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Balanitis contents

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Diagnosis and management
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Balanitis
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Balanitis is an inflammation of the glans (head) of the penis. It usually causes redness and/or a blotchy rash on the glans, sometimes with a discharge. The condition may be itchy or uncomfortable but often feels completely normal.

Click on images for magnified view.

Why balanitis occurs

Balanitis is not sexually transmitted. It results from an overgrowth of organisms that are normally present on the skin of the glans. The condition most commonly occurs in men who have a foreskin (i.e. have not been circumcised). The environment under the foreskin is warm and moist, and these conditions favour growth of organisms that cause balanitis.

These organisms are able to multiply and cause inflammation if moisture is allowed to persist under the foreskin for a while. This may be more likely to occur if you have not washed for a couple of days, or sometimes after sexual activity (vaginal, oral or anal - with or without a condom).

One of the most common organisms associated with balanitis is a yeast known as Candida albicans.   Balanitis can result from an overgrowth of Candida due to moisture and warmth under the foreskin. It is important to remember that Candida is normally present under the foreskin in small quantities. In normal amounts it doesn't cause any problems and does not require treatment.

Sometimes there are underlying conditions, for example diabetes or skin conditions, that make balanitis worse.

Management of balanitis

The aim of treatment is to keep the area clean and dry to make it difficult for organisms to grow under the foreskin  Medication (e.g. cream or ointment) is rarely necessary, and is usually less effective than good hygiene.

Partners do not require treatment unless they have symptoms.

Guidelines for foreskin hygiene

	Once a day, ideally when you have a shower, slide your foreskin back towards your body until the glans is completely uncovered (Figures 1a and 1b). Do not use any force. If there is any resistance or discomfort, check with a doctor.
Wash the end of your penis and foreskin thoroughly using warm water only. Alternatively, sorbolene and glycerine cream (available from chemists and supermarkets) may be used as a substitute for soap.
	After washing, dry the end of the penis and foreskin thoroughly. If convenient, sit with the glans exposed to the air for 10 minutes. More thorough drying can be achieved by using a fan or hair dryer (Figure 2).
	After drying, replace the foreskin (Figures 3a & 3b).
	When you urinate, slide the foreskin back so that urine does not wet the foreskin (Figures 4a & 4b). After urination, dry the end of the penis and replace the foreskin.

If you are prone to develop balanitis a few hours after sex, wash the penis as described above, shortly after having sex. Make sure the glans is completely dry before replacing the foreskin.

These measures should lead to a rapid improvement in symptoms and will help prevent balanitis in future. 

If you experience repeated attacks of balanitis despite adequate foreskin hygiene, consult your doctor.

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