From the Guidelines
Balanitis, an inflammation of the glans penis, should be treated promptly with improved hygiene and topical antifungal or antibiotic creams, depending on the cause, to prevent complications and improve quality of life. For mild cases, improved hygiene is essential—wash the area gently with warm water daily, avoiding soap, and thoroughly dry afterward. Keep the foreskin retracted if possible during healing to allow air circulation. Over-the-counter antifungal creams like clotrimazole 1% applied twice daily for 7-10 days are effective for fungal balanitis, which is common, as suggested by the Centers for Disease Control and Prevention 1. For bacterial infections, topical antibiotics such as mupirocin 2% ointment applied three times daily for 7 days may be prescribed.
Key considerations in managing balanitis include:
- Identifying and treating the underlying cause, whether fungal or bacterial
- Maintaining good hygiene to prevent recurrence
- Considering the potential for underlying conditions such as diabetes or phimosis that may contribute to recurrent balanitis
- Recognizing when symptoms necessitate medical attention, such as significant redness, swelling, discharge, or pain, or failure to improve with self-treatment
It's also important to note that while guidelines for conditions like lichen sclerosus provide insight into the management of genital skin conditions 1, the primary approach to balanitis focuses on addressing the immediate cause of inflammation and preventing future episodes through improved hygiene and, if necessary, circumcision in cases of phimosis. Prompt and appropriate treatment of balanitis is crucial to prevent complications, reduce morbidity, and improve quality of life.
From the Research
Diagnosis of Balanitis
- Balanitis is a descriptive diagnosis for a heterogeneous group of infectious or inflammatory dermatoses that have to be differentiated from malignant conditions 2
- The diagnosis of balanitis involves a complete skin examination and a thorough patient history with respect to topically applied products and sexual behavior 2
- Balanitis can be caused by various factors, including Candida spp., bacterial infections, viral infections, parasites, and other sexually transmitted infections (STI) 2, 3
- Lichen planus, psoriasis, and contact dermatitis can also lead to inflammatory conditions of the glans penis 2
Treatment of Balanitis
- Infections must be treated, and the glans penis should be kept dry 2
- A balanced genital hygiene is essential in patients with balanitis 2
- Therapeutic circumcision can be considered as a last resort for most forms of chronic balanitis 2
- Antifungal agents are commonly used to treat infectious balanitis, with Candida spp. being the most frequently isolated microorganisms 4
- Antibiotic therapy may be used to treat bacterial infections, such as those caused by Staphylococcus spp. and Streptococci 4, 5
- Topical treatments, such as clotrimazole cream, can be effective in treating candidal balanitis 6
Specific Causes and Treatments
- Candidal balanitis can be treated with antifungal agents, such as clotrimazole cream 6
- Bacterial infections, such as those caused by Staphylococcus haemolyticus, can be treated with antibiotic therapy, such as oral ciprofloxacin and topical mupirocin 5
- Erosive balanitis caused by Staphylococcus haemolyticus can be treated with oral ciprofloxacin and topical mupirocin 5