Persistent Glans Inflammation: Seeking Solutions for Recurring Symptoms

Q: Persistent Glans Inflammation: Seeking Solutions for Recurring Symptoms

Hello： When visiting the urology department of the hospital, in addition to using topical ointments, it is also important to maintain cleanliness and dryness (very important). <br>Use condoms during sexual activity. <br>If parents have diabetes, it is advisable to check fasting b

Balanitis has been persistent?

Hello, Doctor.
About three months ago, I experienced a skin break on my foreskin, along with redness and a burning sensation on the glans.
At that time, the doctor diagnosed it as a candidal infection and prescribed Clotrimazole cream.
After applying it for a month, the condition of the glans improved, but the foreskin still had some skin breakage.
During the follow-up visit, the doctor mentioned that it wasn't completely healed and advised me to continue applying the cream.
Now, three months later, the foreskin is fine, but the glans has become red and burning again, and it even appears a bit wrinkled.
I suspect this might be related to prolonged moisture and not keeping it dry.
Should I continue using the original cream, or should I return for a reevaluation? Thank you!

Xiao Hei, 20~29 year old female. Ask Date: 2023/04/16

Dr. Du Shixi reply Urology

Hello: When visiting the urology department of the hospital, in addition to using topical ointments, it is also important to maintain cleanliness and dryness (very important).
Use condoms during sexual activity.
If parents have diabetes, it is advisable to check fasting blood sugar levels.
If there has been unsafe sexual behavior, it is recommended to undergo sexually transmitted infection (STI) testing.
Wishing you good health.

Reply Date: 2023/04/16

More Info

Persistent glans inflammation, particularly after a previous diagnosis of a candidal infection, can be a frustrating and uncomfortable issue. Your symptoms of redness, burning sensation, and changes in the appearance of the glans (head of the penis) suggest that there may still be an underlying issue that needs to be addressed.
Given that you initially received treatment with a topical antifungal cream (likely containing clotrimazole or a similar agent), and while there was some improvement, the recurrence of symptoms indicates that the infection may not have been fully resolved or that there may be other contributing factors at play.

Possible Causes of Persistent Symptoms
1. Incomplete Treatment: Sometimes, fungal infections can be stubborn and may require a longer duration of treatment or a different antifungal agent. If the initial treatment was not sufficient, the infection could persist.

2. Secondary Infection: The moist environment you mentioned can lead to secondary infections, either fungal or bacterial. Keeping the area dry is crucial in preventing these infections.

3. Contact Dermatitis: Irritation from soaps, detergents, or even the antifungal cream itself can cause inflammation. If you have changed any personal care products recently, this could be a factor.

4. Underlying Conditions: Conditions such as diabetes can predispose individuals to recurrent infections. If you have any other health issues, it may be worth discussing them with your healthcare provider.

5. Poor Hygiene: While it may seem counterintuitive, inadequate hygiene can lead to the accumulation of moisture and bacteria, exacerbating inflammation. Conversely, over-washing can also irritate the skin.

Recommendations
1. Return to Your Healthcare Provider: Given that your symptoms have persisted and changed, it is advisable to return to your healthcare provider for a thorough evaluation. They may want to perform a physical examination and possibly take a culture to identify the specific organism causing the inflammation.

2. Consider a Different Treatment: If a fungal infection is confirmed, your doctor may prescribe a different antifungal medication or a longer course of treatment. If a bacterial infection is suspected, antibiotics may be necessary.

3. Maintain Dryness: Keeping the area dry is essential. After bathing, ensure that the area is thoroughly dried. You might consider using a moisture-absorbing powder, but be cautious with products that contain fragrances or irritants.

4. Avoid Irritants: If you suspect that soaps or other products may be causing irritation, consider switching to hypoallergenic or fragrance-free options.

5. Monitor Symptoms: Keep track of any changes in your symptoms, including any new irritants or changes in hygiene practices. This information can be valuable for your healthcare provider.

6. Lifestyle Modifications: If you are experiencing recurrent infections, consider lifestyle factors such as diet, stress, and overall health, as these can impact your immune system and susceptibility to infections.

Conclusion
Persistent glans inflammation can be a complex issue that may require a multifaceted approach to treatment. It is crucial to work closely with your healthcare provider to identify the underlying cause and appropriate treatment. Do not hesitate to seek medical attention, especially if your symptoms worsen or do not improve with initial treatments. Your health and comfort are paramount, and timely intervention can help prevent further complications.

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