Penile Balanitis is a very common complaint, which mostly affects boys under four years old and uncircumcised men who have a tight foreskin. The condition is indicated when the head of the penis (the glans) becomes red, sore and inflamed, sometimes with raised areas of plaque, which can often affect the foreskin because of the thick lumpy discharge that is caught underneath it.
Although, genital herpes, Chlamydia and syphilis also list penile balanitis as a symptom, it is most often the result of a yeast infection; an allergy to washing detergents; a bacterial infection due to a build up of debris under the foreskin; or a skin complaint like psoriasis.
In most cases, prevention is easily achieved through improved personal hygiene and the glans should be carefully washed in warm water every day, ensuring that the foreskin is gently pulled back to facilitate removal of any smegma which has collected underneath. The foreskin should then be returned to its original position as leaving it pulled back can result in it becoming trapped beneath the glans (paraphimosis). If the penile balanitis is due to an allergy to soap or if there is inflammation present, an emollient or aqueous cream can be substituted for soap as this does not interfere with the balance of the skin's natural Ph levels.
If the penile balanitis becomes painful or weeps, visit to your healthcare professional immediately as it may be necessary to see whether a bacterial or yeast infection is the culprit; either of these will require a different topical cream to alleviate the discomfort. Repeat yeast infections could indicate a systemic Candida infection elsewhere in the body and it might be necessary to address the patient's diet as relying on medication on a regular basis can make the problem worse in the long-term.
Zoon's Balanitis is a rare type of benign penile dermatosis which affects older uncircumcised males with a reddish brown rash on the glans, characterised by distinctive pin point cayenne pepper type dots.
For sufferers where the foreskin is really tight (phimosis) and it is impossible to clean properly, circumcision used to be the surgical response but, these days, a dorsal relieving incision known as a preputioplasty is more often used. This is a small operation where a vertical cut is made through the tight ring that is limiting the movement of the foreskin and then stitched together horizontally. It takes 2-3 weeks for this to heal, but full retraction of the foreskin should then be possible.
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