Recurrent Balanitis: Causes, Treatments, and Care Tips

Q: Recurrent Balanitis: Causes, Treatments, and Care Tips

Hello： If you have been taking care of your skin as described, you may need to consider your lifestyle, diet, rest, and sleep. <br>Wearing loose-fitting underwear and being mindful of sexual activity can also help. <br>Additionally, it is important to consider whether family memb

Treatment of balanitis and phimosis?

I apologize for the inconvenience, but I would like to consult a physician regarding balanitis and posthitis.
First, in mid-October 2023, I experienced inflammation of the glans, with symptoms primarily consisting of pain.
After visiting a doctor and taking medication for a few days, I felt much better.
However, three weeks later, the glans and foreskin suddenly became red, swollen, and itchy.
After seeing a doctor, I was diagnosed with balanoposthitis, and the doctor prescribed a steroid ointment and some oral medication.
After a short period of treatment, I noticed significant improvement, with only occasional itching.
During a follow-up visit, the doctor prescribed more oral medication, indicating that I was almost better.
However, after stopping the medication for one to two weeks, the symptoms recurred.
This time, the symptoms included persistent scaling, itching, and difficulty retracting the foreskin, but the glans and foreskin were not as red and swollen as before.
I consulted two different doctors.
The first one suggested it might be eczema, but after taking the prescribed medication and applying ointment, there was no significant improvement.
I then saw another doctor, who prescribed steroid ointment and oral medication, which again led to noticeable improvement after a short time.
However, after more than a week of stopping the medication, the itching returned, and this time, red bumps appeared, accompanied by itching and occasional clear discharge, although there was no odor.

I would like to understand why these symptoms keep recurring and why they vary each time.
Each doctor I consulted (I have seen five doctors in total, some of whom said it was not serious and did not prescribe any medication) mentioned that it was not severe.
During this time, I also tested negative for HPV, syphilis, and HIV.
Although I have some degree of phimosis, it does not prevent retraction of the foreskin, and I can retract it normally during an erection.
Regarding genital care during treatment, I always dry myself with tissue after urination, wash my hands before touching my genitals, and thoroughly clean the area during daily showers.
After washing, I dry it with non-linting paper towels.
I also apply the medication as instructed by the doctor, using a thin layer.
During the treatment period, I did not engage in any sexual activity or masturbation.
After fully recovering, I maintained the same care routine, except I stopped applying the ointment, but the symptoms still keep recurring.
I kindly ask the physician to clarify my concerns, as I am truly distressed and unsure of what to do next.

yy, 20~29 year old female. Ask Date: 2024/01/20

Dr. Du Shixi reply Urology

Hello: If you have been taking care of your skin as described, you may need to consider your lifestyle, diet, rest, and sleep.
Wearing loose-fitting underwear and being mindful of sexual activity can also help.
Additionally, it is important to consider whether family members have diabetes or if there is a history of obesity, as these factors can have an impact.
Such issues often recur in clinical practice.
Patience is key.
Wishing you good health.

Reply Date: 2024/01/20

More Info

Recurrent balanitis, or inflammation of the glans penis and foreskin, can be a frustrating and uncomfortable condition. Your experience of recurrent symptoms despite treatment is not uncommon, and understanding the underlying causes, treatment options, and care tips can help manage this condition more effectively.

Causes of Recurrent Balanitis
1. Infections: Balanitis can be caused by various infections, including bacterial, fungal (such as Candida), or viral infections. The fact that you have had multiple episodes suggests that there may be an underlying infection that has not been fully resolved or that you may be prone to infections.

2. Skin Conditions: Conditions like eczema, psoriasis, or contact dermatitis can also lead to balanitis. If the skin on the penis is sensitive or reacts to certain soaps, detergents, or even the materials in condoms, this could trigger inflammation.

3. Hygiene Practices: While you mentioned maintaining good hygiene, it's important to ensure that the area is not overly dry or irritated. Over-washing or using harsh soaps can strip the skin of its natural oils, leading to irritation.

4. Anatomical Issues: Conditions such as phimosis (tight foreskin) can make it difficult to clean the area properly, leading to a buildup of smegma and increasing the risk of infection.

5. Underlying Health Conditions: Diabetes and other conditions that affect the immune system can predispose individuals to recurrent infections, including balanitis.

Treatment Options
1. Topical Steroids: As you have experienced, topical steroids can reduce inflammation and help with symptoms. However, prolonged use can lead to skin thinning, so it's essential to use them as directed by your physician.

2. Antifungal or Antibacterial Treatments: If a fungal or bacterial infection is suspected, your doctor may prescribe antifungal or antibacterial medications. It's crucial to complete the full course of treatment even if symptoms improve.

3. Avoid Irritants: Identify and avoid any potential irritants, such as certain soaps, lotions, or laundry detergents that may be exacerbating your symptoms.

4. Regular Follow-ups: Since you've seen multiple doctors, it may be beneficial to consult a dermatologist or a urologist specializing in genital skin conditions for a more tailored approach.

Care Tips
1. Gentle Cleaning: Continue to maintain good hygiene by gently cleaning the area with mild soap and water. Avoid scrubbing, which can irritate the skin.

2. Moisturizing: After cleaning, consider using a gentle, fragrance-free moisturizer to keep the skin hydrated. This can help prevent dryness and irritation.

3. Monitor Symptoms: Keep a diary of your symptoms, noting any triggers or changes. This information can be valuable for your healthcare provider in determining the best course of action.

4. Lifestyle Modifications: If you have any underlying conditions like diabetes, managing those effectively can help reduce the frequency of infections.

5. Consider Circumcision: In some cases, if recurrent balanitis is significantly impacting quality of life, circumcision may be considered as a definitive treatment option.

Conclusion
Recurrent balanitis can be challenging to manage, especially when symptoms vary with each episode. It is essential to work closely with your healthcare provider to identify the underlying causes and develop a comprehensive treatment plan. If you continue to experience symptoms, consider seeking a specialist who can provide more focused care. Remember, maintaining good hygiene and avoiding irritants are key components in managing this condition effectively.

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