Definition

Balanitis is an inflammation of the head of the penis that can cause swelling, irritation and pain. It is estimated that around 3-11% of men will suffer from balanitis in their lifetime. Balanitis is generally caused by a fungal infection, although it can be caused by certain bacteria or viruses.

Balanitis is not a sexually transmitted infection. Balanitis is not transmitted from one individual to another, although cases of the organism causing balanitis can occur. This disease is also not an emergency case, but patients who often experience relapses need to be examined further.

There are three types of balanitis:

Balanitis Zoon

The main type of balanitis that occurs in middle-aged men who have not been circumcised, the head of the penis, looks typically red because of inflammation.

Balanitis Circinata

The type of balanitis that occurs because of reactive arthritis (a joint inflammation that occurs in response to infection in the body). Besides inflammation and redness, there are wounds or skin lesions on the head of the penis.

Keratotic and Micaceous Balanitis

This form of balanitis is very rare; usually, there are scaly warts found on the head of the penis. This type of balanitis occurs in men over 60 years of age.

Causes

There are various habits and medical conditions that can cause balanitis. The most common cause is poor personal hygiene, especially in men with uncircumcised penises. The warm, moist environment under the foreskin of the penis is an ideal place for fungus to grow. Candida albicans is the most common fungus that causes balanitis. This fungus, which initially lives normally on the skin of the penis, can grow excessively, causing inflammation of the head of the penis.

Besides the causes above, other things that can cause balanitis are:

• The foreskin of the penis is very tight and cannot be retracted (phimosis) in young children, making it difficult to clean the inside of the foreskin.
• Parasitic infections (scabies) on the penis.
• Sexually transmitted infections (STIs) such as gonorrhea, chlamydia, or syphilis.
• The presence of wounds on the penis.
• Skin conditions that cause itchy, dry, and scaly skin.
• Reactive arthritis, a condition of joint inflammation that occurs in response to infection in the body.

Risk factor

Balanitis can occur in men of any age, although boys under 4 years old and uncircumcised men are at the highest risk of balanitis. Children under 5 years old are more likely to have phimosis, a condition in which the foreskin is difficult to retract from the head of the penis. Phimosis makes the foreskin challenging to clean, creating a favorable environment for the growth of fungi and bacteria.

Other factors that can increase a man's risk of balanitis include:

• Being middle-aged.
• Having a sensitivity to the chemicals in soaps and condoms.
• Allergies to certain medications.
• Diabetes high blood sugar levels in the urine can be a risk factor for yeast infections.
• Severe obesity, etc.

Symptoms

Symptoms of balanitis can come on suddenly or develop slowly. Patients usually complain of redness, swelling, itching, and pain in the head of the penis. Other symptoms that may appear include:

• The head of the penis looks shiny and feels tight
• Pain when urinating
• A thick, cheese-like fluid coming out from under the foreskin (smegma)
• An unpleasant odor
• The foreskin is difficult to retract

Diagnosis

The doctor will ask about your symptoms and assess your risk of contracting sexually transmitted infections. Inform the doctor about your medical history and the treatments you have taken to relieve your symptoms. After that, the doctor will physically examine the genital area to see if there is inflammation, wounds, and signs of infection. If there is fluid other than urine or sperm coming out of the tip of the penis, a sample of the fluid can be taken and examined in the laboratory. Supporting examinations can be performed if the doctor suspects another underlying disease is causing the patient's symptoms.

Management

Medications and medical procedures

Treatment given to overcome balanitis will depend on the cause of the inflammation. Therapy aims to exclude the diagnosis of sexually transmitted infections and minimize complaints. The doctor can give antifungal drugs in creams/ointments for 1-3 weeks. You need to apply the cream to the head of the penis as prescribed by the doctor. Tell your doctor if you have allergies to certain drugs.

If the head of the penis looks severely inflamed, the doctor can give a combination of antifungals as oral medication with cream/ointments, and can be accompanied by low-potency steroid drugs. Antibiotics are prescribed if the patient also experiences a bacterial infection.

People with diabetes are advised to control their blood sugar regularly. If you or your child often experience balanitis and the treatment that has been given is not very effective, then circumcision or circumcision procedures can be considered. Doctors also recommend circumcision procedures for people with phimosis.

Home care

Routinely cleaning and drying the genitals is a preventive step that you can take to prevent a recurrence of the disease. Be careful not to overdo it in cleaning the genitals with soap, because this can worsen the condition. You can follow these steps:

• Gently pull back the foreskin and wash the area with warm water.
• Gently dry the penis area, including the underside of the foreskin after washing the penis or urinating, so that urine is not trapped under the foreskin.
• If you use a condom, choose a condom for sensitive skin.
• Wash your hands before urinating or touching the penis.
• Use moisturizer to keep the penis moist.

You are not advised to use soap, bubble bath, or baby wipes to clean the penis area. Do not pull back the foreskin if it is difficult. Teach your child to maintain the cleanliness of his genitals.

Complications

Untreated balanitis can cause long-term inflammation. The wound can become wider and ulcers or ulcers can form on the head of the penis. If left untreated, inflammation can cause problems with urination. Balanitis can cause health problems, such as:

Balanostitis, is an inflammation of the head of the penis and its foreskin. Balanoposthitis causes itching, irritation, and swelling of the foreskin and head of the penis.

Phimosis. Long-term inflammation can cause scar tissue to form on the penis, which makes the foreskin shrink. The foreskin can become so tight that it cannot be pulled back over the head of the penis.

The infection spreads to the bloodstream, a serious condition that can cause organ damage.

Prevention

To prevent balanitis, it is important to maintain genital hygiene by washing and drying it regularly. When bathing, pull back the foreskin and clean the inside and underside. Always use a condom during sex to reduce exposure to sexually transmitted infections, one of the risk factors that can cause genital inflammation.

When to see a doctor?

You can go to the doctor if you experience pain, irritation, or redness on the penis. The risk of balanitis increases if you have not been circumcised. Although balanitis is usually not a serious condition, it is still important to consult a doctor if you or your child experience it to find the cause.

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