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Balanitis

Balanitis is swelling of the head of the penis and sometimes the foreskin is also affected. It is not normally serious and may be prevented with good hygiene.

Balanitis (balanoposthitis) is swelling of the head of the penis. The foreskin (the loose flap of skin that covers the head of the penis) is also often affected.

Balanitis is a common condition affecting both boys and men, although it happens more often in men who have not been circumcised.

Symptoms of balanitis include swelling, redness and soreness of the end of the penis. There might also be a thick discharge under the foreskin.

Read more about the symptoms of balanitis.

When to see your GP

Visit your GP or local sexual health or genitourinary medicine (GUM) clinic if you have any of the symptoms of balanitis. While balanitis is not usually serious, it can be a sign of another condition, such as a sexually transmitted infection (STI) or thrush (a type of yeast infection).

Also visit your GP if your son develops balanitis. They may need prescription-only medication, such as antibiotics.

Who is affected?

Balanitis can happen at any age. An estimated one in 20 boys under five years old are affected by balanitis. One in 10 men who attend a sexual health or genito-urinary (GUM) clinic have balanitis.

Skin irritation is the most common cause of balanitis in boys. This can occur because it's not always possible to pull back the foreskin fully at this age, leading to a build up of a cheesy-looking substance called smegma that can irritate the skin.

Irritation by smegma is also a common cause of balanitis in uncircumcised men if the penis is not kept clean.

Other cause of balanitis in men include:

Read more about the causes of balanitis.

Balanitis is not normally serious and can often be prevented by avoiding irritants and good hygiene.

Read more about preventing balanitis.

Treating balanitis 

Most cases of balanitis are easily managed with a combination of creams or ointments, good hygiene and avoiding substances that irritate the penis.

In rare cases of balanitis that keep coming back, circumcision (surgical removal of the foreskin) may be recommended. For example, in cases where the foreskin can't be pulled back (phimosis) to be cleaned or there is persistent dribbling of urine following urination.

Read more about treatment for balanitis.



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Balanitis

Your GP should be able to diagnose balanitis by the redness and inflamed (swollen) appearance of the glans.

Your GP should be able to diagnose balanitis by the redness and inflamed (swollen) appearance of the glans.

You may initially feel embarrassed about visiting your GP with the symptoms of balanitis, but it's important that you do.

This is because your symptoms could be a sign of a more serious underlying condition, such as diabetes.

You or your child may also need prescription-only medication, such as antibiotics or antifungals (see treating balanitis for more information).

Seeing your GP

To determine what is causing balanitis, your GP will examine your (or your child’s) penis and ask a number of questions to help determine the cause. They may ask:

  • how often you clean your penis
  • whether you may have been exposed to irritants, such as soap or bubble bath
  • whether you have a history of skin conditions, such as eczema
  • whether you may have damaged the head of your penis during sex

For children, your GP may also ask:

  • whether you have noticed your child playing with their foreskin
  • for younger children, how often they have their nappy changed

Further testing is usually only needed if the symptoms are particularly severe or do not clear with treatment. This usually involves taking a small sample of cells from the head of the penis (a swab) and testing them for infection.

In addition to taking a sample of cells from your penis, your GP may refer you for blood and urine tests to measure your blood sugar levels. This is to check whether you have developed diabetes, which may be making you more vulnerable to infection.

Your GP may also recommend that you are tested for sexually transmitted infections (STIs). They may refer you to a sexual health clinic.



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Balanitis

Treatments for balanitis include corticosteroid creams for skin irritation, fungal creams for fungal infections, and antibiotics for bacterial infections.

If you or your child has balanitis, the recommended treatment will depend on what is causing the condition.

In all cases of balanitis you should avoid potential irritants and make sure to practise good hygiene. For example:

  • keep your penis clean by washing it with warm water twice a day
  • avoid using soap and other irritants – you could use aqueous cream as a soap substitute
  • wash your hands thoroughly after going to the toilet

Potential irritants to avoid

If you have balanitis, urine is the most important irritant to keep away from the skin of your penis. Other irritants to avoid include:

  • soap and shower gel
  • bubble baths
  • baby wipes
  • latex condoms
  • lubricants
  • antiseptics
  • hygiene sprays

Read about preventing balanitis for more information on hygiene and avoiding irritants.

Skin irritation

If your balanitis is the result of skin irritation, you will usually be prescribed a topical corticosteroid (steroid cream or ointment).

Apply the cream to the head of your penis once or twice a day until your symptoms have gone. Do not use the medication for more than 14 days in a row because this could lead to side effects, such as itchy skin and a skin rash.

It is important to avoid potential irritants and make sure that the head of your penis and your foreskin do not come into contact with urine after you urinate.

Fungal infection

If your balanitis is the result of a fungal infection, you will be prescribed either an antifungal cream or an oral antifungal medication (tablet or capsule), such as fluconazole

Fluconazole is not recommended for children who are under 16 years old. It can also cause side effects, including:

  • headache
  • skin rash
  • nausea and vomiting
  • diarrhoea 

If your symptoms are particularly troublesome, you may also be prescribed a seven-day course of a topical corticosteroid, usually in the form of a cream or ointment.

Bacterial infection

If a bacterial infection is the cause of your balanitis, you will be prescribed a seven-day course of oral antibiotics (antibiotic tablets or capsules).

An antibiotic called amoxicillin is usually recommended. However, if you are allergic to penicillin, erythromycin or clarithromycin may be prescribed.

Common side effects of these types of antibiotics include:

  • skin rash
  • nausea and vomiting
  • diarrhoea
  • abdominal pain

Again, if your symptoms are particularly troublesome, you may also be prescribed a seven-day course of a topical corticosteroid.

Follow-up

All the treatments listed above should start working in seven days. Contact your GP if your symptoms do not improve after this time because you may require an alternative treatment.

Referral to a specialist

If your balanitis is not caused by an infection and your GP cannot identify the cause, you may be referred to a dermatologist (skin specialist) or genito-urinary (GUM) clinic for further investigation.

If you have phimosis (a tight foreskin) and you have repeat episodes of balanitis, you may be advised to have a circumcision.



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