What is Balanoposthitis?

Balanitis is an inflammation of the glans (head of the penis) that may occur at any age. It usually coexists with inflammation of the foreskin (the retractable skin covering the glans) and then it is called 'balanoposthitis'. The inflammation occurs more frequently in boys below 4 years old and in uncircumcised men. 

What causes Balanoposthitis?

The etiology of balanoposthitis may involve many different causes:

  • Poor hygiene of the area.. The most common cause is improper hygiene, which in combination with a narrow foreskin, does not allow the revelation of the glans and removal of smegma (cheesy sebaceous matter collecting between the glans penis and foreskin).
  • Infections, non-sexually transmitted.  There are various bacterial or fungal infections of the penile skin that may cause balanoposthitis. The most common fungus is Candida, which also causes vaginitis in women. There is usually some predispository factor for the development of balanoposthitis, such as:
    • Pre-existing aseptic inflammation of the region due to some allergy or irritation 
    • Diabetes Mellitus
    • Phimosis, which prevents the removal of sebor and good hygiene of the area.  
  • Sexually Transmitted Infections (STIs). There are several sexually transmitted infections causing balanoposthitis, such as herpes genitalis (genital herpes), chlamycia and gonhorrea.
  • Allergies - Rashes. The skin of the glans is particularly sensitive and getting in contact with some substances may cause some allergic reaction or irritation. For example:
    • If urine and smegma stay under the foreskin for a long time, this may cause inflammation.
    • Some soaps, laundry detergents and softeners.
    • Condoms and lubricants used during sexual intercourse.
    • Skin diseases. There are some skin diseases that may cause balanoposthitis (e.g. psoriasis)

How is Balanoposthitis diagnosed?

Most of the times, just the clinical examination is enough for the physician to set the diagnosis. The potential cause in many cases can be determined by the picture of the glans. In case the physician is not certain about the cause, the following can be recommended:

  • Culture of secretional discharge from the glans region, for detecting the microbe causing the infection
  • Testing for Diabetes Mellitus, if there is suspicion it may be the underlying cause 
  • Testing for Sexually Transmitted Diseases
  • In rare cases, when the clinical picture persists, specimen may have to be obtained from the lesion for biopsy

How is Balanoposthitis treated?

Irrespective of the cause, you should always remember the following:

  • Wash the penis with lukewarm water and then dry it thoroughly and gently
  • Do not use antiseptics, but a mild soap with neutral Ph for sensitive areas

Depending on the cause, the physician may recommend some of the following therapeutic regimens:

  • Anti-fungal ointment, if Candida is the cause
  • Oral antibiotics, in case balanoposthitis is due to sexually transmitted infection
  • Mild Corticosteroids (ointment), when it is due to an allergic reaction or irritation
  • Circumcision, in case there are many relapses and concomitant phimosis

Are there preventive measures for Balanoposthitis?

The following guidelines may help in preventing some cases of balanoposthitis:

  • Wash the glans carefully every day, pulling softly the foreskin back. Dry the region gently.
  • In the case of balanoposthitis related to condom use, try to use a condom specially for sensitive skin.
  • Wash your hands before urinating, particularly if you have come in contact with chemicals.
  • Always use condom when having sex, particularly with a new sexual partner.