Can Balanitis Cure Itself?

Balanitis is the inflammation of the head of the penis, usually due to infection.

Balanitis is a common condition that causes inflammation of the head of the penis, called the glans. When the head of the penis and foreskin are inflamed, it is referred to as balanoposthitis. Balanitis affects 3-11% of males and is one of the most common reasons men and boys need to see a urologist.

Symptoms of balanitis and balanoposthitis include: 

• Discharge from the penis 
• Pain, tenderness, redness on the head of the penis (glans)
• Difficulty retracting the foreskin
• White or yellow buildup under the foreskin (smegma)
• Impotence (difficulty getting or maintaining an erection, also called erectile dysfunction)
• Pain with erection
• Burning or pain on urination (dysuria)
• Itching
• Fever (uncommon)
• Difficulty urinating or inability to urinate (in very severe cases)

Risk factors for developing balanitis and balanoposthitis include: 

• Diabetes 
• Especially patients treated with dapagliflozin
• Poor hygiene of foreskin
• Obesity
• Congestive heart failure
• Cirrhosis of the liver
• Use of chemical irritants (certain soaps or lotions)
• Allergies to certain medications 

Certain infections, including some sexually transmitted diseases (STDs), can cause balanitis and balanoposthitis, including: 

• Yeast infections (Candida)
• Streptococcus infections
• Gonorrhea 
• Chlamydia 
• Human papilloma virus (HPV)
• Trichomonas
• Syphilis

There are some other conditions that may lead to types of balanitis, such as:

• Lichen sclerosus
• Zoon balanitis 
• Reiter disease 

A doctor will perform a physical exam to look for balanitis and balanoposthitis, including: 

• Redness and swelling of the head of the penis (glans) and foreskin
• Discharge from the penis
• Skin ulceration or open sores on the head of the penis
• Swelling, redness, or discharge from the urethra 
• Swollen lymph glands in the groin 
• White or yellow buildup under the foreskin (smegma)

Lab tests that may be ordered to help diagnose the cause of balanitis or balanoposthitis include:

• Culture of the discharge to check for infection
• Syphilis test
• Urinalysis 
• Blood sugar levels
• HIV testing
• Swab for yeast infection (Candida)
• Ultrasonography or bladder scan may be if urinary obstruction is suspected

Treatment for balanitis and balanoposthitis depends on the underlying cause, however, it starts with cleaning the head of the penis (glans) and foreskin. 

Once the cause of balanitis or balanoposthitis is diagnosed, self-care at home may be all that is needed to treat the condition. Patient education on improving personal hygiene is important. To properly clean the head of the penis and foreskin retract the foreskin and gently clean with soap and warm water.

If there is an infection or inflammatory cause of balanitis and balanoposthitis, treatments may include:

• Antifungal creams or ointments applied topically
• Topical steroids
• Antibiotic creams such as bacitracin 
• If there is evidence of infection to the skin (cellulitis), oral antibiotics such as cephalosporins may be prescribed

If the balanitis or balanoposthitis is severe and is causing urinary obstruction, this is a medical emergency that may require local incisions to the foreskin and possibly corrective surgery. A urologist may need to be consulted in severe cases.

Complications of balanitis or balanoposthitis may include:

• Chronic pain of the head of the penis (glans)
• Lesions on the glans or foreskin 
• Infection
• Urinary retention or blockage of the bladder
• Urethral narrowing (stricture)
• Sexual dysfunction 
• Phimosis (foreskin is unable to retract)
• Paraphimosis (foreskin is trapped behind the head of the penis – this is a medical emergency)

The important steps in prevention of balanitis or balanoposthitis include:

• Maintaining good personal hygiene
• Controlling diabetes
• Managing other chronic medical disorders
• Weight loss for obese patients