Use Your Head: Know the Symptoms of Balanitis and How It Is Diagnosed

Balanitis is a term that describes a relatively common, fairly easy-to-treat condition of the penis. It involves pain, irritation and inflammation of the skin of the penis head and develops most frequently in boys and men who are uncircumcised.

Guys who have a condition called phimosis, in which the foreskin is unusually tight and difficult to pull back, are at an especially high risk for contracting balanitis. That's because the foreskin's tightness prevents easy cleaning and drying underneath it. The very tightness of it contributes to the trapping of dirt, oils and fungus, which can then more easily proliferate and exacerbate the irritation of balanitis.

Balanitis is usually indicated by redness, itching and other symptoms. It can stem from a bacterial, viral or fungal infection, but the underlying cause is usually a yeast (fungal) infection. When it does appear, balanitis is frequently linked to a guy's lack of attention to cleaning and a lack of due care with his hygiene practices.

Perhaps for this reason, balanitis is more common in children younger than 4 years old and in men who face health issues such as obesity, diabetes, declining cognition and declining ability to care for themselves.

If a man is obese and has excess skinfolds and fat, it can be a challenge to keep the area clean in general, especially as he grows older, less flexible and less cognizant of hygiene issues. Plus, the excess blood sugar caused by diabetes produces extra "food" on the skin that allows the yeast fungus to flourish.

Read on to learn more about balanitis symptoms, how to diagnose balanitis, and what risks you could face by ignoring it.

Symptoms of balanitis

Somewhere between 3 percent and 11 percent of people with penises experience balanitis at some point, according to StatPearls, a healthcare education resource. While it is more frequently seen in uncircumcised people, circumcised people can still get balanitis.

"Balanitis is just a catch-all term that means inflammation of the penis head," said Neel Parekh, M.D., a men's fertility and sexual health specialist with Cleveland Clinic. "Guys will come into the office with redness, swelling, itching, pain, discharge; those are some of the common symptoms."

Some other symptoms to look out for include the following:

• Soreness and irritation around the head of the penis
• Foreskin that appears tight and shiny
• Itchy skin on the glans (penis head)
• Unusual penile discharge
• Sore spots on the glans
• A white, thick discharge called smegma appears under the foreskin more frequently and is thicker than usual
• An unpleasant odor from your penis
• Urination becomes painful
• Lymph nodes in your groin grow tender and painful

How is balanitis diagnosed?

By and large, balanitis isn't anything to be alarmed about, as long as you get it properly diagnosed and promptly treated. Getting an exam is a crucial point, as the list of symptoms above is shared across many other conditions, including a number of sexually transmitted infections (STIs).

Even if you strongly suspect balanitis and have no reason to believe you've contracted an STI, it's a good idea to be seen by a doctor to rule out anything that's not benign.

Luckily, most clinicians can diagnose balanitis based strictly on what they see and what you tell them in terms of your lifestyle. There's not likely to be much need for any highly involved tests.

"It's really just your physical exam and history," Parekh said. "Sometimes there's discharge, and you can culture a discharge, and some specialists may take scrapings from the head of the penis and analyze that to get more information. But typically, in my practice, I just treat it empirically."

If balanitis is determined to be the problem, the first-line treatment is likely to be something simple: You'll probably be sent home with a topical antifungal cream and be provided with some literature and counseling about hygiene.

What can happen if you ignore balanitis?

For most guys who don't have other aggravating factors in play, that office visit and a tube of antifungal cream may well mark the end of their balanitis saga.

However, men who leave balanitis to its own devices risk the condition taking on a much more serious aspect. Sometimes it's beyond their control; some people simply cannot physically clean or perhaps even access their penis, and others might not be able to feel what's going on down there due to nerve damage caused by diabetes.

"Unfortunately, a lot of these guys are diabetic and obese, and even if they are circumcised, oftentimes their penis is just buried in their fat, and it just makes it difficult to keep their penis clean and dry," Parekh said.

On its own, balanitis is a relatively unremarkable skin irritation. That kind of soreness, though, if it's chronic and left chronically untreated—especially in moist, not terribly clean areas—can cause other complications.

"If you leave balanitis untreated, it can lead to scarring," Parekh said. "It can also lead to a narrowing of the urethra, to urinary tract infection and even phimosis."

Other possible untreated balanitis complications can include:

• Lichen sclerosus. Balanitis xerotica obliterans (BXO) is another name for this condition that causes hard, white patches on the skin that can interfere with urine and semen flowing through the urethra.
• Ulcerative lesions. These painful sores can blister, ulcerate and bleed, causing more scarring and opening up the skin to further infections.
• Increased risk of penile cancer. These kinds of chronic irritations are linked to penile cancer, as are several of the above-named penis conditions.

Conclusions

Balanitis can be annoying but not a serious concern in otherwise healthy people who get prompt treatment.

Where you get into trouble with conditions like this is if you let your weight and/or blood sugar get out of hand or you're too hesitant to get checked out. So see your doctor.

Don't have a doctor you see regularly? You should. Fortunately, telehealth makes it easy to connect with a healthcare professional who can answer your questions and evaluate your situation. Many physicians offer video visits, which are a good way to see a doctor quickly since a lot of them have same-day appointments. Giddy Telehealth is an easy-to-use online portal that provides access to hundreds of professionals whose expertise covers the full scope of medical care, including men's health.