Balanitis

Balanitis is inflammation of the glans penis. The term balanoposthitis is used when the foreskin is also affected. It can occur in men of all ages, but uncircumcised individuals and those with poor hygiene or certain underlying conditions are at higher risk.

Common causes include infections, most often fungal infections caused by Candida albicans, and bacterial infections. Irritants such as soaps, detergents, or condoms with spermicides, as well as dermatologic conditions (eczema, psoriasis, lichen sclerosus) and conditions like diabetes, can contribute. Poor hygiene and persistent moisture under the foreskin can also promote balanitis.

Symptoms typically include redness and swelling of the glans, itching or burning, discomfort or pain during urination or sexual activity, discharge, and occasionally a foul odor. Some men may notice tenderness or small lesions.

Diagnosis is usually clinical, based on history and physical examination. Tests may be performed if an infection is suspected or to identify a specific pathogen: swabs or cultures, urine analysis, and evaluation for diabetes or other underlying conditions. In cases with suspected sexually transmitted infections, appropriate STI testing is recommended.

Treatment depends on the cause. Fungal balanitis is treated with topical antifungals (for example, clotrimazole or miconazole) applied to the glans for about one to two weeks; more severe cases may require oral antifungals. Bacterial balanitis is treated with topical or short-course oral antibiotics. Irritant dermatitis is managed by removing the irritant and using soothing emollients; short courses of topical corticosteroids may be used for inflammation under medical guidance. Addressing risk factors, especially diabetes control and improved genital hygiene, reduces recurrence. In recurrent or persistent cases, circumcision may be considered in consultation with a clinician.

Most balanitis responds well to treatment; complications are uncommon but can include recurrent episodes, phimosis, or scarring in rare cases. Seek medical advice if symptoms worsen, do not improve with initial treatment, or if fever or severe pain develops.