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Balanitis – Causes, Symptoms and Treatment

Balanitis is an inflammation of the glans penis. It can be caused by infections, skin irritation, or underlying conditions and is generally well treatable.

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Things worth knowing about "Balanitis"

Balanitis is an inflammation of the glans penis. It can be caused by infections, skin irritation, or underlying conditions and is generally well treatable.

What is Balanitis?

Balanitis is an inflammation of the glans penis (the rounded tip of the penis). When the foreskin (prepuce) is also affected, the condition is referred to as balanoposthitis. It can affect males of all ages but is more common in uncircumcised men and boys.

Causes

Balanitis can be triggered by a variety of factors:

Infections: Fungal infections (most commonly Candida albicans), bacterial infections, or sexually transmitted infections such as chlamydia or gonorrhoea.
Skin irritation: Poor hygiene, excessive washing, soap residue, condoms, or lubricants that cause irritation.
Skin conditions: Psoriasis, lichen sclerosus, eczema, or contact dermatitis.
Underlying medical conditions: Diabetes mellitus significantly increases the risk, as glucose in the urine promotes the growth of fungi and bacteria.
Phimosis: A tight foreskin that makes thorough cleaning difficult can predispose to inflammation.

Symptoms

Common symptoms of balanitis include:

Redness, swelling, and warmth of the glans
Itching or burning sensation
Pain, especially during urination or sexual intercourse
Unpleasant odour
White or yellow discharge under the foreskin
Skin changes such as flaking or small blisters

Diagnosis

Diagnosis is typically made through a physical examination. To identify the underlying cause, the following investigations may be performed:

Swab of the affected area for microbiological analysis
Blood glucose testing to rule out or confirm diabetes mellitus
Urine analysis
In recurrent or unclear cases: skin biopsy to exclude conditions such as lichen sclerosus

Treatment

Treatment depends on the underlying cause:

Fungal infection: Antifungal creams (e.g., clotrimazole) or oral antifungals (e.g., fluconazole).
Bacterial infection: Antibiotic creams or oral antibiotics depending on the causative organism.
Skin conditions: Topical corticosteroid creams to reduce inflammation and itching.
Hygiene measures: Gentle daily washing with lukewarm water, avoiding harsh soaps and irritants.
Diabetes management: Good blood sugar control significantly reduces the risk of recurrence.
Surgical intervention: In cases of chronic recurrent balanitis or phimosis, circumcision may be recommended.

When to See a Doctor

Medical advice should be sought if symptoms persist for more than a few days, worsen, do not improve with self-care, or are accompanied by fever or severe pain. A medical consultation is also necessary if a sexually transmitted infection is suspected.

References

Edwards S. et al. - 2014 European guideline on the management of balanoposthitis. International Journal of STD & AIDS, 2014; 25(9): 615-626.
Fahmy M. - Disorders of the Scrotum and Penis. In: Clinical Pediatric Urology. Springer, 2017.
NHS - Balanitis. www.nhs.uk, accessed 2024.

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