What is balanitis?
Balanitis is an inflammatory condition involving the glans penis (head of penis). It is often associated with posthitis or inflammation of the foreskin in an uncircumcised male. If both conditions occur at the same time, it is better known as balanoposthitis. Studies have shown, balanitis affects 1 in every 25 boys and 1 in 30 uncircumcised males during their lifetime. Uncircumcised men and boys under 4 years of age are the highest risk group to develop balanitis, although it can occur at any age.
What causes balanitis?
The most common cause of balanitis is almost always due to inadequate personal hygiene in the uncircumcised male. Inadequate cleansing or too much cleansing in that area will increase the chance of bacteria overgrowth or yeast. This condition is further made worse when the foreskin cannot be fully retracted. The warm and moist environment under the foreskin favours the growth of fungi like Candida sp.
Infection with Candida species of fungi most commonly occur in individuals with poorly controlled diabetes. Besides, other bacteria causing sexually transmitted diseases (STD) can also cause balanitis. For example, Neisseria gonorrhoea, chlamydia sp., trichomonas sp, and syphilis. On the other hand, there are other non-infectious causes to consider as well. These include:
- Poor personal hygiene being the most common
- Chemical irritants like detergent, fragrance soaps, spermicides etc
- Uncontrolled diabetes
- Fixed drug eruptions (tetracycline, sulfa drugs)
- Oedematous conditions (congestive heart failure, nephrotic syndrome, cirrhosis)
- Allergic reaction to condom latex or contraceptive jelly
- Reiter syndrome
What are the symptoms of balanitis?
The sign and symptoms include:
- Redness around the glans penis
- Tight, shiny skin on the glans
- A thick cheesy white discharge under the foreskin
- Unpleasant smell
- Itchiness and discomfort over the glans
In severe cases, the foreskin may become adherent to the underlying glans and be difficult to retract.
If you experience any of the above symptoms, you should seek medical attention as soon as possible.
How to treat balanitis?
The main aim is to make sure it is not caused by STD. Your doctor will perform STD screening based on the risk of exposure involved. However, the way to prevent balanitis is to always keep the glans and foreskin clean and dry. Daily showering and cleaning of this area is necessary. Try to avoid using soaps or detergents to clean the area as these products may cause irritation.
Topical anti-fungal usually for one to three weeks is the treatment of choice. 1% clotrimazole twice daily or miconazole 1% twice daily are used as the first line.
Mild topical steroids can also be used for treatment. In severe cases, it may require systemic antifungals or antibiotics.
Some experts recommend circumcision for individuals with recurrent balanitis or immunocompromised and diabetic individuals. Studies showed that circumcised males have lower prevalence of balanitis.