Poor hygiene
Poor hygiene is the most common cause of balanitis, with young boys being at particular risk. This is because the head of their penis can become irritated due to having a tight foreskin.
This can make it difficult to pull the foreskin back to clean, leading to poor hygiene and a build-up of a substance called smegma. Smegma is a ‘cheesy’, white secretion that is produced by glands inside the penis. Smegma can cause the skin around the penis to become irritated and inflamed, triggering the symptoms of balanitis.
Poor hygiene is also a surprisingly common cause of balanitis in men as well as in boys.
Other causes
Other causes of balanitis include:
- fungal infection (thrush) – people with diabetes are particularly at risk of developing this type of infection because their immune system (the body’s natural defence against infection and illness) is usually weakened
- bacterial infection – streptococcal bacteria is the most common type of bacteria to cause balanitis
- irritation – caused by an adverse skin reaction to certain substances, such as a bubble bath, or soap (the medical term for this type of skin reaction is contact dermatitis)
- an underlying skin condition, such as atopic eczema, or psoriasis (see below)
- in boys, repeated manipulation of the foreskin, e.g. playing or fiddling with their foreskin
Additional causes of balanitis in men include:
A number of other skin conditions are known to cause symptoms of balanitis in men.
They are:
- lichen planus – a non-infectious, itchy rash that can affect a number of areas of the body
- lichen sclerosus – a skin condition of unknown cause that affects the skin around the genitals and anus, causing it to become inflamed and itchy
- Zoon's balanitis – a rare condition of unknown cause that usually affects middle-aged men and causes the head of the penis to become red, shiny and itchy
- circinate balanitis – a type of psoriasis that can sometimes affect men with reactive arthritis (a type of arthritis that causes inflammation throughout the body, including the head of the penis)
Sometimes, if all of the skin conditions that can cause balanitis have been ruled out, you may have non-specific balanoposthitis. This is when the foreskin and the surface of the glans are inflamed, red and swollen, making it painful and difficult to pass urine. Balanoposthitis is usually treated with antibiotics, but in very severe cases circumcision may be required.
