From the Guidelines
For atopic dermatitis leading to balanitis on the glans penis, I strongly recommend a treatment approach that prioritizes reducing inflammation and preventing further irritation, as outlined in the most recent guidelines for atopic dermatitis management 1. The treatment should involve:
- Applying a mild-to-moderate potency topical corticosteroid, such as triamcinolone 0.1% ointment, twice daily for 7-10 days to reduce inflammation
- Following the steroid course with regular application of a gentle, fragrance-free moisturizer, like petroleum jelly or ceramide-containing emollients, to help repair the skin barrier
- Maintaining good genital hygiene by washing gently with warm water only (no soap) and thoroughly drying afterward
- Avoiding potential irritants, including scented products, harsh soaps, and tight-fitting underwear This approach is supported by the understanding that atopic dermatitis is a chronic, pruritic inflammatory skin disease that can affect adults and is often associated with elevated serum immunoglobulin (IgE) levels and a personal or family history of type I allergies, allergic rhinitis, and asthma 1. It's also important to note that treatment of sex partners is not necessary unless they have symptomatic balanitis or penile dermatitis, in which case they should be treated with a topical agent 1. Key considerations for managing atopic dermatitis leading to balanitis on the glans penis include:
- Reducing inflammation to prevent further irritation and potential secondary infections
- Repairing the skin barrier to promote healing and prevent future episodes
- Maintaining good genital hygiene to prevent further irritation and infection
- Avoiding potential irritants to reduce the risk of exacerbating the condition By following this treatment approach and prioritizing good genital hygiene and avoidance of irritants, individuals with atopic dermatitis leading to balanitis on the glans penis can effectively manage their symptoms and reduce the risk of complications.
From the Research
Atopic Dermatitis and Balanitis
- Atopic dermatitis can lead to balanitis, which is inflammation of the glans penis, as seen in patients with a history of atopic illness 2.
- Balanitis can have various etiologies, including infectious and noninfectious causes, and accurate diagnosis is essential for management 3, 4.
- A study found that 72% of patients with recurrent balanitis had irritant dermatitis, and a history of atopic illness and frequent genital washing with soap were common in these patients 2.
Clinical Features and Management
- The clinical features of balanitis include inflammation of the glans penis, and in some cases, the prepuce (balanoposthitis) 4.
- Management of balanitis involves treating the underlying cause, and in cases of irritant dermatitis, use of emollient creams and restriction of soap washing can control symptoms satisfactorily 2.
- Topical corticosteroids are the first-line treatment for atopic dermatitis flare-ups, and topical calcineurin inhibitors can be used in conjunction with topical corticosteroids 5.
Treatment of Atopic Dermatitis
- Maintenance therapy for atopic dermatitis consists of liberal use of emollients and daily bathing with soap-free cleansers 5.
- Fusidic acid, an antibiotic, can be used in the treatment of atopic dermatitis with suspected staphylococcal/secondary infection, and in persistent cases of eczema where staphylococcal superantigen may be playing an exacerbating role 6.
- Newer medications, such as crisaborole and dupilumab, are effective in treating atopic dermatitis but are currently cost prohibitive for most patients 5.