Balanitis
Dear Dr.
Hsu,
I previously visited a urologist and was diagnosed with balanitis.
I was prescribed a topical ointment containing clobetasol and neomycin.
Although I have been applying the medication as instructed, the redness on the glans continues to slowly expand (compared to the adjacent normal glans, which appears slightly pale).
When I retract the foreskin to urinate, I often notice that the red areas on the glans are moist and sticky (indicating that the glans and foreskin are in a consistently moist condition).
After urinating, when I rinse with clean water, an opaque substance frequently forms on the red areas.
Regardless of whether I rinse with water or not, when I dry with toilet paper, it not only causes slight pain but also leaves residue on the paper.
During showers, whether I rinse with clean water or apply the ointment, a white membranous substance sometimes appears on the glans.
I am unsure if this is due to the superficial skin of the glans being damaged or if there is another reason.
Consequently, I have been applying the ointment and rinsing with water with increasingly gentle pressure, as I am hesitant to repeat the process too many times.
Additionally, every morning upon waking, the first sensation I feel is pain from the friction between the glans and foreskin due to an erection.
Previously, there was only redness of the foreskin, and following your advice, cleaning was quite convenient.
However, now that the inflammation has spread to the glans, resulting in redness and a moist, sticky condition, are there any additional cleaning precautions I should take? For instance, should I dry the red, exudative areas of the glans with toilet paper, or should I leave them alone?
A-Ming, 20~29 year old female. Ask Date: 2016/01/07
Dr. Xu Weikai reply Urology
A-Ming: Hello, it seems to be a localized infection causing some discharge.
The recommended cleaning method for the glans and foreskin is as follows: 1.
Clean the glans several times a day.
2.
It is best to clean the smegma after each urination; rinsing is preferable, but if that's not convenient, simply patting dry is sufficient.
3.
Cleaning method: * use only cool, clean water Do not use soap, body wash, or any cleaning agents.
If you feel dryness, you can apply petroleum jelly, baby oil, or a gentle, non-irritating moisturizer locally.
4.
If this occurs frequently, there may be other underlying issues, and it is advisable to seek professional medical advice.
If there are any unclear points, feel free to ask again for further discussion.
Online responses should only serve as a reference; if necessary, it is still important to visit a medical facility.
This message is from the Department of Urology, Taitung Hospital, Ministry of Health and Welfare, and is answered by Dr.
Hsu Wei-Kai.
Reply Date: 2016/01/07
More Info
Managing balanitis, particularly when it involves symptoms such as redness, moisture, and discomfort in the glans (the head of the penis), requires careful attention to hygiene and treatment. Balanitis can be caused by various factors, including infections (bacterial or fungal), irritants, or underlying skin conditions. Given your description, it seems that you are experiencing a persistent case of balanitis, which may require a more comprehensive approach to care and treatment.
Understanding Balanitis
Balanitis is characterized by inflammation of the glans, often leading to symptoms such as redness, swelling, and discharge. The moist and sticky condition you describe may indicate a buildup of smegma, which is a combination of dead skin cells, oils, and other bodily fluids. This can create an environment conducive to infection, further exacerbating the inflammation.
Treatment and Care Tips
1. Hygiene Practices:
- Gentle Cleaning: It is crucial to maintain cleanliness in the area. Use warm water to gently wash the glans and the surrounding area daily. Avoid using harsh soaps or chemicals that can irritate the sensitive skin.
- Drying: After washing, gently pat the area dry with a soft towel. Avoid vigorous rubbing, which can cause further irritation. If there is discharge or moisture, it is advisable to use a clean, soft cloth or tissue to absorb excess moisture without causing friction.
2. Medication Application:
- Follow Instructions: Continue applying the prescribed ointments (like clotrimazole and neomycin) as directed by your healthcare provider. Ensure that the area is clean and dry before applying the medication to enhance absorption and effectiveness.
- Avoid Overuse: If you notice that the area is becoming more irritated or if you experience increased pain, it may be beneficial to consult your doctor. Overuse of topical medications can sometimes lead to skin thinning or further irritation.
3. Moisture Management:
- Avoid Excess Moisture: Since you mentioned that the glans remains moist and sticky, try to keep the area as dry as possible. After urination, gently dab the area with a soft tissue to remove any moisture. If you notice a persistent discharge, it may be a sign of infection that requires further evaluation.
- Breathable Underwear: Wear loose-fitting, breathable underwear to allow air circulation, which can help reduce moisture buildup.
4. Pain Management:
- Avoid Irritation: If you experience pain during erections due to friction between the glans and the foreskin, consider using a water-based lubricant during sexual activity to minimize discomfort.
- Consult Your Doctor: If the pain persists or worsens, it is essential to discuss this with your healthcare provider. They may recommend additional treatments or adjustments to your current regimen.
5. Monitoring Symptoms:
- Track Changes: Keep an eye on the symptoms. If the redness and irritation do not improve within a few days of consistent treatment, or if you notice any signs of infection (such as increased swelling, pus, or fever), seek medical attention promptly.
6. Avoiding Irritants:
- Limit Friction: Try to avoid activities that may cause friction or irritation to the area, such as vigorous exercise or sexual activity, until the inflammation subsides.
Conclusion
Managing balanitis effectively involves a combination of proper hygiene, appropriate use of medications, and monitoring for any changes in symptoms. If you find that your symptoms are not improving or are worsening despite following these guidelines, it is crucial to return to your healthcare provider for further evaluation. They may need to reassess your condition, consider alternative treatments, or investigate any underlying issues that may be contributing to your symptoms. Remember, maintaining open communication with your healthcare provider is key to effectively managing your condition.
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