Balanitis

About balanitis

Balanitis is a skin condition that affects the glans of your penis causing swelling, redness and discomfort. Inflammation can also spread down the shaft of your penis and affect your foreskin.

Balanitis can be acute (usually over quite quickly) or chronic (lasting for more than a few weeks). When describing an illness, the terms 'acute' and 'chronic' refer to how long you have had it, not to how serious the condition is. You can also have balanitis that keeps coming back after treatment. This is called recurrent balanitis.

Balanitis can affect boys and men that are circumcised, as well as those that are uncircumcised. However, if you haven’t been circumcised, you’re more likely to get balanitis. Balanitis can develop in men and boys of any age.

Symptoms of balanitis

Symptoms of balanitis may include:

  • a red rash at the tip of your penis – this may look scaly or you may have ulcers
  • soreness and swelling at the tip of your penis
  • itching and discomfort
  • discharge or pus under your foreskin or from the end of your penis – this may smell unpleasant
  • difficulty pulling back your foreskin
  • pain during sexual intercourse

Occasionally, you may also have more general symptoms, such as a rash on other parts of your body, a sore mouth, pain in your joints, or swollen and painful glands. You may also feel tired and lethargic.

Some of the symptoms of balanitis can also be caused by a sexually transmitted disease (STI). So, if you have any of these symptoms, see your doctor.

Complications of balanitis

Balanitis can lead to a condition called phimosis. This is when you can’t pull back your foreskin fully from the head of your penis due to scarring on your foreskin.

It can also cause a blockage in your urethra (the tube you pass urine through). If your urethra becomes blocked, it can cause problems passing urine. If this happens, you may not be able to empty your bladder properly, which can be uncomfortable and can sometimes lead to a urine infection.

Causes of balanitis

There are several causes of balanitis. The main ones are listed below.

  • Skin conditions, such as eczema, psoriasis and lichen planus.
  • Poor hygiene.
  • Contact dermatitis. This is caused by substances that come into direct contact with your skin and cause irritation, such as soap, shower gel or latex in condoms.
  • Infections. Bacteria and yeasts live naturally under your foreskin. A warm and moist environment and poor genital hygiene can cause bacteria and yeasts to grow faster than usual. This can lead to an infection and cause balanitis. You’re more likely to develop an infection if you’re uncircumcised or if you have unprotected sex. If you have diabetes, you’re also more likely to develop infections.

Diagnosis of balanitis

Your doctor will ask about your symptoms and examine you. He or she may also ask you about your medical history.

Your doctor may take a swab from the tip of your penis. The sample will be sent to a laboratory to check for any infection. Your doctor may also ask you to have a test for STIs.

As balanitis can sometimes be a sign of diabetes, your doctor may ask you to have a blood test to check for the condition.

If your balanitis keeps coming back after treatment, your doctor may also suggest a biopsy. This involves taking a small sample of skin from your penis and sending it to a laboratory for testing.

Treatment of balanitis

Treatment for balanitis depends on the cause. For many men and boys, balanitis will get better with good hygiene alone.

Self-help

It's important to keep your penis clean and dry. Use warm water on its own, without any soap or shower gel. Your doctor may suggest using an emollient cream, such as aqueous cream, to soothe and clean the area.

If your balanitis is caused by an irritant, such as condoms or soap, stop using the product that is causing the irritation. Your symptoms should go once your skin is no longer in contact with the substance causing the problem.

Medicines

Your doctor may prescribe a steroid cream that you can apply directly to your skin. This will reduce the inflammation and ease your symptoms. If you have an infection, your GP may prescribe an antifungal cream or ointment to put on your skin. Alternatively, you may be prescribed a combination of both a steroid and antifungal cream.

If your infection is bacterial or the cream or ointment you’ve been prescribed doesn’t work, your GP may give you a course of antibiotic tablets.

Always ask your GP for advice and read the patient information leaflet that comes with your medicine.

If your balanitis doesn’t get better after treatment or if it keeps coming back, your GP may refer you to an urologist. An urologist is a doctor who specialises in identifying and treating conditions that affect the urinary system.

Surgery

Very occasionally, circumcision is used to treat balanitis. Circumcision is an operation to remove the foreskin from your penis. Your doctor may suggest a circumcision if your balanitis keeps coming back or you have complications from it.

Prevention of balanitis

Good hygiene is essential in preventing balanitis. It's important to try and keep your penis clean and dry.

Can nappy rash cause balanitis in babies?

Answer

Yes, nappy rash can irritate the head of your baby’s penis (glans) and foreskin causing balanitis.

Explanation

Nappy rash is skin irritation in the area where your baby’s nappy sits. It’s a common condition that affects up to one in three babies. It’s most common in babies between the age of nine and 12 months.

Wearing a nappy creates warm and moist conditions on your baby’s skin. In these conditions, bacteria and yeasts that live naturally on the skin can grow and spread until they cause irritation. Also, if a wet or dirty nappy is left on for too long, the ammonia in your baby’s urine and enzymes in his or her faeces can damage the skin and cause a nappy rash. Nappy rash can affect your baby’s penis causing balanitis.

Nappy rash is usually mild and appears as shiny red patches of skin. If your baby has more severe nappy rash, the skin may look red, dry and cracked and may blister. Your baby might also be distressed or uncomfortable.

Nappy rash can be treated and prevented by:

  • changing your baby's nappy as soon as possible after it becomes wet or dirty
  • using nappies with extra absorbency
  • leaving the nappy off so your baby can have some nappy free time
  • using a cream to protect the skin
  • bathing your baby every day using just warm water

If your baby has severe nappy rash or a nappy rash that keeps coming back, see your GP. 

How should I clean my penis to prevent balanitis?

Answer

Wash your penis with water and dry the area thoroughly once a day.

Explanation

Keeping your penis clean and dry may help prevent balanitis.

Slide your foreskin back so that the head of your penis (the glans) is uncovered. Wash the area with warm water only. Using soap can irritate your skin, and is a common cause of balanitis. You can use a non-soap cleanser such as aqueous cream to clean the area, but make sure it's completely rinsed off.

After you have finished washing, dry the area thoroughly. Slide your foreskin back and carefully pat dry the head of your penis with a soft towel.

If you find that you develop balanitis after having sex, you may find that washing your penis shortly after may help to prevent it.

Should I stop having sex if I have balanitis?

Answer

If you have balanitis, you may find sexual intercourse uncomfortable so may want to wait until your symptoms get better before having sex. Balanitis can also be caused by sexually transmitted infection (STIs), so if you think you may have an STI, you shouldn’t have sex until you have seen your GP or been to a sexual health clinic.

Explanation

Symptoms of balanitis may include rash, pain, tenderness and swelling at the tip of the penis. Having sex when you have these symptoms can be painful. Also, latex condoms may irritate your symptoms further.

The symptoms of balanitis can include rash, pain, tenderness and swelling at the tip of your penis. Having sex when you have these symptoms can be uncomfortable or painful, so you may want to finish any treatment for balanitis before you have sex again.

Latex condoms can irritate your skin and cause balanitis, so choose a non-latex condom instead.

It's worth remembering that some STIs, such as gonorrhoea, syphilis or chlamydia, can cause balanitis. Research shows about one in 10 men attending sexual health clinics have balanitis. So, if you have balanitis, and you think you may have an STI, you should see your GP or go to a sexual heath clinic for diagnosis and treatment.

Balanitis can be caused by having sex with a partner who has vaginal thrush. If you continue having sex with a partner who has vaginal thrush, and she leaves it untreated, you may keep getting symptoms (recurrent balanitis). It's important that your partner is treated for thrush before you have sex again.