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Balanitis: Types, Causes, Symptoms, Diagnosis, Complications, Treatment And Prevention

Balanitis is a type of inflammation of the glans, or the head, of the penis caused due to infections or chronic skin conditions. It is common in nature and affects 1 in 20 males. Although not of serious nature, balanitis is painful and causes irritation. Boys under the age of 4 years and uncircumcised men are at the highest risk, but it can happen at any age [1] .

Women can also have balanitis, as the term is used to describe an inflammation of the clitoris.

Types Of Balanitis

The inflammatory condition is of three types and they are as follows [2] :

  • Zoon's balanitis: This type is defined by the inflammation of the head of the penis and the foreskin and usually affects middle-aged to older men are not circumcised.
  • Pseudoepitheliomatous keratotic and micaceous balanitis: This type is characterized by scaly, wart-like skin lesions on the head of the penis.
  • Circinate balanitis: It normally occurs as a result of reactive arthritis.

Causes Of Balanitis

The inflammation is usually caused by infections, chronic skin condition and lack of proper hygiene. Improper hygiene, such as both inadequate cleansing and too much cleansing can cause balanitis [2]. Usually caused by an overgrowth of either bacteria or yeast, balanitis affects the foreskin of the penis, as it is easy for the organisms to grow there due to the moisture [3] .

Apart from that, several causes attributed to the condition. An infection caused by Candida albicans is the most common cause of balanitis. Sexually transmitted infections (STIs) such as Herpes simplex virus, Chlamydia, and syphilis are also considered as causes of balanitis [4] .

In addition to the aforementioned, the following are also considered as the causes of balanitis [5] :

  • Skin conditions such as lichen planus, eczema, psoriasis and dermatitis
  • Irritants such as chemicals used in condoms, lubricants, and spermicide; detergents or washing powders; and perfumed soaps and shower gels (which when not rinsed off properly can irritate the skin)
  • Reactive arthritis
  • Diabetes
  • Phimosis
  • Certain medications such as laxatives, sleeping pills, painkillers, and antibiotics

Symptoms Of Balanitis

The common signs of the inflammatory condition are as follows [6] :

  • Swollen glands near the penis
  • An unpleasant smell
  • Inflammation, soreness, itchiness, or irritation of the glans
  • A thick, lumpy discharge under the foreskin
  • Sores on the glans
  • Redness around the glans
  • Tight, shiny skin on the glans
  • Tight foreskin that cannot be pulled back
  • Painful urination

Diagnosis Of Balanitis

The condition is usually diagnosed during a physical examination because most of its symptoms are visible (redness and inflammation). The doctor may examine the skin for any dermatosis or skin disease, that involve the genital area.

If the discharge is there, the doctor may take a sample of it with a cotton swab or collect a urine sample. Apart from these, a urine test (if diabetes is suspected) and a blood test (to determine the glucose levels) may be required [7] .

In some cases, a biopsy may be done, in which a sample of the inflamed skin is taken and sent to the lab for testing.

Complications Of Balanitis

If left untreated, the condition can worsen and cause the following complications [8] :

  • Scarring of the opening of the penis
  • Inadequate blood supply to the penis
  • Retracting the foreskin is painful
  • Phimosis, it develops from long-standing (chronic) balanitis

Treatment For Balanitis

The medical care provided for the condition depends on its cause [9] . The doctor will advise you to stop the use of perfumed soaps, lotions, or powders as they are the most common causes of irritation.

After the diagnosis, the doctor may prescribe a medicated anti-itch cream, which can help stop itching and inflammation. In case of an infection, the doctor may prescribe an antibiotic or antifungal medication to help clear it, which will help with inflammation, swelling, itching, and discharge [10] . Medicated creams with steroids to reduce inflammation may also be prescribed.

In case of recurrence, the doctor might suggest circumcision.

Prevention Of Balanitis

It is easy to limit the onset of the inflammatory condition. Practising proper hygiene is the central and primary step in preventing balanitis [11] [12] .

  • Wash your penis regularly and completely dry off.
  • Avoid using perfumed or deodorizing products on your penis.
  • After peeing, dry underneath the foreskin gently.
  • A sitz bath may help to manage symptoms, as the warm water can reduce discomfort.
View Article References
  1. [1] Hall, A. (2019). Plasma Cell (Zoon’s) Balanitis. In Atlas of Male Genital Dermatology (pp. 71-73). Springer, Cham.
  2. [2] Morris, B., & Krieger, J. (2018). Balanitis and related inflammatory conditions affecting the penis.
  3. [3] Pulido-Perez, A., & Suarez-Fernandez, R. (2017). Circinate balanitis. New England Journal of Medicine, 376(2), 157-157.
  4. [4] Borgia, F., Vaccaro, M., Foti, A., Giuffrida, R., & Cannavò, S. P. (2016). Zoon’s balanitis successfully treated with photodynamic therapy: Case report and literature review. Photodiagnosis and photodynamic therapy, 13, 347-349.
  5. [5] Piaserico, S., Orlando, G., & Linder, D. M. (2019). Zoon Balanitis: misdiagnosis or missed diagnosis?. Journal of the European Academy of Dermatology and Venereology.
  6. [6] Chessa, M. A., Sechi, A., Baraldi, C., Barruscotti, S., Leuzzi, M., Gurioli, C., ... & Neri, I. (2018). Zoon's plasma cell balanitis: clinical and dermoscopic features in pediatric patients.
  7. [7] Piaserico, S., Orlando, G., Linder, M. D., Cappozzo, P., Zarian, H., & Iafrate, M. (2019). A case–control study of risk factors associated with Zoon balanitis in men. Journal of the European Academy of Dermatology and Venereology.
  8. [8] Yao, X. Y., Zhou, X. B., Zhang, W. G., Liu, B. Y., Wen, G. D., Zhang, J. Z., & Zhou, C. (2018). Candida Balanitis with Hyperplastic Plaque Mimicking Vascular Neoplasm. Chinese medical journal, 131(10), 1253.
  9. [9] Bunker, C. B. (2019). Zoon balanitis-does it exist?. Journal of the European Academy of Dermatology and Venereology: JEADV.
  10. [10] Micevic, G., Perkins, S. H., & Zubek, A. E. (2018). Balanitis associated with FOLFIRI chemotherapy. JAAD case reports, 4(1), 58-60.
  11. [11] Kumar, S., Singh, S., Vikas, V., & Soni, J. (2017). KEYWORDS Balanitis Xerotica Obliterans, Buccal Mucosa Graft, Ventral Onlay, Tunica Vaginalis. SINGLE STAGE VENTRAL ONLAY BUCCAL MUCOSAL GRAFT URETHROPLASTY BASED ON TUNICA VAGINALIS FLAP FOR BALANITIS XEROTICA OBLITERANS RELATED URETHRAL MEATAL AND NAVICULAR FOSSA STRICTURES, (96364).
  12. [12] Melo, R. C., & Ramos, M. (2019). CCS03. 3 Zoon balanitis in HIV-infected patient.

Read more about: swelling inflammation
Story first published: Tuesday, November 26, 2019, 18:00 [IST]
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