Balanitis

Medically Reviewed by Poonam Sachdev on May 21, 2024
Written by Matt McMillen
8 min read

Balanitis is soreness and redness in the head of your penis. It can make you uncomfortable in one of the most sensitive areas: the head of your penis, as well as the loose flap of skin that covers the tip if you haven't been circumcised. It can be treated, and it's often easy to prevent.

You can get balanitis at any age, but it's most common in children under the age of 4, whether circumcised or not. Anyone can get it, but you have a higher risk of balanitis if you haven't been circumcised and don't clean your foreskin thoroughly. Diabetes also raises your risk of balanitis.

Balanitis usually happens because of a bacterial, fungal, viral, or parasitic infection. 

Noninfectious types of balanitis are also possible. These include: 

Zoon's balanitis. This chronic type of balanitis affects middle-age people, most often those who haven't been circumcised. It causes your penis head to become red and inflamed. About 1 in 10 people with balanitis have this type.

Circinate balanitis. This type of balanitis is caused by reactive arthritis, a type of arthritis caused by an infection. You get sores on the head of your penis alongside the redness and swelling when you have this type.

Pseudoepitheliomatous keratotic and micaceous balanitis (PKMB).This type of balanitis is very rare and affects only people over 60. It causes scaly warts or bumps on the head of your penis.

Fixed drug eruption. This is an allergic reaction to a drug, which causes a lesion to develop on the head of your penis. They're rare. Antimicrobial medications, like antibiotics and antifungal drugs, as well as nonsteroidal anti-inflammatory drugs (NSAIDs) are most often to blame.

Lichen planus. This is a chronic inflammatory skin condition that can cause balanitis when it affects the penis, called genital lichen planus. It causes an itchy rash and soreness, as well as scarring and phimosis, a condition in which the foreskin can't be pulled back.

There are two related conditions that are very similar to balanitis:

  • Balanoposthitis is inflammation or infection of the head of the penis and the foreskin. Technically, balanitis is inflammation or infection of the head of the penis only.
  • Phimosis is when you can't pull back, or retract, the skin over the head of your penis (foreskin).

 

The symptoms of balanitis can develop gradually or they can come on quickly. Symptoms include:

  • Redness or other discoloration on your penis
  • Swelling
  • Pain  and irritation on the head of your penis
  • Itching  beneath your foreskin
  • White, foul-smelling discharge under your foreskin. Skin folds can trap dead cells, discharge, and oils. If you don't wash regularly, this debris can build up and form smegma, which smells bad.
  • Tight, shiny skin on the tip of your penis
  • Swelling
  • Painful urination
  • Sores or lesions on the head of your penis
  • Trouble pulling back your foreskin (phimosis). Remember that it's normal for young children to have a tight foreskin.

If your balanitis gets worse, it can start to hurt when you pee or cause problems with your sex life. You might not be able to get an erection.

Difference between balanitis and herpes

Unlike balanitis, herpes--or herpes simplex 2--is a sexually transmitted disease. While both cause discomfort, balanitis can be cured. Genital herpes is a chronic condition that you will have for life. Another difference: you can't catch balanitis from someone else; it's not contagious. Herpes, on the other hand, spreads from person to person via saliva and genital contact.

How long does balanitis last?

Once treatment begins, balanitis typically clears up within a week.

Most cases of balanitis develop in people who have a foreskin and don't keep it clean and dry. That's because the types of organisms that cause balanitis, such as fungi, thrive in that moist and warm environment. Fungal infections cause most cases of balanitis.

Make sure to keep your penis clean after you use the bathroom. When showering or bathing, use a mild, unscented soap, because harsh chemicals and perfumed soaps can irritate the skin on your penis and trigger balanitis, too.

Other cause of balanitis include:

  • Poorly managed diabetes and some type 2 diabetes medications, such as dapagliflozin (Farxiga). The drug works by flushing sugar out of your body in your urine. Sugar creates a breeding place for yeast to grow.
  • Drug allergies, such as to antibiotics like tetracycline and sulfonamides
  • Health conditions that cause water retention and swelling, like congestive heart failure, cirrhosis, and kidney disease
  • Obesity
  • Allergic reactions to latex condoms or contraceptive gels
  • Reactive arthritis, a kind of arthritis triggered by infection
  • Skin conditions like eczema and psoriasis
  • Sexually transmitted diseases such as chlamydia and gonorrhea
  • Bacterial infections
  • Scabies, an infection caused by tiny insects called mites that can burrow into your skin
  • Injury to your penis, such as getting it caught in a zipper

Causes of balanitis in children

Balanitis is most common in kids under age 4. As with adults, bad hygiene is the most frequent culprit. Kids have a higher risk if they're still in diapers because coming into contact with poop and pee -- such as while wearing a dirty diaper -- can trigger balanitis.

Balanitis can develop due to rough handling of the foreskin or penis injury, such as getting it caught in a zipper. Chemicals in some soaps also may cause balanitis.

Another cause related to the foreskin: phimosis. This is a condition in which the foreskin can't be pulled back -- or retracted -- over the head of the penis. This is normal in newborns. The foreskin typically becomes retractable in infancy, but phimosis can continue until age 5 or 6.

In most cases, your doctor can diagnose balanitis based on your symptoms and by doing a physical exam. They may run tests to be sure, such as:

  • Serum glucose test (to screen for diabetes)
  • Lab tests of any discharge
  • Tests to see if you have a sexually transmitted disease (STD) or other infection
  • Tests for the medical conditions that cause balanitis
  • A biopsy to remove a small piece of skin tissue for lab analysis

Your treatment will depend on what caused your balanitis:

  • Antibiotics, including topical creams and pills, treat bacterial balanitis and balanitis caused by a sexually transmitted disease.
  • Antifungal creams treat balanitis caused by candida yeast infection. In severe cases, doctors may prescribe an oral antifungal drug.
  • Steroid creams can relieve balanitis caused by skin disease or an allergic reaction .

To help with swelling, you can soak your penis in a sitz bath, a shallow warm bath you can sit in. You can add a salt solution to the water to help ease symptoms. In some cases, a salt bath may be all you need to start clearing up your balanitis.

Over-the-counter pain medications also can relieve swelling and reduce the pain caused by balanitis. These include nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) and acetaminophen (Tylenol). Ice and cold compresses also can ease swelling.

If you still have your foreskin, your doctor may recommend circumcision if your balanitis keeps coming back. You're more likely to need the procedure if you have a foreskin that's hard to retract. Another option: a dorsal slit. This doesn't remove your foreskin. Instead, it creates an opening that allows your foreskin to move back over the head of your penis.

Does balanitis go away on its own?

Most of the time, balanitis requires treatment. Don't let it go untreated--your symptoms may get worse or you may experience additional symptoms.

Can you cure balanitis naturally?

You'll need medications to cure the underlying cause of your balanitis. However, your treatment should include keeping your penis clean and dry. This is particularly important if you have a foreskin, which you should pull back and rinse with warm water then dry thoroughly. This will help to clear up your balanitis and keep it from returning.

Without treatment, balanitis can cause complications such as:

  • Narrowing of the urethral opening (meatus), the opening through which urine leaves the body
  • Urinary retention
  • A backflow of urine toward the kidneys (vesicoureteral reflux)
  • Painful retraction of the foreskin called phimosis
  • A lack of blood to the penis caused by foreskin being trapped behind the head of the penis, a medical emergency called paraphimosis
  • Chronic inflammation that can become cancerous, though this is rare.

If you have HIV, diabetes, or another condition that weakens your immune system, the type of yeast infection that often causes balanitis can lead to a serious bloodstream infection.

The best way to lower your risk of balanitis: keep your penis clean and dry. 

Follow these steps often:

  • Gently pull back and clean under your foreskin with warm water.
  • Use a mild soap, not shower gel or soaps with harsh ingredients.
  • Dry the area gently and completely.

When you have sex, wear a condom. This will protect you against sexually transmitted diseases, which can cause balanitis.

If you have diabetes, managing your blood sugar can help prevent balanitis. Follow your treatment plan, including medications, dietary changes, and exercise. Talk to your doctor if you struggle to keep your blood sugar level in check.

 

Balanitis causes pain and swelling on the head of your penis. It occurs more frequently in people with an uncircumcised penis. Fortunately, it's easy to treat most of the time. It also can be prevented by taking simple steps to improve your hygiene. Balanitis can lead to complications if untreated, so see your doctor if you think you have it.

How does balanitis go away?

Balanitis doesn't go away on its own. It requires treatment. See your doctor, who can determine what caused it and how best to cure it.

How do you treat balanitis?

Treatment depends on the cause. For example, if a yeast infection triggered your balanitis, your doctor likely will prescribe an antifungal cream. You should feel better within a week after starting treatment.

What can be mistaken for balanitis?

One type of balanitis, called circinate balanitis, can look like a skin condition called psoriasis. Genital herpes, a sexually transmitted disease, has some similar symptoms to balanitis, such as pain and irritation.

What is the amoxicillin dosage for balanitis?

If you have balanitis caused by a bacterial infection, your doctor may prescribe amoxicillin. The dose will depend on how severe your balanitis is.