Chronic Balanitis

I'm an uncircumsized, sexually active male, 40 years old. About 18 months ago, I developed what seemed like a run-of-mill fungal infection (redness, itchiness, some swelling) on my foreskin. After treating it with some over-the-counter fungal cream, the flare-up died down, but the foreskin area remained red and oversensitive. The crown of the penis head remained a bit purplish and more swollen than normal. I saw a urologist, but he didn't see anything serious. I stopped using the cream, and the flare-up - itchiness, swelling - returned. I went back to my uro who said it looked like a candida infection. He prescribed topical Nizoral.

I applied Nizoral for a month, twice a day, along with taking other precautions - washing the area without soap, drying it throughly after each shower, refraining from sexual activity except for 'gentle' masturbation. But again, while the itchiness, the swelling & worst of the inflammation went away within 3-4 days of application, the red, rash-like conditions remained. When I stopped using the cream, the flare-up sysmptoms consistent with a fungal infection came back within 2-3 weeks.

This has now become a cycle. I would use Nizoral for weeks or even months at a time, the rendness & rash-like condition remains, but no flare-ups. I'd stop using the cream, and at first it appears that the area is healing itself, but the flare-ups return within 2-3 weeks, sometimes a month. Inevitably I'd have to return to Nizoral, and inevitably get frustrated that the chronic rash remains.  

During the past year I saw a dermatologist (at least 8-10 visits), who prescribed Elidel and 2 other creams. These only increased the redness & oversensitivity of the area. Canesten is less helpful than Nizoral, I found. I've tried refraining from sexual activity, but it doesn't appear to make any difference (I practice safe sex anyway). I'm not sure if dietary changes are needed - I've asked both the uro & the dermatologist I saw about this, but they have nothing to offer in this regard.

Is this a fungal infection that's partially resistant to anti-fungals? Which is why Nizoral can suppress the worst of the infection but not eradicate it? Neither the uro nor dermatologist appear to know - and neither one thinks I have a serious problem. But it's been a year and a half & I've forgotten what my foreskin used to look like when it was healthy. Honestly, I'm fairly depressed about it. What do I have? And what are potential next steps in treatment here? What haven't I tried?

All & any help are much, much appreciated. Thank you for your time.

[BhumikaMD]

Hi,

Balanitis is inflammation of the glans (glands) penis. Lack of aeration and irritation because of smegma and discharge surrounding the glans (glands) penis causes inflammation and edema.More common in uncircumcised males.

It is usually caused by poor hygiene in uncircumcised men. The inflammation can be due to infection, harsh soaps, or failure to properly rinse soap off while bathing.
One common organism associated with balanitis is a yeast known as Candida albicans.  Balanitis may occur because of excessive growth of Candida, due to moisture and warmth under the foreskin.

It can be treated by applying Miconazole, an anti-fungal medication.Most cases of balanitis can be controlled with medicated creams and good hygiene.

Inflammation has many possible causes, including irritation by environmental substances, physical trauma, and infection by a wide variety of pathogens, including bacteria, virus, or fungus—each of which require a particular treatment.

Retract the foreskin daily and soak in warm water to clean penis and foreskin. Apply bacitracin (not Neosporin) for pediatric patients if bacterial infection is suspected.
Apply topical clotrimazole for adult men with probable candidal balanitis.

If the symptoms persist, you would need to consult your doctor.

Let us know if you need any other information.

Regards.

[Edward648]

Hey, I too have had that for bout year, and like you the Doc's saw no problem and actually told me while your getting older your skin is going to be thinner and more sesniative while that may be true why did it get worse at times and better at times. so with much reading on here and other spots i concluded that it was blanatitusdue to chronic prostritus, and i have been treated for prostritus three four times but it never seemed to do the trick then i read where just 7 or 14 days is not enough to kill bacteria of that nature you need at least 21 to 30 days worth of doxy(antibotic (antibiotic)) i talked my gp into giving me 21 days, i had also read where a gentle prostrate massage would help loosen built up semen or fluids in the prostrate i didnt know how to do that and had to google it (lol) so i tried that awkward massage and took my 21 days and low an behold reddnes has left hopefully for good i have only done massage couple times as its seems very demeaning to me, anyway hope that helps you as if you have tried all the yeast fighitng methods and its still there then something eles is causing it.  good luck

[alphacentauri]

Thanks for your comments. Edward648, I don't think balanitis is directly connected with CP. Also, keep in mind, most cases of CP are not bacterial and will not be treated with antibiotics. I've had this problem as well: a combination of alpha-blockers and quercetin supplements got rid of my symptoms over a course of 8 months.

I had another visit with a dermotologist. He agreed to do a swab test but didn't think it will help. At the moment the rash is stable, so until I know the swab test results, I'll take the wait-and-see approach.

[fyfo]

What's happen? Is there any change?
Im askin' because I have the same problem :(

[fyfo]

What's happen? Is there any change?
Im askin' because I have the same problem :(

[jjk53]

i have the same problem. it has been 6 months and i 've seen my primary doctor and specialists for about 10 times and used 5 different creams. still no hope.