Balanitis and balanoposthitis

Balanitis is when the tip of the penis (the glans) becomes inflamed or irritated.

Balanoposthitis is when both the tip and the foreskin are inflamed. Balanoposthitis only affects males who have not been circumcised.

Posthitis is when only the foreskin is inflamed.

Symptoms of balanitis and balanoposthitis may appear on the tip of the penis or foreskin, and include:

• redness
• discomfort or pain
• itching
• skin flaking
• swelling

Balanitis and balanoposthitis can be caused by infections or non-infectious skin conditions.

Non-infectious causes include:

• dermatitis (eczema) — this includes contact dermatitis from an irritant
• psoriasis — this is more likely if you have a family history of psoriasis
• lichen sclerosus — this appears as white, itchy patches and is most common in young males before puberty
• lichen planus — this is a type of inflammation that may be caused by certain medicines or hepatitis C infection
• Zoon's balanitis — a chronic (long-term) condition that causes inflammation of the skin on the head of the penis
• reactions to certain medications — also known as a fixed drug eruption
• pre-cancerous skin changes — like penile intraepithelial neoplasia (PIN) or squamous cell carcinoma (SCC)

Examples of infectious causes include:

• fungus — such as yeast (thrush) or dermatophytes (ringworm)
• bacteria — usually from streptococci or staphylococci bacteria
• viruses — such as herpes, chickenpox, HPV (warts) and monkeypox

Sexually transmitted infections (STIs) are rarely the cause of balanitis or balanoposthitis.

Sometimes, a yeast infection in males may be an irritation caused by sensitivity to a yeast carried by a female sexual partner.

You should see your doctor if you notice unusual redness, discomfort, itching, skin flaking or swelling of the tip of the penis or foreskin.

If your partner has these symptoms, you might also want to see a doctor, as sometimes the cause of balanitis and balanoposthitis is contagious.

Seeing a doctor early can help stop the problem from getting worse and help you get the right treatment.

If you need to see your doctor but cannot wait for an appointment, you may be able to get treatment at a Medicare Urgent Care Clinic. Use the Service Finder to find your nearest one.

To diagnose balanitis and balanoposthitis, your doctor will ask you questions about your symptoms and examine your genital area.

Diagnosis may involve questions about your sexual history and testing for sexually transmitted infections (STIs), such as herpes, syphilis or chlamydia. Your doctor may also take swabs to look for infections like thrush or bacteria.

You may need a urine test to check for diabetes, which can increase the risk of thrush.

Sometimes, your doctor will recommend you have a biopsy (where they take a small tissue sample) to check for serious problems like pre-cancerous changes, especially if your symptoms do not improve or if it is not clear what is causing the symptoms.

If doctors think the cause might be a skin condition or an allergy, they may refer you to a dermatologist (skin specialist).

Your treatment will depend on what is causing balanitis or balanoposthitis.

Self-care at home

While the skin is inflamed, it is best to avoid using soaps on the area. If you are using creams on the head of the penis or foreskin, they can make condoms less effective.

Soaking the area in warm salty water can help with swelling and discomfort. Use a soap-free cleanser and a plain moisturiser like white soft paraffin. Pain medicine may be helpful.

How you clean your penis depends on if you can pull the foreskin back easily. If the foreskin can be pulled back, gently pull it back to wash underneath during baths or showers, rinse off any soap, dry the area and then move the foreskin back into place. If the foreskin can't be pulled back, do not try to force it. Just wash the outside of the area carefully.

If your doctor has diagnosed balanitis or balanoposthitis ask if your sexual partner needs to be aware or tested too.

Medicines for balanitis and balanoposthitis

The medicines you need will depend on the cause of the inflammation.

Your doctor will treat balanitis or balanoposthitis caused by contact dermatitis in the same way as other skin irritations in the groin area. They may prescribe a topical corticosteroid cream and will suggest that you avoid anything that may be causing the irritation. Antibiotic creams do not usually work and steroid tablets are not often needed.

If the balanitis or balanoposthitis has an infective cause, your doctor will prescribe a medicine to treat the infection. This may include an antibiotic or an antifungal medicine and may involve tablets or creams.

Your doctor may also prescribe a steroid cream or ointment.

Other medicines may be prescribed for other causes of balanitis or balanoposthitis.

Other treatment options

If balanoposthitis keeps coming back or if the foreskin is too tight to pull back (a condition called phimosis), your doctor may recommend circumcision. This is a minor surgical procedure in which the foreskin is removed to help prevent future problems.

Balanitis and balanoposthitis can sometimes lead to complications, especially if they last a long time or are not treated properly. These problems happen because inflammation affects the head of the penis and the foreskin.

Main complications include:

• Phimosis and paraphimosis — ongoing inflammation can cause scarring. This makes the foreskin too tight to pull back (phimosis), or it may get stuck behind the head of the penis and not go back into place (paraphimosis). These conditions might need surgery.
• Urethral narrowing (stenosis) — the opening where urine (wee) comes out can become smaller due to inflammation and scarring, making it hard to urinate.
• Changes to penis structure — scarring can change the shape or function of the penis. It may damage the frenulum (the small band of tissue under the head), flatten natural grooves or make the foreskin tight and narrow.
• Risk of developing cancer — if balanitis or balanoposthitis are chronic (continue for a long time), especially when linked to a skin condition called lichen sclerosus or infection with HPV (human papillomavirus), there is a small chance of developing pre-cancer or cancer of the penis.

In many cases, balanitis and balanoposthitis can be prevented with good personal care. Gently washing the penis each day, avoiding irritants like soaps and making sure the area under the foreskin is dried properly can help. If the foreskin can be pulled back, it is important to dry the area fully after washing to stop moisture from building up — but do not force it if the foreskin is tight, as this can cause problems.

Good hygiene, managing health conditions like diabetes and avoiding harsh personal care products (such as baby wipes or products with added fragrance) also lower the risk.

While these steps are helpful, some people may still get balanitis and balanoposthitis. If you have concerns or repeated infections, speak to your doctor for advice and support.

Visit Healthy Male for more information on:

• balanitis and balanoposthitis
• how to clean your penis properly
• other common penis problems

Visit The Royal Children's Hospital Melbourne to read about penis and foreskin care in children.

Visit healthdirect to learn how to maintain good hygiene and take care of your penis.

Call healthdirect on 1800 022 222 at any time to speak to a registered nurse (known as NURSE-ON-CALL in Victoria) for more information and advice.

Information for Aboriginal and/or Torres Strait Islander peoples

Visit Better to Know, a sexual health resource for Aboriginal and/or Torres Strait Islander peoples.

Other languages

The Royal Children's Hospital Melbourne has information about penis and foreskin care in many community languages.

Talk. Test. Treat. has a collection of sexual health resources translated into many community languages.

Information for sexually and gender-diverse families

ACON is a community organisation that helps sexuality and gender diverse people take control of their sexual health.