Balanitis is an inflammation of the glans (head) of the penis. It usually causes redness and/or a blotchy rash on the glans, sometimes with a discharge. The condition may be itchy or uncomfortable but often feels completely normal.
Why balanitis occurs
Balanitis is not sexually transmitted. It results from an overgrowth of organisms which are normally present on the skin of the glans. The condition most commonly occurs in men who have a foreskin (i.e. have not been circumcised). The environment under the foreskin is warm and moist, and these conditions often favour the growth of the organisms that cause balanitis.
These organisms are especially likely to multiply and cause inflammation if moisture is allowed to persist under the foreskin for a while. This may occur if you have not washed for a couple of days, or sometimes after sexual activity (vaginal, oral or anal – with or without a condom).
One common organism associated with balanitis is a yeast known as Candida albicans. Balanitis may occur because of excessive growth of Candida, due to moisture and warmth under the foreskin.
Management of balanitis
The aim of treatment is to keep the glans and foreskin clean and dry to make it difficult for organisms to grow under the foreskin. Medication (e.g. cream or ointment) is rarely necessary, and is usually less effective than good hygiene measures.
Once a day, ideally when you have a shower, slide your foreskin back towards your body until the glans is completely uncovered (Figures 1a and 1b). Do not use any force. If there is any resistance or discomfort, check with a doctor.
Wash the end of your penis and foreskin thoroughly using warm water only. Alternatively, sorbolene and glycerine cream (available from chemists and supermarkets) may be used as a substitute for soap.
After washing, dry the end of the penis and foreskin thoroughly. If convenient, sit with the glans exposed to the air for 10 minutes. More thorough drying can be achieved by using a fan or hair dryer (Figure 2).
After drying, replace the foreskin.
When you urinate, slide the foreskin back so that urine does not wet the foreskin (Figures 4a & 4b). After urination, dry the end of the penis and replace the foreskin.
If you are prone to develop balanitis a few hours after sex, wash the penis as described above shortly after having sex. Make sure the glans is completely dry before replacing the foreskin.
These measures should lead to a rapid improvement in symptoms and help prevent further episodes of balanitis.
If you experience repeated attacks of balanitis despite adequate foreskin hygiene, consult your doctor.