Balanitis

Balanitis is pain, swelling and inflammation of the head (glans) of your penis. The head of your penis can look discolored (red, purple, gray or white) or have discolored patches. You may also have shiny, swollen areas of skin. Sometimes, inflammation affects both the head of your penis and the foreskin. This is balanoposthitis.

Balanitis (pronounced “BAL-uhn-AHY-tis”) is a common condition that happens most often in males who haven’t been circumcised. It’s normal to have concerns whenever something affects the sensitive areas of your body. But in most cases, balanitis isn’t serious.

Infections are often the cause. This is because the moist, warm area under your foreskin makes it easy for bacteria and yeast to grow. But balanitis isn’t an infection itself, and you can’t spread it to others. Still, it’s important to see a healthcare provider to determine the cause and get the best treatment.

Types

Infections are the most common cause of balanitis. But there are some noninfectious types. These include:

• Zoon’s balanitis: This is a long-lasting (chronic) type. It’s more common if you’re uncircumcised and between the ages of about 40 and 60.
• Circinate balanitis: This type is a result of reactive arthritis. It also causes small sores (lesions) on the head of your penis.
• Pseudoepitheliomatous keratotic and micaceous balanitis (PKMB): This rare type causes scaly warts or bumps on the head of your penis.
• Fixed drug eruption: This is when sores appear on the head of your penis due to certain medications or chemicals.
• Lichen planus: A rash develops on one or more parts of your body, including the head of your penis.

Symptoms of balanitis

Balanitis symptoms may appear suddenly or develop over time. The most common symptoms include:

• Pain and irritation on the head of your penis
• Discoloration or discolored patches on your penis
• Itching under your foreskin
• Swelling
• Areas of white or shiny skin on your penis
• White, cheesy-looking discharge (smegma) under your foreskin
• A bad smell
• A burning feeling or pain while peeing (dysuria)

What is the main cause?

If you have foreskin, the most common cause of balanitis is not regularly cleaning your penis and under your foreskin.

Other balanitis causes may include:

• Genital yeast infection (candidiasis)
• Sexually transmitted infections (STIs), including gonorrhea and chlamydia
• Scabies
• A sensitivity or allergy to soaps or chemicals
• Skin conditions that cause itchy, dry and scaly skin, like psoriasis and eczema
• Diabetes
• Reactive arthritis

Complications

Untreated balanitis can cause long-term inflammation. Lasting inflammation on the head of your penis can lead to other health issues, like:

• Hardened skin tissue, which can make it difficult or impossible for pee and semen to flow through your urethra
• Scarring that causes your foreskin to become so tight that you can’t pull it back

In rare cases, there’s a link between some types of balanitis and conditions that have similar symptoms. These include:

• Basal cell carcinoma
• Squamous cell carcinoma
• Kaposi sarcoma
• Extramammary Paget’s disease (EMPD)
• Penile cancer

How doctors diagnose balanitis

A healthcare provider will:

• Review your medical history
• Ask about your symptoms
• Perform a physical exam of your penis

They may recommend tests to help determine the cause. These include:

• Swabbing the opening of your urethra or the head of your penis to check for infections
• Blood tests or pee tests to check for diabetes or other infections
• Removing a small sample of skin tissue (biopsy) if they think you have another condition that looks like balanitis

How do you get rid of balanitis?

Treatment depends on the cause. Your healthcare provider may recommend:

• Regularly washing your penis and foreskin and thoroughly drying them
• Applying an antifungal cream like clotrimazole to treat a yeast infection
• Antibiotics to treat certain STIs
• Managing diabetes

If you get balanitis a lot, your provider may recommend removing your foreskin. If you don’t want a full circumcision, they may perform a dorsal slit. A dorsal slit won’t remove your foreskin. But it’ll open the tight ring up so you can see the head of your penis.

Will it go away by itself?

Most cases of balanitis need some kind of treatment. If you don’t get treatment, your symptoms may get worse. You may also develop more symptoms.

Recovery time

In most cases, you should start to feel better within a few days or a week after starting treatment. Contact your healthcare provider if your symptoms get worse or you develop new symptoms.

When should I see my healthcare provider?

Schedule a visit with a healthcare provider if you have balanitis symptoms. They can prescribe the best treatment for you and recommend ways to prevent it from coming back.

During your appointment, you may want to ask:

• What’s the cause?
• If I don’t have balanitis, what other condition might I have?
• What treatment do you recommend?
• What tests do you recommend to confirm balanitis?
• What are the best ways for me to keep my genital area clean?
• Do I need to see a specialist?

What can I expect if I have balanitis?

With proper diagnosis and treatment, the outlook for balanitis is good.

If you have foreskin, it’s common for balanitis to return after treatment. Your risk increases if you don’t clean your foreskin regularly.

Can I have sex if I have it?

You should avoid having sexual intercourse while you have balanitis, especially if you don’t know its cause. Sexual activity, including masturbation, can cause further irritation. If you have sex, wearing a condom may help protect your skin and reduce discomfort.

Even though balanitis isn’t an STI and you can’t spread it to your partner(s), it’s a good idea to talk to them about it. If they have any questions, encourage them to talk to a healthcare provider.

Is there anything I can do to feel better?

Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen can help to quickly relieve swelling and pain. Not everyone can take these medications, so it’s a good idea to check with your provider first.

You can also ice the area for up to 10 minutes several times a day to help reduce swelling.

Can balanitis be prevented?

You can help prevent it by:

• Bathing often: Wash every day. Pull your foreskin back so you can clean the area underneath.
• Avoiding harsh soaps: Don’t use strong soaps, lotions or laundry detergents. They can irritate your skin.
• Staying dry: Thoroughly dry your penis after bathing. You should also dry the area under your foreskin after peeing.
• Teaching your child proper bathing techniques: Teach your child how to properly clean their penis, especially if they have foreskin.