Definition

Balanitis is swelling of the foreskin and head of the penis.

Alternative Names

Balanoposthitis

Causes

Balanitis is most often caused by poor hygiene in uncircumcised men. Other possible causes include:

• Diseases, such as reactive arthritis and lichen sclerosus atrophicus
• Infection
• Harsh soaps
• Not rinsing soap off properly while bathing
• Uncontrolled diabetes

Symptoms

Symptoms include:

• Redness of foreskin or penis
• Other rashes on the head of the penis
• Foul-smelling discharge
• Painful penis and foreskin

Exams and Tests

Your health care provider may diagnose the problem with only an exam. However, you may need skin tests for viruses, fungi, or bacteria. A skin biopsy may also be needed. An exam by a dermatologist may be helpful.

Treatment

Treatment depends on the cause of the balanitis.

• Antibiotic pills or creams are used to treat balanitis that is caused by bacteria.
• Steroid creams may help balanitis that occurs with skin diseases.
• Anti-fungal cream will be prescribed if it is due to a fungus.

In severe cases, circumcision may be the best option. If you cannot pull back (retract) the foreskin to clean it, you may need to be circumcised.

Outlook (Prognosis)

Most cases of balanitis can be controlled with medicated creams and good hygiene. Surgery is not needed most of the time.

Possible Complications

Long-term swelling or infection can:

• Scar and narrow the opening of the penis (meatal stricture)
• Make it difficult and painful to retract the foreskin to expose the tip of the penis (a condition called phimosis)
• Make it difficult to move the foreskin over the head of the penis (a condition called paraphimosis)
• Affect the blood supply to the tip of the penis
• Increase the risk of penile cancer

When to Contact a Medical Professional

Tell your provider if you have any signs of balanitis, including swelling of the foreskin or pain.

Prevention

Good hygiene can prevent most cases of balanitis. When you bathe, pull back the foreskin to clean and dry the area under it.

References

Augenbraun MH. Genital skin and mucous membrane lesions. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 106.

McLarney RM, Heymann WR. Balanitis. In: Lebwohl MG, Heymann WR, Coulson IH, Murrell D, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 6th ed. Philadelphia, PA: Elsevier; 2022:chap 22.

Virasoro R, Jordan GH, McCammon KA. Surgery for benign disorders of the penis and urethra. In: Partin AW, Domochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 82.