Symptoms include inflammation of the head of the penis. The whole glans can be affected, or it can be confined to small red, sore irritated areas on the skin surface. Often the foreskin is inflamed and unable to be retracted. A thick clumpy discharge may be seen from the glans or beneath the foreskin and an odour may be present. Pain may be experienced on passing urine.

Regular bathing in salt water is recommended to soothe the affected area. Usually balanitis is caused by Candida albicans and for most cases treatment with a topical antifungal agent will be sufficient. If the area is severely inflamed, this can be treated with a mild steroid such as hydrocortisone. A course of antibiotics will clear any bacterial infection resulting from the balanitis.

Published guidelines on the management of balanitis include:

• National guideline on the management of balanitis from the British Association of Sexual Health and HIV
• Balanitis PRODIGY guidance

If the irritation is caused by an infection, sexual intercourse should be avoided until effective treatment has been received. Ensure that all previous and current sexual partners are tested and treated to avoid reinfection. If the irritation is not due to an infection, the male may feel more comfortable avoiding sexual intercourse until the symptoms have cleared.

Not a notifiable disease. Refer to your local policy/infection control team for further information.

Infectious balanitis usually responds promptly to treatment, therefore the risk of complications is low.

Behind the foreskin and the glans should be washed each day with a mild soap and water. The penis and the glans should be completely dry before dressing. If symptoms are due to a reaction to condoms, it is recommended that a brand specifically designed for sensitive skin be used, and condoms containing nonoxynol-9 spermicide be avoided. Underwear should be washed in non-biological detergent and if chemicals or irritants are used, it is recommended that hands be washed before going to the toilet.

None.

None.