Balanitis & Posthitis – Inflammation of the Foreskin Area

Balanitis – Inflammation of the Glans

The term balanitis (from the Greek balanos = glans) refers to inflammation of the glans penis. It can occur in men of any age and is not infectious in the sense of being directly transmissible, though it can be co-caused by sexually transmitted pathogens.

Typical symptoms are redness, swelling and warmth of the glans, accompanied by burning, itching or pain. Occasionally a whitish coating, discharge or an unpleasant odour may also occur. The causes are varied: fungal infections — above all Candida albicans — are common, as are bacterial infections caused by gram-positive or gram-negative organisms that settle beneath the foreskin. Irritation from harsh soaps, shower gels, disinfectants or latex condoms can trigger a non-infectious balanitis. Skin conditions such as lichen sclerosus, psoriasis or contact dermatitis are also possible causes.

Predisposing factors include phimosis, which makes cleaning the glans more difficult and creates a warm, moist environment for pathogens, as well as diabetes mellitus, since elevated glucose levels in the urine promote fungal growth.

Diagnosis is made clinically; in cases of unclear findings or recurrent episodes, swabs to identify the pathogen are advisable. Treatment depends on the cause: antifungal creams for fungal infections, antibiotic preparations for bacterial cases, topical corticosteroids for inflammatory irritation. Gentle, regular genital hygiene with plain water or pH-neutral products is recommended alongside treatment. For recurrent balanitis, particularly in combination with phimosis, circumcision can be the most effective permanent solution.

Posthitis – Inflammation of the Foreskin

Posthitis refers to inflammation of the foreskin (prepuce). The causes and triggers are largely the same as for balanitis: fungal infections (mainly Candida), bacterial infections, chemical irritation from care products or allergens, mechanical stress from friction, as well as predisposing underlying conditions such as diabetes mellitus or phimosis.

Symptomatically, posthitis presents with redness, swelling and tenderness of the foreskin, pain or burning — particularly when retracting the foreskin — itching, and occasional discharge beneath the foreskin. In cases of severe swelling, urination can become difficult.

Balanitis and posthitis frequently occur together — this combination is referred to as balanoposthitis and requires treatment that addresses both structures.

Diagnosis and Treatment

Clinical diagnosis is made through inspection. In cases of an unclear pathogen spectrum, recurrent episodes or treatment-resistant courses, swabs for microbiological diagnostics and — if a skin condition is suspected — a dermatological assessment are advisable. Blood glucose screening is recommended for a first occurrence with no apparent cause.

Depending on the cause, treatment focuses on topical antifungal, antibiotic or anti-inflammatory preparations. General measures — gentle intimate hygiene with plain water, avoiding irritating care products, loose cotton underwear to prevent moisture build-up — support healing and act preventively. For repeated episodes, particularly with accompanying phimosis, circumcision is an effective and lasting solution.

Relevance Before Surgical Procedures

Before planned procedures in the intimate area — such as penis lengthening, girth enhancement or penis enlargement — the presence of acute balanitis or posthitis is a temporary contraindication. An existing inflammation increases the risk of infection, impairs wound healing and can jeopardize the surgical outcome. As part of our preoperative assessment, we explicitly check for inflammatory changes; a planned procedure is only carried out once healing is complete.