Balanitis - Specialists and Information

Causes of rapid inflammation include:

• Bacterial infection
• Other microorganisms (including fungal infections caused by Candida albicans)
• Substances that irritate the skin, such as toxic or allergenic agents (for example, in cases of contact allergy to genital jewelry, condoms, or laundry detergents)

An infection is usually caused by unprotected sexual intercourse or poor or excessive hygiene. Conditions such as diabetes mellitus (diabetes) or phimosis (tight foreskin) also increase the risk of foreskin inflammation.

For example, phimosis in preschool-aged boys is the most common cause of posthitis. Inflammation of the foreskin is often accompanied by inflammation of the glans (balanitis). When the glans is affected, doctors refer to the inflammation as balanoposthitis.

Inflammation of the foreskin (posthitis) is an inflammation of the foreskin @ icedmocha /AdobeStock

Characteristic symptoms of foreskin inflammation include:

• Swelling, redness, and pain in the area of the foreskin and, in some cases, the glans
• Itching and burning in the inflamed area
• Pain when urinating
• Yellow, pus-like, and foul-smelling discharge
• Possibly a whitish coating and blistering
• Pain in the groin area due to swelling of the adjacent lymph nodes in the groin

In addition, small, localized or widespread weeping skin lesions may develop. In rare cases, ulcers may also occur. As the disease progresses, a general feeling of illness and fever may develop as signs of sepsis.

This is a life-threatening condition and requires emergency medical treatment.

Balanitis is diagnosed based on its characteristic symptoms. The doctor will also determine whether the inflammation is caused by diabetes, an allergy, or mechanical or chemical irritation.

During the physical examination, the doctor examines:

• the penis
• the inflamed area, and
• the adjacent lymph nodes in the groin area

They check for any swelling.

To rule out a possible infection, he takes a swab of the inflamed foreskin using a cotton swab. He then sends the sample to a laboratory, which tests the swab for specific pathogens. Once the pathogen has been identified, the doctor can plan targeted treatment.

In some cases, a urinalysis is necessary. If a contact allergy is suspected, an allergy test is also recommended.

Treatment depends on the cause of the inflammation:

• If the inflammation is bacterial in origin, treatment with antibiotics is recommended.
• For fungal infections, an antifungal medication (an agent that kills fungi) is used. As a rule, the patient does not need to take this orally in the form of tablets. In most cases, an ointment containing the active ingredient is sufficient. The patient applies this ointment to the inflamed area.
• If the inflammation has a non-infectious cause, such as in the case of a contact allergy, corticosteroid-containing preparations are recommended. In addition, it is advisable to avoid the allergen in the future (e.g., by switching laundry detergents). If the inflammation continues to spread, oral antibiotics or antifungals, or immunotherapy, may be considered.

Sexually active individuals should ensure that their partner also receives treatment in the event of an infection.

Home Remedies for Foreskin Inflammation

Patients can treat mild irritation with antiseptic sitz baths containing an antiseptic solution.

The use of chamomile is also recommended. If you are allergic to chamomile, tea tree oil or baking soda can be used instead.

Antiseptic baths also provide supportive care as part of drug therapy. Rinsing with saline solution is often helpful as well.

Wound ointments (such as those containing dexpanthenol) can further reduce symptoms.

Since balanitis can also result from excessive genital hygiene, thorough hygiene is recommended. However, avoid harsh and alkaline soaps and disinfectants.

With frequent use, these soaps strip the skin of its protective oils, making it more susceptible to pathogens. In addition, you should use only low-oil lotions for skin care.

Circumcision for Chronic Inflammation Due to Foreskin Constriction

If phimosis (a tight foreskin) is present and repeatedly leads to inflammation, partial or complete removal of the foreskin (circumcision) is recommended.

The procedure should be performed during a period when there is no infection. Circumcision can also be beneficial for people with diabetes, as they are frequently affected by foreskin inflammation.

Sketch of a circumcision @ Nena /AdobeStock

When the prescribed medications are used consistently and treatment is started promptly, balanitis usually heals without any problems.

If left untreated, inflammation at the tip of the penis can lead to cicatricial phimosis, a specific form of foreskin narrowing.

In this condition, the inflammation causes small wounds that later develop into scars, which narrow the foreskin. An infection can also spread upward into the urinary tract, leading to additional sites of inflammation there.

As a result, inflammation may occur in the following areas:

• Bladder
• Urethra
• Prostate and/or
• Epididymis

In the worst-case scenario, the infection spreads into the bloodstream and causes life-threatening sepsis.