Penis Infection

What is balanitis?

Balanitis refers to an inflammation of the head of the penis (or glans penis). Inflammation of the undersurface of the foreskin is technically called "posthitis," but the term is rarely used today. Balanitis has come to mean inflammation of glans penis or foreskin or both.

What causes balanitis?

Many factors contribute to balanitis. These include extra-long foreskin, foreskin that cannot be retracted behind the head of the penis (phimosis), poor hygiene, venereal diseases, trauma, incontinence and diabetes mellitus.

While balanitis can be caused by almost any chemical or bacterial irritant, the most common source of balanitis is a yeast called Candida albicans. Diabetics are particularly prone to candida infections, and frequently the first symptom of diabetes is a case of balanitis.

What are the symptoms of balanitis?

With most cases of balanitis the foreskin is red, painful, swollen and often weeping. In cases that do not respond to standard treatment, culture of the skin is indicated to see what bacteria or yeast might be present.

What else causes symptoms similar to those of balanitis?

One must always be aware that cancer of the penis may, on rare occasions, present with redness, swelling and pain. Normally, cancers are not painful and are well demarcated. A variant of pre-cancer called "Erythroplasia of Queyrat" shows bright red, well-demarcated, painless lesions on the head of the penis. A biopsy must be taken if cancer is suspected.

How is balanitis treated?

Keeping the foreskin dry is important. The warm, dark moisture of the undersurface of the foreskin is a wonderful place for bacteria and yeast to grow. You must frequently dry the head of the penis and undersurface of the foreskin area. Wash the area with clear water; then gently pat dry. THEN dry the area thoroughly with a hand-held hair dryer using a warm (not HOT) setting. Repeat this maneuver as often as possible during the day. If you cannot easily withdraw the foreskin because of pain, DO NOT WITHDRAW THE FORESKIN BEHIND THE HEAD OF THE PENIS AND LEAVE IT WITHDRAWN.

A prescription for a cream with a small amount of antifungals can be helpful. Usually we use Nystatin or Miconozole creams or ointments. In more severe cases we might add a steroid with antibiotic, such as Mycolog cream or ointment. This is to be used sparingly over the areas of redness and is to be applied after thorough drying. The drugs cannot be used indefinitely and if no improvement occurs within a few days, let us know. In any event, you should not consistently se the drugs for more than a week. Intermittent use when needed is OK. In severe cases, oral antifungal medications are necessary, such as diflucan or broad spectrum antibiotics for bacterial infections. Again, if the inflammation does not respond, biopsy may be needed to ensure that cancer of the penis is not present.