Balanitis: Inflammation of the Penis Head

Balanitis is inflammation of the head of the penis (also known as the glans). When the foreskin is also inflamed, it is referred to as balanoposthitis. Balanitis and balanoposthitis mainly occur in uncircumcised men.

Balanitis is a condition affecting about 11% of adults with penises and 4% of children with penises. It is most common in those over 40, although it can occur at any age.

This article describes the symptoms, causes, complications of balanitis and balanoposthitis. It also provides an overview of the treatment options.

Balanitis Symptoms

Balanitis and balanoposthitis can cause the following symptoms:

• Redness, swelling, and tenderness of the penis head
  
• A thick discharge from under the foreskin (called smegma)
• Bleeding under the foreskin
• A foul odor
• Itching
  
• Painful urination

Complications

Though rare, balanitis and balanoposthitis can lead to complications that can affect both urinary and sexual function. This is especially true if the condition is severe or recurrent.

Possible complications include:

• Balanitis xerotica obliterans (BXO): A progressive skin condition that can cause the hardening of the glans and foreskin
• Meatal stenosis: The abnormal narrowing of the urethra (the passage through which urine exits the body)
• Paraphimosis: The inability to pull the foreskin over the head of the penis
• Phimosis: The inability to retract the foreskin

Balantitis is also associated with a three-fold increased risk of penile cancer.

Causes

The exact cause of balanitis and balanoposthitis is often unclear. Poor hygiene is thought to play a central role.

In people with foreskins, the accumulation of smegma can cause an inflammatory reaction that leads to swelling and redness. The warmth and moisture under the foreskin also provide the perfect environment for bacterial and fungal infections.

Risk factors of balanitis include:

• Having a foreskin
• Poor penile hygiene
  
• Scented soaps or shower gels
• Harsh detergents and fabric softeners
• Overwashing the penis
• Physical friction
• Spermicidal lubricants
• Diabetes
• Antibiotic use
• Allergies (such as an allergy to latex condoms)

Infections

Infections, whether viral, bacterial, or fungal, can cause balanitis and balanoposthitis. These include:

• Penile thrush: A yeast infection caused by the fungus Candida albicans
• Sexually transmitted diseases: Including chlamydia, gonorrhea, and syphilis
• Staphylococcus aureus: A bacteria commonly associated with skin infections
• Streptococcus pyogenes: The same bacteria associated with strep throat

Treatment

If you develop the signs and symptoms of balanitis, it is important to seek medical attention. If left untreated, balanitis can lead to complications like paraphimosis.

Treatment options include:

• Improved hygiene: With water and gentle soap rather than harsh detergents
• Avoidance of irritants: Including harsh soaps and spermicidal lubricants
• Oral or topical antibiotics: Used to treat bacterial infections
• Topical antifungals: The standard treatment for penile thrush
• Diabetes management: If diabetes is a contributing factor
• Circumcision: May be advised for recurrent balanitis or in the event of phimosis or paraphimosis

Summary

Balanitis is the inflammation of the head of the penis. Symptoms include redness, swelling, itching, and a foul-smell discharge from under the foreskin. In rare instances, balanitis can lead to phimosis (the inability to retract the foreskin) or paraphimosis (the inability to pull the foreskin back over the head of the penis).

Balanitis mainly affects people with penises who are not circumcised. Poor hygiene, diabetes, harsh soaps and detergents, and bacterial or fungal infections contribute.

The treatment of balanitis varies by the cause. The treatment options include antibiotics, antifungals, and, in severe or recurrent cases, circumcision. Good penile hygiene is also essential.