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Ask the Doc: How can you tell if balanitis is fungal or bacterial?

Question

How can you tell if balanitis is fungal or bacterial?

Answer

Balanitis is inflammation of the glans penis; the bit that people refer to as the head of the penis. Posthitis is inflammation of the foreskin. Often, balanitis and posthitis occur together. When this happens, it’s called balanoposthitis.

Inflammation is the result of the body’s response to infection (by microorganisms like bacteria, viruses and fungi) or injury. The signs of inflammation are redness, swelling, heat, pain and impaired function.

So, when you have balanitis, your glans can be red, swollen, warm to touch, painful and can cause foreskin problems like phimosis or paraphimosis, and even result in infections in the blood in people with weak immune systems.

Like other types of inflammation, balanitis can be caused by bacteria, viruses or fungi. You need to see a doctor to work out which type of microorganism is causing the problem. The presence or absence of pus, ulcers, or inflammation of the urethra (the ‘tube’ that carries urine and semen through the penis), can help to narrow it down.

In most cases, balanitis and balanoposthitis are caused by a species of yeast that normally lives on the skin without causing problems (Candida albicans), so treatment usually involves two or three weeks of using an antifungal cream.

Regardless of which type of microorganism is causing your balanitis or balanoposthitis, the best way to prevent the problem is with good hygiene. If balanitis or balanoposthitis keeps coming back, your doctor might suggest you be circumcised because these health problems are rare in males who have had this done. 

A/Prof Tim Moss
A/Prof Tim Moss

Associate Professor Tim Moss has PhD in physiology and more than 20 years’ experience as a biomedical research scientist. Tim stepped away from his successful academic career at the end of 2019, to apply his skills in turning complicated scientific and medical knowledge into information that all people can use to improve their health and wellbeing. Tim has written for crikey.com and Scientific American’s Observations blog, which is far more interesting than his authorship of over 150 academic publications. He has studied science communication at the Alan Alda Centre for Communicating Science in New York, and at the Department of Biological Engineering Communication Lab at MIT in Boston.

References

Way et al., 2022. Balanitis. StatPearls available at https://www.ncbi.nlm.nih.gov/books/NBK537143/ 

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