From the Guidelines
Treatment for balanitis typically involves addressing the underlying cause while maintaining good hygiene, with the most effective approach often being a combination of topical antifungal or antibacterial agents and good genital hygiene practices 1. For mild cases, regular cleaning with warm water (avoiding soap) and keeping the area dry is often sufficient.
- If caused by a fungal infection, antifungal creams like clotrimazole 1% or miconazole applied twice daily for 7-14 days are effective.
- Bacterial infections may require antibiotics such as mupirocin ointment or oral antibiotics like cephalexin 500mg four times daily for 7-10 days.
- For inflammation, a mild corticosteroid cream like hydrocortisone 1% can reduce swelling and discomfort. If balanitis is related to diabetes, blood sugar control is essential.
- Uncircumcised men should retract the foreskin during washing and ensure the area is completely dry afterward. Persistent or recurrent balanitis may require evaluation for underlying conditions or consideration of circumcision, as noted in guidelines for managing related conditions like lichen sclerosus 1. Treatment should continue until symptoms resolve completely, usually within 1-2 weeks, and sexual activity should be avoided until healing is complete to prevent irritation and transmission of potential infections, with consideration of treating sex partners who have symptomatic balanitis or penile dermatitis 1.
From the Research
Treatment Options for Balanitis
- Infections must be treated and the glans penis should be kept dry, ensuring a balanced genital hygiene in patients 2
- Therapeutic circumcision can be considered for most forms of chronic balanitis as a last resort 2
- Topical mupirocin ointment has been shown to be effective in treating Zoon's balanitis, also referred to as balanitis circumscripta plasmacellularis (BCP) 3, 4
- Other treatments for BCP have included circumcision, topical calcineurin inhibitors, phototherapy, and laser therapy 3, 4
Importance of Diagnosis and Treatment
- Balanitis can have numerous complications, including severe pain, urethral stenosis, phimosis, sexual dysfunction, and if untreated, malignancy 5
- A thorough patient history with respect to topically applied products and sexual behavior is essential for diagnosis 2
- Any fixed, chronic or suspicious lesion must be rapidly assessed by a biopsy to rule out pre-malignant lesions 6
Considerations for Management
- Normal aspects of the balanopreputial area should be explained to patients to avoid anxiety 6
- The difference between the circumcised and uncircumcised penile skin should be considered when diagnosing and treating dermatoses of the glans and corona 6
- A comprehensive guide to balanitis, including its various etiologies, clinical workup, and treatments, is necessary to improve clinical outcomes 5