Balanitis

Balanitis is one of the most common skin conditions that affects the penis. Many males develop balanitis at some point in their lives, so it’s important to be aware of the symptoms, causes, and treatments of the condition. Recognizing the signs of balanitis and seeking treatment right away will reduce your risk of pain, discomfort, and complications.

What Is Balanitis?

Balanitis is the swelling and inflammation of the foreskin or the head of the penis. It can be uncomfortable, but it’s not usually a serious medical concern. Most cases clear up easily with treatment, which includes topical medication and hygiene changes.

Balanitis

Causes

Balanitis can be caused by a number of different problems, but it usually results from a skin infection or other irritation. The most common cause of balanitis is infection with Candida albicans, a species of yeast that causes thrush.

In many cases, improper hygiene causes irritation, which can eventually lead to balanitis. Not washing enough, washing too much, not properly rinsing, and using scented soap can all irritate the skin on the penis. Skin conditions that cause dryness or inflammation, including eczema, psoriasis, and dermatitis, can all lead to balanitis, too.

Some medications may cause balanitis as a side effect. These include certain antibiotics, sleeping pills, laxatives, and painkillers. Untreated diabetes also can result in skin problems that affect the entire body, including the penis. Sexually transmitted infections like gonorrhea, trichomoniasis, chlamydia, and syphilis can increase the risk of developing balanitis as well.

Facts and Statistics

  • Balanitis affects about 1 in every 30 uncircumcised males at some point in their lives.
  • Uncircumcised men and boys under the age of four have the greatest risk, but the condition can affect all males of any age.
  • Balanitis is not a STD, but it can be a symptom of one.
  • In most cases, balanitis goes away within three to five days of treatment.
  • Balanitis is particularly common in people with diabetes. One study found that 35 percent of uncircumcised males with diabetes mellitus had been diagnosed with balanitis at some point.
  • Untreated balanitis can increase the risk of penile cancer, but penile cancer is still very rare.
  • Balanitis should not be confused with balanitis xerotica obliterans, a condition that causes scar tissue to form in the foreskin. Some of the symptoms are similar, but the causes and treatments are different.

Signs and Symptoms

Symptoms of Balanitis

The main symptom of balanitis is the swelling or irritation of the foreskin or head of the penis. The irritation often looks like small red dots or plaques, but in severe cases, the inflammation can cause tiny breaks in the skin that are extremely sensitive to the touch. Other common symptoms include the following:

  • Itching
  • Tightened foreskin
  • Painful urination
  • Discharge under the foreskin
  • Unpleasant smell

Types of Balanitis

There are three main types of balanitis. The most common is Zoon balanitis, which is the inflammation of the head and foreskin of the penis. This typically affects middle-aged and older men who are uncircumcised.

Pseudoepitheliomatous keratotic and micaceous balanitis causes more severe inflammation with scales and skin lesions.

The third type is circinate balanitis, which results from reactive arthritis, a form of arthritis triggered by an infection. Not everyone with reactive arthritis will develop balanitis, but it’s a common symptom of the disease.

Diagnosis

In most cases, a general practitioner can diagnose balanitis with a visual exam. The redness and irritation is often very noticeable, so diagnosis of balanitis is usually easy. Because balanitis has many causes, doctors also usually try to figure out the source of the irritation.

Diagnosis of Balanitis

If there is discharge, the doctor may use a cotton swab to take a sample and test it for bacteria or fungus, which may help them diagnose the cause of the inflammation. If the doctor suspects diabetes, they may order a urine test or blood test. If a general practitioner isn’t sure what’s causing the balanitis, they may refer the patient to a dermatologist or urologist.

If the doctor suspects that the balanitis is caused by a chronic skin condition, they may perform a biopsy, which involves removing a small amount of tissue from the penis and examining it for diseases. This procedure is done under local anesthetic.

Treatment

Balanitis is usually easy to treat, but it won’t go away on its own. The best treatment for balanitis depends on the cause. If the inflammation is caused by an allergic reaction, a mild steroid cream may help. If a bacterial or fungal infection is responsible for the irritation, antifungal or antibiotic medications may be best.

Treatment for Balanitis

Your doctor will probably recommend that you discontinue the use of scented soaps, lotions, and other products as they may be causing or worsening the irritation. Warm water is best for cleaning the area. If itching is severe, your doctor may also prescribe an anti-itch cream.

Some people are more predisposed to balanitis than others. If the condition keeps coming back despite repeated attempts to treat it, your doctor may recommend circumcision. Another option is for a doctor to surgically create a slit along the top of the foreskin, which will lower the risk of infection and inflammation.

Home Remedies

It’s unlikely that home remedies will cure balanitis, but they can reduce symptoms and lower the risk of the irritation returning. The best home remedy for balanitis is good hygiene. Avoiding harsh, scented soaps and instead using warm water to clean the penis will prevent the irritation from getting worse. Drying the penis and foreskin gently immediately after washing can help, too.

One popular home remedy is a mixture of Burow’s solution and diluted vinegar, which can relieve irritation, itching, and stinging. Soak a cloth in this solution to create a compress, and gently apply it to the irritated area. Aloe vera gel can also be very soothing on inflamed and irritated skin.

Even if you find that home remedies help with symptom management, you should still visit a doctor if you think you have balanitis. A doctor can provide stronger and more effective treatments and can determine the cause of the irritation, so you can prevent it from recurring.

Outlook

Balanitis is usually short-term and easy to treat, but the outlook can vary depending on the severity of the inflammation. If you seek treatment right away, the symptoms can clear up within a few days. If it goes untreated for a long time, though, it may be more difficult to get the irritation under control.

In most cases, balanitis is a one-time issue. However, some people do experience recurring balanitis. If the irritation keeps returning, you may need to undergo a more drastic treatment, such as circumcision.

Complications

With the proper treatment, balanitis typically clears up without complications. The earlier you seek treatment, the better the outlook will be. More severe cases of balanitis may lead to the following:

  • Scarring of the skin on the penis
  • Painful retracting of the foreskin
  • Lack of blood supply to the penis
  • Long-lasting pain
  • Difficulty urinating

Some people with chronic, long-lasting balanitis develop phimosis, which is the inability of the foreskin to retract. If this happens, circumcision or a surgery to cut a slit in the top of the foreskin are usually the best treatment options.

Prevention

Because balanitis sometimes results from other medical conditions, it’s not always preventable. However, you can reduce your chances of developing balanitis by practicing good hygiene. Daily washing of the penis with warm water is the best way to prevent inflammation. Soap should be avoided as it can cause dryness and irritation. After washing, dry the area completely.

If you have sensitive skin, you should use a non-biological washing powder for your underwear, which will reduce the risk of skin irritation. Condoms made for sensitive skin can also help lower your chances of getting balanitis.

FAQs

How do I know if I have balanitis?

The most common symptoms of balanitis are redness, swelling, and irritation on the foreskin or the head of the penis. You may also see a thick discharge or experience pain while urinating. However, the best way to know if you have balanitis is to speak to your doctor. They’ll be able to tell for sure, and they can try to determine the cause of the inflammation as well.

Is balanitis an STD?

Balanitis is not an STD. Some people develop balanitis after sex from a reaction to the condom or lubricant, but the condition is not caused by the sexual contact itself. Balanitis can be a symptom of an STD, though, like syphilis, chlamydia, or gonorrhea.

Should I be worried if I have balanitis?

As long as you get treatment, you shouldn’t be worried. Many people experience balanitis at some point in their lives, and the condition almost always clears up with treatment and doesn’t cause any lasting problems.

If I have balanitis, can I have sex?

If the inflammation is caused by skin irritation, it is safe to have sex. You may experience pain during sex, though, and you should be careful to practice good hygiene before and after sex. If the balanitis is caused by a fungal or bacterial infection, you should avoid having sex until the infection clears up.

Can I get balanitis if I’m circumcised?

It’s very unlikely that a circumcised person would develop balanitis, but it is possible. The condition occurs more commonly in uncircumcised males because the foreskin increases the chances of irritation and infection.

Is balanitis contagious?

Depending on the cause, balanitis may or may not be contagious. When the condition is caused by irritation from soap or chemicals, it’s usually not contagious. When it’s caused by a bacteria or fungus, it may be possible to transfer the infection to another person.

Dr. Jack Johnson, MD