HPV: human papillomavirus; HSV: herpes simplex virus.
* If improvement is noted, offer Candida testing or empiric treatment to female sexual partners.
¶ STIs known to cause balanitis include trichomonas, HSV, syphilis, HPV, gonorrhea, chlamydia, and Mycoplasma genitalium.
Δ Antimicrobial options: If anaerobes suspected (foul-smelling discharge) use topical metronidazole 0.75% cream twice daily for 7 days; if gram positives suspected, use mupirocin 2% cream 3 times daily for 7 to 14 days. Tailor based on response to therapy and culture results. For severe infection, refer to UpToDate topics on balanitis for approach to systemic antimicrobial therapy.