Balanitis (balanoposthitis) is swelling of the head of the penis. The foreskin (the loose flap of skin that covers the head of the penis) is also often affected.
Balanitis is a common condition affecting both boys and men, although it happens more often in men who have not been circumcised.
Symptoms of balanitis include swelling, redness and soreness of the end of the penis. There might also be a thick discharge under the foreskin.
Read more about the symptoms of balanitis.
Visit your doctor or local sexual health or genitourinary medicine (GUM) clinic if you have any of the symptoms of balanitis. While balanitis is not usually serious, it can be a sign of another condition, such as a sexually transmitted infection (STI) or thrush (a type of yeast infection).
Also visit your doctor if your son develops balanitis. They may need prescription-only medication, such as antibiotics.
Balanitis can happen at any age. An estimated one in 20 boys under five years old are affected by balanitis. One in 10 men who attend a sexual health or genito-urinary (GUM) clinic have balanitis.
Skin irritation is the most common cause of balanitis in boys. This can occur because it's not always possible to pull back the foreskin fully at this age, leading to a build up of a cheesy-looking substance called smegma that can irritate the skin.
Irritation by smegma is also a common cause of balanitis in uncircumcised men if the penis is not kept clean.
Other cause of balanitis in men include:
Read more about the causes of balanitis.
Balanitis is not normally serious and can often be prevented by avoiding irritants and good hygiene.
Read more about preventing balanitis.
Most cases of balanitis are easily managed with a combination of creams or ointments, good hygiene and avoiding substances that irritate the penis.
In rare cases of balanitis that keep coming back, circumcision (surgical removal of the foreskin) may be recommended. For example, in cases where the foreskin can't be pulled back (phimosis) to be cleaned or there is persistent dribbling of urine following urination.
Read more about treatment for balanitis.
The symptoms of balanitis can vary in severity and you may not experience all of them.
It is therefore important to visit your doctor or your local sexual health or genitourinary medicine clinic.
You should also visit your doctor if your son develops balanitis. They may require medication, such as antibiotics. Your doctor can give advice on cleaning the head of the penis, particularly under the foreskin.
The causes of balanitis include the build up of a substance called smegma, fungal infections, and sexually transmitted infections (STIs).
In most cases, balanitis occurs when the skin is irritated by the build up of a smelly, cheesy-looking substance called smegma.
Smegma is a natural lubricant that keeps the penis moist. It's found on the head of the penis and under the foreskin.
In young boys, smegma may build up because it can be difficult to fully retract the foreskin at this age. This makes it hard to keep the penis clean.
A build up of smegma can also lead to balanitis in uncircumcised men if the penis is not kept clean.
Other causes of balanitis include:
Additional causes of balanitis in men include:
A number of other skin conditions are known to cause symptoms of balanitis in men, including:
If all causes of balanitis have been ruled out, you may have non-specific balanoposthitis. This is when the foreskin and the surface of the glans are inflamed, red and swollen, making it painful and difficult to pass urine. Balanoposthitis is usually treated with antibiotics, but in very severe cases circumcision may be required.
Your doctor should be able to diagnose balanitis by the redness and inflamed (swollen) appearance of the glans.
You may initially feel embarrassed about visiting your doctor with the symptoms of balanitis, but it's important that you do.
This is because your symptoms could be a sign of a more serious underlying condition, such as diabetes.
To determine what is causing balanitis, your doctor will examine your (or your child’s) penis and ask a number of questions to help determine the cause. They may ask:
For children, your doctor may also ask:
Further testing is usually only needed if the symptoms are particularly severe or do not clear with treatment. This usually involves taking a small sample of cells from the head of the penis (a swab) and testing them for infection.
In addition to taking a sample of cells from your penis, your doctor may refer you for blood and urine tests to measure your blood sugar levels. This is to check whether you have developed diabetes, which may be making you more vulnerable to infection.
Your doctor may also recommend that you are tested for sexually transmitted infections (STIs). They may refer you to a sexual health clinic.
If you or your child has balanitis, the recommended treatment will depend on what is causing the condition.
In all cases of balanitis you should avoid potential irritants and make sure to practise good hygiene. For example:
If you have balanitis, urine is the most important irritant to keep away from the skin of your penis. Other irritants to avoid include:
Read about preventing balanitis for more information on hygiene and avoiding irritants.
If your balanitis is the result of skin irritation, you will usually be prescribed a topical corticosteroid (steroid cream or ointment).
Apply the cream to the head of your penis once or twice a day until your symptoms have gone. Do not use the medication for more than 14 days in a row because this could lead to side effects, such as itchy skin and a skin rash.
It is important to avoid potential irritants and make sure that the head of your penis and your foreskin do not come into contact with urine after you urinate.
If your balanitis is the result of a fungal infection, you will be prescribed either an antifungal cream or an oral antifungal medication.
Fluconazole is not recommended for children who are under 16 years old. It can also cause side effects, including:
If your symptoms are particularly troublesome, you may also be prescribed a seven-day course of a topical corticosteroid, usually in the form of a cream or ointment.
If a bacterial infection is the cause of your balanitis, you will be prescribed a seven-day course of oral antibiotics (antibiotic tablets or capsules).
An antibiotic called amoxicillin is usually recommended. However, if you are allergic to penicillin, erythromycin or clarithromycin may be prescribed.
Common side effects of these types of antibiotics include:
Again, if your symptoms are particularly troublesome, you may also be prescribed a seven-day course of a topical corticosteroid.
All the treatments listed above should start working in seven days. Contact your doctor if your symptoms do not improve after this time because you may require an alternative treatment.
If your balanitis is not caused by an infection and your doctor cannot identify the cause, you may be referred to a dermatologist (skin specialist) or genito-urinary (GUM) clinic for further investigation.
If you have phimosis (a tight foreskin) and you have repeat episodes of balanitis, you may be advised to have a circumcision.
You can usually reduce your chances of developing balanitis if you avoid potential irritants.
It may also help to keep your penis clean. For example:
The hygiene tips above also apply to children, although young boys may not yet be able to clean under their foreskin. This should not be forced and should eventually become possible as they get older.
Babies and young children who still wear nappies may also be at a higher risk of balanitis due to the warm and moist conditions. Make sure you change your child's nappy regularly and use a barrier cream or ointment after each nappy change.
This will reduce the contact that your baby's skin has with urine and faeces. Zinc cream, zinc oxide ointment and petroleum jelly are all suitable barrier creams. Ask your pharmacist for advice about which cream is most suitable for your baby.
Important: Our website provides useful information but is not a substitute for medical advice. You should always seek the advice of your doctor when making decisions about your health.