Balanitis

What Is Balanitis?

Balanitis is soreness and redness in the head of your penis. It can make you uncomfortable in one of the most sensitive areas: the end of your penis and the loose flap of skin that covers the tip. It can be treated, and it’s often easy to prevent.

You can get balanitis at any age. If you're circumcised, you’re not likely to get it. But if you still have your foreskin, you need to take extra care of the head of your penis.

Types of Balanitis

There are three types of balanitis. They show up in different ways:

  • Zoon’s balanitis is the most common type. It causes a red, painful penis head. This is the kind people usually mean when they talk about balanitis.
  • Circinate balanitis may happen in men with 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 is rare and affects only men over 60. It causes scaly warts on the head of the penis.

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

  • Balanoposthitis is inflammation or infection of the head of the penis that includes 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).

Symptoms of Balanitis

You might have:

  • Redness
  • Swelling
  • Pain
  • Itching
  • Discharge in the tip of your penis
  • White, shiny skin on your penis
  • Swelling
  • An unpleasant smell
  • Sores on the penis
  • Bleeding around your foreskin
  • Trouble pulling back your foreskin (Remember that it’s normal for young children to have a tight 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.

If it 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.

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Causes of Balanitis

If you don’t keep that area clean, you raise your chances of getting the infection. Use a mild soap, because harsh chemicals can irritate the skin on your penis and trigger balanitis, too.

It can also happen if your diabetes isn’t under control or as a side effect of certain drugs prescribed to treat type 2 diabetes. For example, if you take dapagliflozin (Farxiga), you’re more likely to get balanitis, because the drug works by flushing sugar out of your body in your urine. Sugar creates a breeding place for yeast to grow.

Bacteria can also cause the infection. Make sure to keep your penis clean after you use the bathroom.

It can also be caused by a type of arthritis known as reactive arthritis or Reiter’s syndrome, which can affect your joints and eyes.

Some medications can cause allergic reactions that can lead to balanitis, including tetracycline and aspirin-type medicines.

You’re also more likely to get the infection if you're overweight or have a condition that makes your body retain water, such as heart, liver, or kidney disease.

Balanitis Diagnosis

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)
  • Tests for the medical conditions that cause balanitis

Balanitis Treatment

Once you have the condition, you can’t just wash it away. Your doctor will prescribe or recommend treatment to clear up the infection.

Your treatment will depend on what set off the balanitis. The prescription usually comes as a cream or ointment. Your doctor might prescribe:

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.

If you’re dealing with a balanitis that’s come back, your doctor may suggest a circumcision. You’re more likely to need the procedure if you have a foreskin that’s hard to retract.

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Balanitis Complications

Without treatment, balanitis can cause complications such as:

  • Narrowing of the opening through which urine leaves the body (urethral strictures)
  • Urinary retention
  • A backflow of urine toward the kidneys (vesicoureteral reflux)
  • Painful retraction of the foreskin
  • A lack of blood to the penis

If it gets worse, you might need to be circumcised to treat it.

Balanitis Prevention

To ensure your balanitis doesn’t come back -- or won’t happen in the first place -- make the extra effort to keep your private parts clean. To do this properly:

  • 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 completely.
  • Make this part of your daily routine, like brushing your teeth.

Other good habits to adopt:

  • Don’t have sex while you’re having balanitis symptoms.
  • Use condoms that fit correctly and are made with materials that will be gentle on your skin.
  • Wash your hands before you pee.
  • If sex triggers your symptoms, wash your penis after you have it.

WebMD Medical Reference Reviewed by Arefa Cassoobhoy, MD, MPH on July 24, 2020

Sources

SOURCES:

American Urological Association: “Plasma Cell Balanitis (Zoon's Balanitis),” “Buried penis in adults - Presentation, Surgical Techniques and Outcome.”

Medscape: “Balanitis.”

Johnsson, K., Journal of Diabetes and Its Complications, 2013.

Lisboa, C. Journal of the European Academy of Dermatology and Venereology, 2009.

American Osteopathic College of Dermatology: “Balanitis.”

StatPearls: “Balanitis.”

Cleveland Clinic: “Balanitis.”

National Health Service (U.K.): “Balanitis.”

UpToDate: “Balanitis in adults.”

Harvard Medical School: “Balanitis.”

University of Rochester Medical Center: “Phimosis and Paraphimosis in Children.”

Melbourne Sexual Health Centre: “Balanitis.”

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