Balanitis

Balanitis is the term doctors use to describe inflammation of the glans, i.e. the head of the penis.

Balanitis can be caused by a bacterial, viral or yeast infection. However, an irritation (for example, due to the use of perfumed soap) or an allergic reaction (e.g. to latex in condoms) may also cause this condition to develop.

Inflammation of the glans can mostly be prevented by regular, gentle personal hygiene.

Pain and redness in the area of the glans may indicate an inflammation.

Other typical symptoms of balanitis are:

• itching
• swelling of the penis
• pain when urinating
• purulent discharge (i.e. pus-containing fluid) from the urethral opening (hole at the tip of the penis)
• plaques or sore areas on the skin
• difficulty pulling back the foreskin

Balanitis may have a range of causes. It is frequently caused by poor intimate hygiene, which results in a build-up of smegma between the foreskin and the head of the penis. Smegma is a substance comprising a mixture of skin oil secreted by glands in the genital area, shed skin cells and bacteria, which provides a breeding ground for infections.

Cosmetic products, such as perfumed soaps, which attack the skin’s protective acid mantle, as well as excessive intimate hygiene can also increase the risk of balanitis.

Balanitis is often triggered by fungi but can also be caused by infections with sexually transmitted bacteria and viruses. These include the pathogens of gonorrhea and syphilis as well as human papillomaviruses, for example. 

In addition, allergic reactions to medication (medication allergy) or latex in condoms (contact allergy) may trigger an inflammation.

Finally, other skin conditions, such as psoriasis or lichen sclerosus (a rare and chronic skin disease in the genital area), may cause the head of the penis to become inflamed.

Inflammation of the glans is relatively common. Around 12 to 20 percent of all men will develop balanitis at some point in their lives. Balanitis is also more likely to occur if phimosis (a condition where the foreskin is too tight to be pulled back) is already present.

The best way to prevent balanitis is to wash the penis and glans regularly. When doing so, uncircumcised men should carefully pull back the foreskin and give the head of the penis a gentle but thorough wash with water. This gentle washing is also advisable if anything could have collected between the glans and the foreskin, such as sport-induced sweat, smegma, residual sperm or lubricant following sex.

It is also important to change young boys’ diapers frequently enough and clean the head of the penis when doing so. The same rule applies here: be thorough but gentle, i.e. do not use any products that could irritate the skin and do not push back the foreskin if it is tight or stuck to the glans.

Redness and skin changes on the glans usually indicate an inflammation. To determine whether the man is suffering from a fungal infection or infection with sexually transmitted bacteria, tests are used to identify pathogens. Further tests, such as blood or urine tests, can be useful to check whether the inflammation has also affected the urinary tract or has been caused by a sexually transmitted disease. They are also able to determine risk factors such as diabetes.

If the man is uncircumcised, the doctor will also determine how easily the foreskin moves and how easily it can be pulled back in order to exclude complications such as phimosis.

Balanitis can usually be simply treated by carefully washing the inflamed area two to three times per day – ideally with clean, warm water. The area can be dried using disposable cotton swabs or dry wipes.

People affected can try to speed up the healing process with compresses and sitz baths (warm, shallow baths) containing an antiseptic like octenidine. Painkillers such as ibuprofen or paracetamol can be used for more severe pain.

Medical advice should be obtained if symptoms do not improve after a week at most. The doctor can determine the precise cause and recommend suitable products to be applied to the area.

If the inflammation is caused by a yeast infection, anti-fungal ointments (anti-fungals) can be applied to the skin. Anti-inflammatory cortisone creams can be used if the cause is an allergic reaction. Antibiotic creams are used to treat inflammations caused by a bacterial infection. Oral medication can sometimes also help.

If you suspect that you have balanitis or are experiencing pain and redness in the glans area, you can contact a urologist.