School: “Balanitis.”
International Journal of Preventive Medicine: “Penile Inflammatory Skin Disorders and the Preventive Role of Circumcision.”
National Health Service: “Balanitis.”
National Health Service: “Circumcision in men.”
New Jersey Urology: “WHAT TO EXPECT AFTER ADULT CIRCUMCISION.”
Wray, A., Velasquez, J., Khetarpal, S. Balanitis, StatPearls Publishing LLC, 2020.