Balanitis issues

[tom001]

I've had balanitis for the last 8 or so months.  I've had 3 doctors look at it and they all said it's irritation.  Topical steroids (betamethasone and later hydrocortisone) did not work.  As I understand it, what's happening is that the top layer of the skin of the affected area on the glans simply won't develop properly.  And so the layer of the epidermis that should be under the top layer is now acting as the top layer.  This irritation is smoother than the unaffected areas of the glans.  My question is:  what would be the best way to treat this?

Thanks,
Tom.

[richi1111]

any feedback would be really helpfull . i hope you can make time to reply

[richi1111]

i have been having the exact same problem as you tom and my dermatologist seems completely useless. did you get it sorted?

[tom001]

Well it's been a month and the Protopic hasn't changed anything.  Made an appointment with a dermatologist again.  Any ideas on why this hasn't responded to steroids and Protopic?

Tom

[BhumikaMD]

Hi,

The white patch could be because of dryness, medication or local reaction.

It would disappear eventualt in the course of treatment. You need to follow up with your doctor regularly.

How are you feeling now?

Let us know if you need any other information.

Regards.

[tom001]

I've been using the protopic for about a week now and I noticed that sometimes the affected skin area looks sort of like a white patch.  Is this normal?

[BhumikaMD]

Hi,

It is nice of you to keep us posted and we are glad to hear that you are symptomatically better.

You would need to continue the medication for a little while after you are completely asymptomatic.

It would be best if you could get a physician consultation before you stop the medicated shampoos.

Let us know if you need any other information.

Regards.

[tom001]

I went to see a dermatologist and I was prescribed Protopic.  I was told to use it twice daily for a month.  Hopefully this will work.

[BhumikaMD]

Hi,

A clinical examination would be required before a conformed diagnosis can be established.

If your doctors say this is dermatitis, then probably it is. You could take a second opinion if you are not convinced.

You need to wash the areas several times with fresh water. Do not use any cosmetic products at the sites.

Apply calamine lotion at the site of the lesions and see if it helps. You could take some oral antihistamine medications like cetrizine or loratadine. You need to maintain a good personal hygiene .

Anti-itch drugs, often antihistamine, may reduce the itch during a flare up of eczema, and the reduced scratching in turn reduces damage and irritation to the skin.

For mild-moderate dermatitis a weak steroid may be used (e.g. hydrocortisone or desonide), whilst more severe cases require a higher-potency steroid (e.g. clobetasol propionate, fluocinonide).

Keeping the affected area moistened can promote skin healing and relief of symptoms.

It would be advisable to consult a skin specialist for your symptoms and a proper clinical examination.

Let us know if you need any other information and post us on how you are doing.

Regards.

[tom001]

Well, all of the doctors I saw said it was some form of dermatitis.  They all said it wasn't an infection.  The steroids didn't really help with it and since using them I've been applying petrolatum after I shower to serve as a protective layer, but I haven't seen any improvements with this either.  What are the other possible ways of treating this?

[BhumikaMD]

Hi,

This could be balanitis. Balanitis is inflammation of the glans penis. When the foreskin (or prepuce) is also affected, it is termed balanoposthitis.

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 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.

[tom001]

Another question:  What's the best way to manage the psychological impact of this?  It's quite unnerving.