Causes of balanitis

The causes of balanitis include poor hygiene, fungal infections, and sexually transmitted infections (STIs).

Poor hygiene

Poor hygiene is the most common cause of balanitis, with young boys being at particular risk. This is usually due to irritation caused by a tight foreskin.

Pulling the foreskin back to clean becomes difficult, leading to poor hygiene and a build-up of a substance called smegma. Smegma is a ‘cheesy’, white secretion 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) 
• bacterial infection – streptococcal bacteria is the most common type of bacteria to cause balanitis
• an allergic reaction or skin 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, repeatedly playing with their foreskin

Additional causes of balanitis in men include:

• having unprotected sex with a woman who has thrush
• sexually transmitted infections (STIs), such as genital herpes, chlamydia, gonorrhoea and syphilis
• irritation caused by the latex used in condoms

A number of other skin conditions are known to cause symptoms of balanitis in men, including:

• lichen planus – a non-infectious, itchy rash affecting a number of areas of the body
• lichen sclerosus – a skin condition affecting the skin around the genitals and anus
• Zoon’s balanitis – a rare condition affecting middle-aged men and causes the head of the penis to become red, shiny and itchy
• circinate balanitis – a type of psoriasis that sometimes affects men with reactive arthritis 

If all causes of 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.