If the head of the penis becomes inflamed, the inflammation is referred to as balanitis. The loose flap of skin that covers the head of the penis - the foreskin - is often affected too. Balanitis can occur at any age, but it is most common in boys under five years old and in uncircumcised men.
What is balanitis?
Inflammation is how the body responds when there is an injury or irritation to the skin or if there is an infection. If there is an inflammation of the head of the penis (the glans), whether caused by damage to the skin or an infection, it is known as balanitis, an umbrella term that covers a number of unrelated conditions. If there is inflammation of only the foreskin, the condition is known as posthitis; if both the glans and foreskin are inflamed, it is referred to as balanoposthitis.
How common is balanitis?
Balanitis can occur at any age. About one in 25 boys, often under the age of five, will develop balanitis, usually due to skin irritation. Balanitis is uncommon in circumcised men (these men had surgery to remove the foreskin), but statistics have found that it occurs in about 11% of men who have visited a genitourinary (GUM) clinic.
What causes balanitis?
In young boys, balanitis is often the result of a skin irritation, usually caused by poor hygiene, such as not removing excess urine from the glans after urinating, or by repeatedly playing with the foreskin.
Poor hygiene also causes balanitis in men. In both boys and men, if the foreskin is tight, it can be difficult to pull back for cleaning. If this area is not cleaned regularly, there can be a build-up of sweat, urine and debris, including a substance known as smegma - the white cheesy secretion released from the penis. If smegma or other irritants are not removed, they can cause balanitis.
There are also a number of other causes that can lead to balanitis.
- Skin irritation: caused by over-washing or scrubbing of the area, by exposure to perfumed soaps or shower gels, or by chemicals found in washing powders, fabric softeners, condoms (such as latex), spermicides, and lubricants.
- Skin conditions: psoriasis or atopic eczema are the more common ones, but others include lichen planus and lichen sclerosus (both are a type of non-infectious itchy skin condition), Zoon's balanitis (a rare condition that usually affects middle-aged men) and circinate balanitis (a type of psoriasis linked to a reactive arthritis).
- Bacterial infection: the most common type of bacterial infection is streptococcal bacteria.
- Fungal infection: Although not considered an STI it can occur after having sex. It also often occurs in people with diabetes.
- Sexually transmitted infections (STIs): including chlamydia, genital herpes, gonorrhoea and syphilis.
- Diabetes: if undiagnosed or poorly managed, there will be excess glucose (a type of sugar) in the urine, which creates an ideal environment for the growth of bacteria, especially if the glans and foreskin are not kept clean.
- Phimosis: When the foreskin does not pull back from the glans because it is too tight, preventing adequate cleaning; this is more common in boys under the age of five.
Sometimes all the causes listed above are ruled out, leading to the diagnosis of non-specific balanitis.