Foreskin problems and circumcision

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What is balanitis?

Balanitis is the medical term used for inflammation of the glans penis (the head of the penis). Balanoposthitis refers to inflammation of both the head and foreskin of the penis.

Balanitis is not the same as lichen sclerosis, which is also known as BXO (balanitis xerotica obliterans).

Balanitis affects between 1 in 3 to just over 1 in 10 men at some point in their lives. Balanoposthitis only affects uncircumcised men and occurs in about 1 in 17 of them.

Balanitis most commonly occurs in (1 in 25) boys under 4 years of age and (1 in 30) uncircumcised men1.

Symptoms of balanitis

If you have balanitis or balanoposthitis, you might experience pain in your penis, swelling and/or redness of the head of the penis.

Causes of balanitis

Fungal infection is the overall most common cause of balanitis, but the irritation of the head of the penis is the most common cause of mild cases of the disease2.

The fungus found most often in cases of balanitis (Candida albicans) is common but doesn’t always cause problems. Poor hygiene in uncircumcised males can lead to infections associated with balanitis1.

Other causes of balanitis include:

  • Infection from other fungi, bacteria, and viruses
  • Chemical irritants
  • Allergies
  • Health conditions like heart failure, obesity, and diabetes.

Balanitis is more common in males who are not circumcised than in those who are, suggesting that circumcision protects against the disease3.

Diagnosis of balanitis

Balanitis and balanoposthitis are usually diagnosed by examining the penis. In some cases, a biopsy might be needed to identify an underlying cause4. Causes of balanitis that need to be excluded during diagnosis, or treated, include skin diseases like eczema, psoriasis and dermatitis.

Treatment of balanitis

Applying an antifungal cream for a couple of weeks is the usual treatment for balanitis. Your doctor might suggest using a mild steroid cream as well.

Oral antifungal medicine might be prescribed in more severe cases of balanitis or balanoposthitis.

Your doctor might prescribe an antibiotic if it looks like there is a bacterial infection associated with your balanitis.

In some men, balanitis or balanoposthitis can recur or persist after treatment.

If you suffer from persistent or recurrent balanitis, your doctor might suggest you consider getting circumcised.

Prevention of balanitis

Good hygiene is the easiest way to minimise your chance of balanitis. But if you have balanitis, washing with soap too often might make it worse.

Health effects of balanitis

It’s important to identify the underlying cause of your balanitis. In many cases, simple improvements in hygiene might be enough to prevent it from coming back after successful treatment.

Seeing your doctor sooner rather than later will minimise the chances of complications from balanitis, which can include:

  • Ulcers
  • Narrowing of the urethra
  • Potentially serious foreskin problems like phimosis and paraphimosis
  • The development of cancer1.

If you have a compromised immune system as a result of age, HIV, or other causes, serious infection can result from the microorganisms that cause balanitis1.

Balanitis is associated with a higher-than-normal risk of penis cancer, but the risk is still very low5.

What to do about balanitis

If your penis is sore, red, or swollen, see your doctor as soon as you can to rule out potentially serious causes, receive effective treatment, and avoid complications.

The microorganisms that cause balanitis can be passed between you and your sexual partner(s), so you should encourage them to see their doctor too.

Questions to ask your doctor about balanitis

  • Is there something about my health that might make me more likely to get balanitis?
  • What’s the best way for me to clean my penis?
  • Is my balanitis enough of a problem that I should consider circumcision?
  • How long will my treatment for balanitis take to have an effect?
  • What changes should I look for to make sure my balanitis is getting better?
  • When should I come back to see you about my balanitis?

[1] Wray et al., 2020. Balanitis. In: StatPearls Available from

[2] Edwards, 1996. Balanitis and balanoposthitis: a review. Sexually Transmitted Infection

[3] Morris & Krieger, 2017. Penile Inflammatory Skin Disorders and the Preventive Role of Circumcision. International Journal of Preventive Medicine

[4] Charlton & Smith, 2019. Balanitis xerotica obliterans: a review of diagnosis and management. International Journal of Dermatology

[5] Pow-Sang et al., 2010. Epidemiology and Natural History of Penile Cancer. Urology