Balanitis: Symptoms, Care, and Treatment Options

Balanitis inquiry?

Hello doctor, two weeks ago I experienced redness, swelling, and itching of my foreskin.
After applying some clindamycin and Mecon cream for a few days, I noticed several circular, depressed wounds in the red and swollen areas.
I'm not sure if they are ulcers.
A few days ago, I couldn't resist masturbating, and I found that one of the wounds started to bleed.
After a day, it seems to have gotten larger.
It hurts when water hits the wound while I’m showering, and I currently have an appointment scheduled.

1.
Doctor, are these symptoms indicative of balanitis? Is it possible that it could be herpes, even though I haven't seen any small blisters? I'm still a bit worried.

2.
Are there any dietary considerations I should be aware of?
3.
Currently, I pull back the foreskin while showering and rinse with plain water, without using body wash.
Afterward, I dry it with a cool hairdryer and apply medication before retracting the foreskin again.
Is there anything wrong with this method?
4.
I now have about three or four wounds; would you still recommend using Mecon cream? (I've heard that using too much is not good) Or should I switch to clindamycin?

Yoyo, 10~19 year old female. Ask Date: 2023/03/20

Dr. Du Shixi reply Urology

Hello,
1.
Doctor, could this be a symptom of balanitis? Is it possible that it could be herpes? Although I don't see any small blisters, I am still a bit worried.
--> This is likely balanitis.
Herpes would typically present with blister lesions, but if you have engaged in unprotected sexual activity, you should inform your doctor about the need for sexually transmitted infection testing.
2.
Are there any dietary considerations I should be aware of? --> A light diet is recommended.
3.
I currently pull back the foreskin while showering and rinse with clean water, without using body wash.
After washing, I dry it with a hairdryer on a cool setting, apply medication, and then retract the foreskin.
Is there anything wrong with this method? --> There is nothing wrong with this approach.
4.
I currently have about three or four wounds.
Should I still apply Meikang ointment? (I’ve heard that using it too much is not good) Or should I switch to Xinmeisu? --> It is not recommended; you should seek medical attention.
Some conditions do not benefit from Meikang ointment.
Xinmeisu is primarily for antibacterial use.
Wishing you good health.

Reply Date: 2023/03/20

More Info

Balanitis, an inflammation of the glans penis, can present with various symptoms, including redness, swelling, itching, and sometimes painful lesions. Your description of red, swollen areas with circular depressions that have developed into bleeding wounds is concerning and warrants careful evaluation. Here’s a comprehensive overview of your situation, addressing your questions and providing guidance on care and treatment options.

1. Symptoms and Diagnosis: Based on your symptoms, it is possible that you are experiencing balanitis, especially given the redness and swelling. However, the presence of circular depressions that bleed raises the possibility of other conditions, such as herpes or even a fungal infection. While herpes typically presents with vesicular lesions (small fluid-filled blisters), it can sometimes manifest atypically. It’s crucial to have a healthcare professional evaluate these lesions to determine the exact cause. A physical examination and possibly a swab of the lesions can provide clarity.

2. Dietary Considerations: While there are no specific dietary restrictions for balanitis, maintaining a healthy diet can support your immune system. Avoiding irritants such as spicy foods, alcohol, and excessive sugar may help reduce inflammation. Staying hydrated is also essential for overall health. If you have any known allergies or sensitivities, be sure to avoid those as well.

3. Hygiene Practices: Your current hygiene routine of gently retracting the foreskin and rinsing with water is appropriate. It’s essential to avoid using harsh soaps or body washes, as these can irritate the sensitive skin of the penis. Using a blow dryer on a cool setting to dry the area is a good practice, as moisture can promote fungal growth. However, ensure that you are not applying excessive heat, which could cause further irritation.

4. Topical Treatments: Regarding the use of medications, it’s essential to follow your healthcare provider’s recommendations. While both clotrimazole (the active ingredient in "欣黴素") and hydrocortisone (found in "美康乳膏") can be effective, they serve different purposes. Clotrimazole is an antifungal, which may be appropriate if a fungal infection is suspected. Hydrocortisone is a steroid that can reduce inflammation but may not be suitable for open wounds, as it can impede healing. Given that you have open sores, it may be best to avoid hydrocortisone until the lesions have healed. Instead, consult your doctor about continuing with clotrimazole or switching to another treatment.

In summary, it’s crucial to have your condition evaluated by a healthcare professional, especially since you have developed bleeding lesions. They can provide a definitive diagnosis and appropriate treatment plan tailored to your needs. In the meantime, maintain good hygiene, avoid irritants, and follow any prescribed treatments. If you notice any worsening of symptoms or new developments, seek medical attention promptly. Your health and comfort are paramount, and addressing these concerns early can lead to better outcomes.

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