Inflammation has many possible causes, including irritation by environmental substances, physical trauma, and infection by a wide variety of pathogens, including bacteria, virus, sexually transmitted diseases, or fungus—each of which require a particular treatment.
O'Farrell et al. (2005) report that failure to wash the whole penis, including retraction of the foreskin, is more common among balanitis sufferers. Birley et al. (1993), however, found that excessive genital washing with soap may be a strong contributing factor to the condition. Diabetes can make balanitis more likely, especially if the blood sugar is poorly controlled.
In a 1988 study by Fergusson et al., penile inflammation was reported in 7.6 cases per 100 boys at risk who were circumcised, and 14.4 cases per 100 boys at risk who were not. Herzog and Alvarez reported that, in their 1986 study, "[both] balanitis (6% vs 3%) and irritation (4% vs 1%) were more frequent among the uncircumcised [boys], but the difference [versus the circumcised boys] was not statistically significant." Van Howe (1997) found that circumcised boys need to be as or more closely monitored for balanitis than uncircumcised boys. In Wilson's study (1947) all 22 cases of balanitis were among men who were not circumcised, however the number of cases was "too small to be of significance". In a retrospective study including 28 cases of monilial balanitis, Taylor and Rodin (1975) found this condition to be more common among men who had not been circumcised. In a study assessing the effects of a war environment on sexual health, Hart (1974) reported that balanitis was "almost entirely confined to the uncircumcised". In a cross-sectional study of 398 patients, Fakjian et al. (1990) reported that balanitis was diagnosed in 12.5% of uncircumcised men and 2.3% of circumcised men. In a study of 225 men, O'Farrell et al. (2005) found that circumcised men were less likely to be diagnosed with balanitis than uncircumcised men. In Mallon's study (2000) of 357 patients with genital skin diseases and 305 controls, most cases of inflammatory penile dermatoses (and all patients with nonspecific balanoposthitis) were in men not circumcised.
According to Leber, balanitis "is a common condition affecting 11% of adult men seen in urology clinics and 3% of children" in the United States; globally balanitis "may occur in up to 3% of uncircumcised males".
Escala and Rickwood (1989) in an examination of 100 cases of balanitis in childhood, concluded that the risk "in any individual, uncircumcised boy appears to be no greater than 4%.". Øster (1968) reported no balanitis in 9,545 observations of uncircumcised Danish boys.
Diagnosis may include careful identification of the cause with the aid of a good patient history, swabs and cultures, and pathological examination of a biopsy.
Symptoms usually begin to appear after 3 days and can include:
Zoon's balanitis also known as Balanitis Circumscripta Plasmacellularis or plasma cell balanitis (PCB) is an idiopathic, rare, benign penile dermatosis for which circumcision is often the preferred treatment. Zoon's balanitis has been successfully treated with the carbon dioxide laser and more recently Albertini and colleagues report the avoidance of circumcision and successful treatment of Zoon's balanitis with an Er:YAG laser. Another study, by Retamar and colleagues, found that 40 percent of those treated with CO2 laser relapsed.
Circinate balantitis (also known as balanitis circinata) is a serpiginous annular dermatitis associated with Reiter's syndrome.
^ abO'Farrell N, Quigley M, Fox P (2005). "Association between the intact foreskin and inferior standards of male genital hygiene behaviour: a cross-sectional study". Int J STD AIDS16 (8): 556–9. doi:10.1258/0956462054679151. PMID16105191. "Overall, circumcised men were less likely to be diagnosed with a STI/balanitis (51% and 35%, P 1⁄4 0.021) than those non-circumcised"
^Fakjian, N; S Hunter, GW Cole and J Miller (August 1990). "An argument for circumcision. Prevention of balanitis in the adult". Arch Dermatol126 (8): 1046–7. doi:10.1001/archderm.126.8.1046. PMID2383029.Cite uses deprecated parameters (help)