Balanitis

What is balanitis?

Balanitis is pain and inflammation (swelling and irritation) of the glans (head) of the penis that happens most often in uncircumcised men or people assigned male at birth (AMAB). Circumcision is a procedure that removes skin (the foreskin) from the head of the penis (glans). Yeast infections typically cause balanitis. However, bacterial infections, viral infections and some skin (dermatological) conditions can also cause balanitis.

What if I have inflammation on the head of my penis and my foreskin?

Balanoposthitis is inflammation of the foreskin and glans. This only occurs in uncircumcised men or people AMAB. Signs of balanoposthitis include itching, irritation and swollen foreskin and glans. Balanoposthitis occurs more often in people who have diabetes or a tight foreskin.

What does balanitis look like?

Balanitis looks like redness, discoloration (red, purple, gray or white) or discolored patches on the head of your penis. You may also have shiny, swollen areas of skin.

Is balanitis an STI?

No, balanitis isn’t a sexually transmitted infection (STI), and it isn’t contagious. However, certain STIs may cause balanitis, and balanitis can look like an STI. Until you receive a balanitis diagnosis from a healthcare provider and they determine that its cause isn’t an STI, it’s a good idea to avoid having sex.

Is balanitis serious?

In most cases, balanitis isn’t serious. However, it’s important to see a healthcare provider to determine its cause and receive the proper treatment.

What are the types of balanitis?

Most commonly, balanitis is due to an infection (fungal, bacterial, viral, parasitic). There are also some noninfectious types, which include:

• Zoon’s balanitis. This chronic (long-lasting) type affects uncircumcised, middle-aged people and causes an inflamed, discolored penis head. It accounts for up to 10% of balanitis cases.
• Circinate balanitis. This type of balanitis is a result of reactive arthritis. Reactive arthritis is a type of arthritis that develops in response to an infection in your body. In addition to inflammation and discoloration, circinate balanitis causes small lesions (sores) on the head of your penis.
• Pseudoepitheliomatous keratotic and micaceous balanitis (PKMB). This very rare form of balanitis causes scaly warts or bumps on the head of your penis. It affects people over 60.
• Fixed drug eruption. This is when a skin lesion appears on areas of your skin as a result of certain medications or chemicals.
• Lichen planus. This is a skin condition that causes a rash to develop on one or more parts of your body.

There’s also a link to some types of balanitis and precancerous or cancerous conditions, including:

• Basal cell carcinoma. This is a type of skin cancer that forms in the basal cells in the outer layer of your skin. It causes lumps or bumps to form. It’s the most common type of skin cancer.
• Squamous cell carcinoma. This is a type of skin cancer that forms in the squamous cells in the outer layer of your skin. It causes bumps, marks or lesions to form. It’s the second most common type of skin cancer.
• Kaposi sarcoma. This is a rare type of cancer that can affect people with weakened immune systems.
• Extramammary Paget’s disease (EMPD). This is a rare condition that causes discolored, scaly, itchy skin around your genitals.

How common is balanitis?

Healthcare providers estimate that up to 10% of men or people AMAB will have balanitis during their lifetime. Balanitis is more likely to occur in uncircumcised children under the age of 4. In adults, it’s more common if you have diabetes or if you have foreskin and don’t properly clean underneath it.

What are the symptoms of balanitis?

Symptoms of balanitis may appear suddenly or develop gradually. They can include:

• Pain and irritation on the head of your penis.
• Discoloration or discolored patches on your penis.
• Itching under your foreskin.
• Swelling.
• Areas of shiny or white skin on your penis.
• White discharge (smegma) under your foreskin.
• A foul smell.
• Pain while urinating (peeing).
• Sores or lesions on the head of your penis. (This symptom is rare and appears with PKMB, which affects people over 60.)

How do people catch balanitis?

If you have foreskin, the most common cause of balanitis is infrequently cleaning your penis and under your foreskin. Other causes include:

• Genital yeast infection (candidiasis).
• Sexually transmitted infections.
• Scabies (tiny burrowing parasite) infection.
• Sensitivity or allergy to harsh soaps or chemicals.
• Skin conditions that cause itchy, dry, scaly skin (such as psoriasis and eczema).
• Diabetes.
• Reactive arthritis, a type of arthritis that develops in response to an infection somewhere in your body.

Who does balanitis affect?

Balanitis primarily affects uncircumcised men or people AMAB because the moist, warm area under the foreskin is the ideal place for yeast and bacteria to grow. It can occur at any age and is more common in people who have tight foreskin that doesn’t easily move over the head of their penis (phimosis). Groups with a higher risk of balanitis include people who:

• Clean their penis or under their foreskin infrequently.
• Are middle-aged or older.
• Have diabetes, because the increased glucose (sugar) on their skin can stimulate bacterial and fungal growth.
• Have obesity.
• Have sexually transmitted infections.
• Have a sensitivity to chemical irritants.

What are the complications associated with balanitis?

Untreated balanitis can cause chronic (long-term) inflammation. Lasting inflammation can lead to health issues, including:

• Balanitis xerotica obliterans (BXO). BXO occurs when skin on the glans hardens and turns white. The hard tissue can make it difficult or impossible for urine (pee) and semen to flow through your urethra (the tube that allows fluids to exit your penis). Another name for BXO is lichen sclerosus.
• Phimosis. Long-term inflammation can lead to scarring on your penis, which can cause the foreskin to become tight. The foreskin can tighten (constrict) so much that you can’t pull it back (retract) over the head of your penis.

Rarely, there’s a link between chronic inflammation and a higher risk of developing penile cancer.

How is balanitis diagnosed?

Healthcare providers diagnose balanitis with a physical examination to determine if an infection is causing your symptoms. Your provider may swab your urethral opening (the hole at the tip of your penis) and send the sample to a lab for testing. Your provider may also order a urine test (urinalysis) or blood test to check for diabetes and other infections. Sometimes your provider may recommend a biopsy if they think you may have another condition that looks like balanitis.

How do I know if I have balanitis?

If you have pain, irritation and discoloration on your penis, you may have balanitis. The risk increases if you have foreskin. See your provider for treatment and to determine what’s causing your symptoms. Other conditions (such as HIV, other sexually transmitted infections or a condition that’s likely to become cancer, called a premalignancy) can cause a rash and discoloration on the penis. It’s important to see your provider to get tested.

What are the treatments for balanitis?

The treatment for balanitis depends on what’s causing the condition. Treatments can include:

• Antifungal creams. If a yeast infection is causing balanitis, your provider will prescribe an antifungal cream such as clotrimazole to treat the infection. You’ll need to apply the cream to the head of your penis and foreskin.
• Antibiotics. If a sexually transmitted infection is the cause of your symptoms, your provider will treat the infection with antibiotics. The antibiotic will depend on the type of infection.
• Thoroughly cleaning your penis more often. Your provider will recommend that you regularly wash and dry under your foreskin to reduce the risk of balanitis returning. Don’t scrub or excessively wash your penis with harsh soaps. Warm water is often enough.
• Diabetes management. If you have diabetes, your provider will show you how to manage the condition.
• Circumcision. If you have recurring symptoms of balanitis, your provider may recommend circumcision. Circumcision is a surgical procedure in which a surgeon removes the foreskin covering your penis. Surgeons recommend this treatment most often for people who have an especially tight foreskin. If you don’t want a full circumcision, your surgeon may recommend a dorsal slit. A dorsal slit won’t remove your foreskin, but it will open the tight ring up so you can see the head of your penis.

Will balanitis go away by itself?

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

What is the fastest way to cure balanitis?

The fastest way to cure balanitis is to talk to a healthcare provider. They can make an official diagnosis, determine the cause and prescribe the best treatment.

To help quickly relieve swelling and pain, you can take over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen (Tylenol®). Not everyone can take these medications, so it’s a good idea to check with your healthcare provider. You can also apply ice or a cold compress wrapped in a light towel for up to 10 minutes several times a day to help reduce swelling.

How soon after treatment will I feel better?

In most cases of balanitis, you’ll start to feel better within a few days or a week after treatment.

How can I prevent balanitis?

Preventing balanitis begins with practicing proper hygiene. To prevent balanitis, you should bathe often. Take the time to pull back your foreskin and clean the area underneath with warm water, and then dry it completely. Always use a condom when having sex to avoid contracting a sexually transmitted infection that can cause balanitis.

What can I expect if I have balanitis?

With a proper diagnosis and treatment, you should make a full recovery.

What is the outlook for people who have balanitis?

Most people with balanitis recover with treatment. For people who have foreskin, it’s common for balanitis to return after treatment. The risk increases if you don’t clean under your foreskin regularly.

How do I help relieve symptoms of balanitis?

To ease the irritation and inflammation of balanitis, you should:

• Bathe often. Wash every day. Be sure to pull your foreskin back so you can clean the area underneath.
• Avoid harsh soaps. Try not to use strong soap or lotions that can irritate your skin.
• Stay dry. After peeing, dry the area under your foreskin so you don’t trap pee under your foreskin.
• Teach proper hygiene. Teach your child how to thoroughly clean their penis, especially if they have foreskin.

Can I have sex if I have balanitis?

You should avoid having sex while you have balanitis, especially if you don’t know its cause. Sex 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 your partner can’t catch it from you, it’s a good idea to be honest with them about it. If they have any questions, encourage them to talk to a healthcare provider.

Can I masturbate if I have balanitis?

If you have balanitis, masturbation can cause further irritation or discomfort. If you have pain, it’s a good idea to avoid masturbating until your penis has time to heal.

When should I see my healthcare provider?

If you have symptoms of balanitis, you should visit your provider. Your provider will test you for infection and recommend good hygiene practices.

What questions should I ask my healthcare provider?

• How can you tell I have balanitis?
• What’s the cause of my balanitis?
• If I don’t have balanitis, what other condition might I have?
• What tests will you conduct to confirm your diagnosis?
• Is it safe for me to have sex?
• What are the best ways for me to keep my penis and genital area clean?
• Is there a medication you can prescribe?
• Do I need to see a specialist?

What is the difference between balanitis and herpes?

Herpes simplex 2 (HSV-2 or genital herpes) is an STI that causes painful sores on your genitals after you come in contact with the saliva (spit) or genitals of someone who has herpes. Genital herpes is a lifelong infection.

Balanitis isn’t an STI. It typically affects people who have foreskin, but it goes away with treatment. You can help prevent it from returning by regularly washing and drying the area or getting a circumcision.

Can I put Neosporin® on balanitis?

Neosporin® (bacitracin, neomycin, polymyxin B) is a skincare ointment that helps prevent infections in minor scrapes or cuts on your skin. If a bacterial infection causes balanitis, Neosporin® may help kill the bacteria. However, in many cases, you may need an oral antibiotic.

A note from Cleveland Clinic

Balanitis can affect up to 1 in 10 people who have a penis, and it’s more likely to occur if you have foreskin. It can be alarming, embarrassing and annoying, but it’s important to talk to a healthcare provider. They can help determine the cause and get you the proper treatment so it goes away. They can also help educate you on the best ways to prevent it from coming back.