Balanitis

Tags: chlamydia hpv gonorrhea herpes syphilis hiv hepatitis

Balanitis is an infection of your foreskin that is most often caused by candida (A type of fungus) and not bacteria. Candida lives everywhere in our environment -- even on our bodies. When your foreskin stays wet (particularly the undersurface) and debris including sweat and dead skin cells accumulate, you provide an excellent place for candida to grow.

If the candida spreads to your foreskin, balanitis develops. Although rare, bacteria can also cause balanitis or you can have a joint infection of bacteria mixed with fungus. When the infection heals, your foreskin scars and tightens. With repeated infections and resultant scarring, your foreskin may not be able to retract over your glans; a condition known as phimosis.

Balanitis can be caused by an STD, but don't put off treatment out of embarrassment. Syphilis and herpes infections can cause your foreskin to swell and redden. Condyloma can frequently appear on your foreskin (as well as under it) but they usually don't cause a skin reaction.

Related conditions
STDs, syphilis, candida, herpes, HPV, phimosis and paraphimosis.

Diagnosis
You doctor can diagnose balanitis just from the appearance of your foreskin. Some perform a culture to determine which organism caused the infection, but usually only after an antifungal cream failed to cure it or if an STD or bacteria is considered to be the cause.

Symptoms
Redness of your foreskin, swelling, difficulty retracting your foreskin, burning or pain. Symptoms can be mild at first but worsen if you don't treat the problem.

How is it acquired?
Balanitis occurs when you don't clean your foreskin and the area under it well. When sweat, urine, semen, a partner's saliva (you get the idea) mix with dead skin cells and debris under your foreskin, you provide an excellent environment for candida to grow. If you don't treat the infection early on, bacteria can also super-infect your foreskin.

How to treat it?
Keeping your foreskin clean and dry so the candida no longer has a hospitable environment is key to treatment. You also want to kill any fungus. Hygiene is extremely important and there are several key steps for good foreskin health: always retract your foreskin to urinate and wipe away that last drop before pulling it back down, retract your foreskin to wash under it but dry well before pulling it back down, soften any hard secretions found under your foreskin with water before trying to wipe them off, be very gentle (to avoid injury) if you pull off secretions stuck to your skin. Beware: any cut or scrape can be another site for infection.

If you have balanitis, cleanse your foreskin several times a day with an antibacterial soap. (No, not Lysol!) Always retract your foreskin (and that might hurt especially if you've let the infection go too long) because you must clean the undersurface.

If you don't, your balanitis will persist and worsen. Don't forget to dry well after each cleansing. After drying, apply antifungal cream, both on the outside and undersurface of your foreskin. Many of these creams are available over the counter and some by prescription. (Lotrimin, Lotrisone, and Nizaril are just a few examples.) Oral antifungal medications (diflucan) are not usually necessary. Circumcision is rarely necessary and reserved for only the worst cases that do not respond to the treatment regimen outlined above.

Myths dispelled
Here are some facts to clear up some common misconceptions.

You do not usually get balanitis from an STD.
The most common cause is a fungal infection.

Prevention
Wash well under your foreskin -- especially after sex. Retract your foreskin when urinating and then wipe away the last drop before pulling it back down. Dry well after washing. If you feel the slightest bit of discomfort or your foreskin looks a little red, buy an antifungal cream and use it. You can get rid of the infection before it gets out of control.

Uncircumcised men and diabetics. Diabetics have a higher rate of candida infections and their foreskin is no exception. They need to pay particular attention to proper foreskin hygiene. Men with HIV are at greater risk of developing candida infections and must pay particular attention to proper foreskin hygiene. Oral medications such as diflucan can help control fungal infections.

Incubation period
Candida is always present, but when you provide the right environment, it can begin to grow and infect your foreskin. You will notice a gradual worsening of symptoms.

Sex
Although far less common, balanitis can be caused by STDs including herpes, syphilis and HPV. After sex, retract your foreskin and clean it well to remove any semen and/or saliva. This may also kill any potential STD before it has a chance to take hold.