Posthitis

Posthitis is cellulitis that affects your foreskin. In Greek, “posthe” means foreskin, and “itis” means inflammation. It isn’t a sexually transmitted infection (STI). It can cause some discomfort and pain. But most of the time, it isn’t serious.

Posthitis (pronounced “pahs-thite-es”) is common. It may affect between 12% and 20% of males who have foreskin. It commonly occurs at the same time as balanitis. Balanitis is inflammation of the head of your penis (glans). Balanoposthitis is when you have inflammation on both your foreskin and glans.

Symptoms of posthitis

Posthitis symptoms include:

• Pain
• Tenderness
• Swelling
• Itching
• Foul-smelling discharge
• Discoloration (red, purple or slightly darker than your usual skin color) that may look like a rash

In severe cases, posthitis can make it difficult to pee.

What is the main cause of posthitis?

The main cause is not regularly washing your foreskin and the sensitive skin underneath. This can allow bacteria and fungi to build up. Common bacteria that cause posthitis include:

• Streptococcus
• Haemophilus parainfluenzae
• Klebsiella
• Staphylococcus epidermidis

But posthitis has many other causes. These include:

• Not being able to pull back your foreskin (phimosis)
• Fungal infections, including candidiasis
• STIs, including gonorrhea
• Psoriasis
• Eczema
• Dermatitis
• Allergies, including latex condoms, lubricants, spermicides and corticosteroids

Inflammation can also occur if you scrub your foreskin while cleaning the area.

Is it a yeast infection?

Not always. But candidiasis is a yeast infection that can cause posthitis. It occurs when an overgrowth of the fungus Candida albicans affects your foreskin.

Risk factors

The biggest risk for posthitis is if you have foreskin. Circumcision is a surgical procedure that removes the foreskin from your penis. This usually happens shortly after birth. But not always. If you’re uncircumcised, you still have your foreskin.

You’re at a greater risk of posthitis if you wear diapers or absorbent underwear. These make it easier for bodily fluids and irritants to collect under your foreskin, like:

• Sweat
• Pee
• Dead skin
• Bacteria
• Debris

You may also be more likely to have posthitis if you have diabetes, phimosis or penile cancer.

Complications

Recurrent infections are when you get posthitis many times over the course of a year. This may be a sign that you have diabetes.

Untreated posthitis can also cause paraphimosis. This is when you can’t pull your foreskin back down over the head of your penis. It can cut off circulation to the tip of your penis. Paraphimosis is a medical emergency.

Can I have sex if I have foreskin inflammation?

Posthitis isn’t an STI. But an STI may cause posthitis. You should avoid sexual intercourse until you know the cause.

Friction during sex can also cause more irritation and discomfort. Avoiding sex may help posthitis go away faster.

It’s a good idea to be honest with your partner(s) if you have posthitis. If they have any questions, encourage them to talk to a healthcare provider before you have sex. If you have sex while you have posthitis, carefully clean and dry your foreskin afterward. Reapply any medications.

How doctors diagnose posthitis

Your healthcare provider will first review your health history and ask about your symptoms. They’ll also perform a physical exam of your penis. They usually won’t need to conduct any tests to confirm posthitis. But they may recommend tests to determine the cause.

Tests that are used

A healthcare provider may recommend the following tests to determine the cause of posthitis:

• Skin test: Your provider will gently rub a cotton swab over your foreskin. They’ll send the swab to a lab to help identify bacteria and viruses.
• Urethral discharge swab: Your provider will gently insert a cotton swab about 0.75 inches (2 centimeters) into your urethra and gently rotate it. They’ll send the swab to a lab to help identify bacteria and viruses.
• Pee test: You’ll pee into a special cup, and your provider will send your sample to a lab for analysis. They’ll look for different causes of posthitis. These include bacteria or high sugar (glucose) levels. High glucose levels could be a sign of diabetes.

How do you get rid of posthitis?

Posthitis treatment depends on the cause. Treatments may include:

• Antibiotics: Antibiotics can treat bacterial and viral infections. Be sure to finish the complete course. If you don’t, the infection can come back and be harder to treat.
• Antifungal creams: Antifungal creams can treat fungal infections. Apply the cream to your foreskin as prescribed by your provider.
• Antihistamines: Antihistamines can treat allergens that cause posthitis.
• Circumcision: Your provider may recommend removing your foreskin if you get posthitis a lot.
• Diabetes management: If you have diabetes, your provider can help. Management may include monitoring your glucose, cholesterol and triglyceride levels. You may also need to manage your blood pressure, follow a food plan and get regular physical activity.
• Regular bathing: Wash your foreskin and genitals every day with soap and warm water. Be sure to thoroughly rinse and dry.

Is there anything else I can do?

You can also help ease inflammation and discomfort by:

• Avoiding harsh soaps and lotions: Use soaps and lotions that are free of perfumes, dyes and alcohol. Look for “fragrance-free,” “hypoallergenic” or “for sensitive skin” on product labels.
• Wearing loose underwear and pants: Tight underwear and pants trap heat and moisture around your groin. This can create a good environment for fungi to grow.
• Using mild laundry detergent: Use mild laundry detergents to wash your clothes, especially your underwear and pants. It’s also a good idea to use an extra rinse cycle to wash out all of the detergent.
• Staying dry: After peeing, dry your foreskin and the skin under your foreskin.

When should someone seek medical attention?

Talk to a healthcare provider if posthitis causes problems peeing. You should also reach out if you have discomfort or pain for more than a week.

During your appointment, you may want to ask questions like:

• What’s the cause?
• If I don’t have posthitis, what other condition may I have?
• Do I also have balanitis?
• What tests do you recommend to confirm the cause?
• Is it safe for me to have sex?
• Is there a medication you can prescribe?
• Should I see a dermatologist, urologist or another specialist?

What is the prognosis for posthitis?

The outlook for most people who have posthitis is good. In most cases, it goes away on its own within a week.

The risk of posthitis coming back is higher if you don’t regularly clean under your foreskin. If you get posthitis often, your provider may recommend circumcision.

Can posthitis be prevented?

The best way to prevent posthitis is to bathe regularly. Carefully wash your foreskin and genital area with soap and warm water. Pull your foreskin back to clean the skin underneath. Pat dry.

It’s also a good idea to wear a condom while having sex. Wearing a condom can help prevent STIs that cause posthitis.