What is balanoposthitis?
Balanitis is the inflammation of the glans penis. Posthitis is inflammation of the foreskin. Balanoposthitis is a combination of these 2 conditions. We usually shorten it to just balanitis to refer to both conditions as they commonly occur together. Inflammation can come from either irritants, or infections, or both.
How do I know if I have balanoposthitis? What are the common symptoms to watch for?
Symptoms include redness, swelling, itch, pain/discomfort of the affected areas. There may be a malodorous smell and increase in smegma build-up. If the swelling is more serious, there may be difficulty in retraction of foreskin, also known as phimosis.
Is balanoposthitis contagious?
Balanoposthitis may be contagious if it is due to an infectious cause. Fungal or bacterial infections may be passed from the male to female tract, resulting in what we commonly refer to as yeast infection/vaginitis. For females with recurrent yeast infections, we always want to check their partners and treat any balanitis if it is present.
If balanitis is caused by irritation, this is not contagious.
Can poor hygiene cause balanoposthitis?
Yes. Poor hygiene is a significant contributing factor to balanitis. When the foreskin and glans penis is not kept clean, smegma can build up which can irritate the skin and increases the risk of infection.
Will balanoposthitis go away on its own?
Mild cases may go away on their own. With better hygiene and avoiding irritants, the body can recover once the triggering factor is removed. However, many cases do require medical treatment. Leaving it untreated may result in complications such as recurrent infections and even scarring.
Can balanoposthitis be a sign of a more serious condition?
Yes. Balanoposthitis risk is increased if there is any underlying diabetes. The skin may also be irritated not just from skin infections, but sexually transmitted diseases as well. If the lesion looks suspicious, penile cancer has to be ruled out too.
What causes balanoposthitis — is it bacterial, fungal, or both?
Many times, infectious causes may be bacterial, fungal or both. We commonly cover for both fungal and bacterial infections with combination treatment with antifungals and antibiotics. If antimicrobials are given, and there is still no improvement, other causes we may think of include skin conditions e.g. eczema, poor hygiene, contact irritants such as soaps or even allergies such as to latex.
How is balanoposthitis diagnosed at the clinic?
Balanoposthitis is diagnosed clinically with a thorough history taking and physical examination. If it is resistant to treatment, we may consider doing some swabs to source for the exact etiology.
What treatments are available for balanoposthitis? Do I need antibiotics or antifungal medication?
We usually treat with a mix of topical and oral meds which will include anti-microbials (antibiotic + antifungal) and some mild steroids to reduce inflammation. If the case is mild enough, we may just use topical medications. Lifestyle change with avoidance of irritants and hygiene improvement is also necessary.
How long does it take to recover from balanoposthitis?
For mild cases you should see clinical improvement with just topical meds in 2-3 days. For more severe cases, it should improve with oral meds within the week. If cases are persistent, we may try different medications one after the other.
When should I see a doctor for balanoposthitis?
You should see a doctor early, as treating mild cases is much easier than treating advanced cases. We will also try to rule out if there are any underlying conditions such as diabetes or sexually transmitted infections.. If there is paraphimosis, where the foreskin is trapped behind the glans penis, this is an emergency and you must seek medical attention immediately.
Can recurrent balanoposthitis be prevented?
Yes. With good hygiene practices, avoiding irritants and managing underlying conditions such as diabetes, the risk of balanoposthitis can be greatly reduced/prevented.
Is circumcision recommended for those with frequent balanoposthitis?
Circumcision is indicated for recurrent balanoposthitis, or balanoposthitis which is resistant to treatment. If there is no foreskin, there is no foreskin infection!
Medically reviewed by Dr. Harold Ma, and Dr. Chester Lan.