Why are my penis and foreskin red and painful? Balanitis.

Tight, painful foreskin? It could be balanitis.Balanitis is common in men who haven’t been uncircumcised.  It’s most common in boys under the age of 5 but can happen at any age.

What are the symptoms of balanitis?

  • Redness/swelling of the end (‘head’, or ‘glans’) of the penis and/or foreskin.  There may be small, red patches on the skin or the whole head of the penis may be affected
  • Pain at the head of the penis
  • Discharge from under the foreskin that may be thick and smell bad
  • Difficult/impossible to pull the foreskin back
  • Pain when you pass urine.

What causes balanitis?

There can be a number of causes for balanitis.  The glans of the penis is sensitive to irritants such as soaps, dirt, chemicals, infection etc.

  1. Hygiene.

The most common cause is poor hygiene of the glans and foreskin.  If the penis isn’t washed and dried properly, there can be a build up of urine residue, skin cells, sweat etc, which forms the curd-like substance, smegma.  This can irritate the head of the penis and cause balanitis.

Phimosis is a condition causing the foreskin to be tight so that it can’t easily be pulled back.  This makes it difficult to wash and dry the penis and may contribute to the hygiene problem.

Over washing and drying can also irritate the head of the penis.

  1. Infection.

Bacterial infection can be a further complication of poor hygiene, where the bacteria breed under the foreskin.

Yeast infection (candida) such as thrush can also cause balanitis in the same way.  This is same yeast that causes thrush in women.

Sexually transmitted infections such as herpes, chlamydia and gonorrhoea can cause balanitis and other symptoms that make it painful to pee.

  1. Chemical irritation from soaps, washing powder/fabric conditioner, disinfectant, condoms, spermicides, chemicals from your hands transferred to the penis when you go to the toilet.
  2. Skin conditions such as some forms of lichen sclerosis.  Other skin conditions such as psoriasis can be mistaken for balanitis but this is rare.
  3. Uncontrolled diabetes.  If the sugar levels in the blood are high, they will also be high in the urine.  Sugar residues that stay on the skin make the foreskin/head of the penis good breeding grounds for infections.

How is balanitis treated and cured?

Treatment will depend on the cause.  Your doctor will probably be able to make a diagnosis by examining the penis.

  • For infection, your health care professional will probably take a swab of the area to send to the lab for culture.  Antibiotic tablets and creams will tackle a bacterial infection. Antifungal agents (creams/tablets) will deal with yeast infections.
  • Good hygiene is essential unless being over hygienic has caused the problem.  Talk to your healthcare professional about this if you need to.
  • If the foreskin is tight and doesn’t allow good cleaning etc, then circumcision may be the best long term option for you.
  • The right steroid creams for skin conditions will help these.

How can I stop it coming back?

As poor hygiene is the most common cause, make sure you’re careful with retracting the foreskin and washing and drying the head of the penis well.  Use luke warm water and a mild soap in the bath or shower.  Make sure the glans and foreskin are properly dry before dressing.

If you suspect irritation has come from a new soap/washing powder etc then stop using it immediately and make a note not to buy/use the brand again.

Act similarly if you think the irritation might have come from condoms or spermicides.  Buy condoms for sensitive skin.

Always use a condom when you have sex with a new partner, to avoid infection.

Wash your hands before using the toilet if you work with chemicals that could be causing the problem.

If you have diabetes, see your practitioner to have your blood sugar levels checked.

Patient.co.uk has another good article about balanitis, as does Medline Plus.

If you’re worried about your symptoms or medical problem but don’t want to seek professional help because you feel embarrassed, silly or that it’s your fault, read this page now:  How to talk to a doctor about an embarrassing problem.

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