Patient education: Balanitis in children (The Basics)

What is balanitis? — This is the medical term for when the head of the penis is swollen, sore, or inflamed.

Doctors use the term "balanoposthitis" when the foreskin is also affected. The foreskin is the skin that covers the tip of the penis in people who are not circumcised.

What causes balanitis? — Different things can cause balanitis. They include:

●Infection – Yeast infection is a common cause, especially in children who wear diapers. It is also common in children with diabetes. Other types of infection in the groin area can also cause balanitis.

●Irritation – This is often related to not cleaning the penis or foreskin thoroughly. But it can also happen if the area is cleaned too much, too roughly, or with harsh soaps. This can irritate the area.

●Injury – Injury can happen if the foreskin is roughly pulled back. The penis can also be injured from rubbing against clothing or being caught in a zipper.

What are the symptoms of balanitis? — The symptoms often get worse over 3 to 7 days. They can include:

●Pain, tenderness, or itching on the head of the penis (figure 1)

●Red sores on the head of the penis or the foreskin

●Thick, bad-smelling pus on the head of the penis

●Pain when urinating or trouble urinating

If these symptoms are not treated, the penis can swell. In a child who is not circumcised, the foreskin can get stuck to the head of the penis or just below the head of the penis. The foreskin can also form scars.

Should my child see a doctor or nurse? — Yes. If your child has the symptoms described above, see a doctor or nurse right away.

Go to the emergency department if your child is not circumcised and their foreskin is stuck just below the head of the penis and won't move. This could cause permanent damage if not treated right away (figure 2).

Will I need tests? — It depends. A doctor or nurse can usually tell if a child has balanitis by doing an exam and learning about their symptoms.

Sometimes, the doctor will do tests to find out what is causing balanitis. These might include:

●Taking samples of fluid from the penis to check for infection

●Other tests to check for infection or diabetes

How is balanitis treated? — If the child is not able to urinate, this is treated first:

●If the child cannot urinate because of pain, sitting in a warm bath might help.

●The doctor might also try using cream to numb the area.

●If these things do not work, your child's doctor might suggest other treatments. They might also refer you to a specialist called a "pediatric urologist."

To help relieve other symptoms:

●Your child should soak their penis 2 or 3 times a day. Older children can do this by sitting in shallow bath with warm water.

●Your child's doctor or nurse can show you how to clean the penis and foreskin. It's very important to never forcibly pull back the foreskin.

●Do not use soap, bubble bath, or powders while the child still has symptoms. These things can make irritation worse.

Other treatment depends on the cause of the balanitis:

●If your child has a yeast infection, this is treated with medicines called "antifungals." These come as a cream or gel that goes on the penis.

●In some cases, the doctor might suggest using an antibiotic ointment.

●If balanitis is caused by an allergy or skin reaction to soaps, medicines, or chemicals, continue to avoid these things. Your child's doctor might suggest using a steroid cream or ointment on the area to help it heal.

Can balanitis be prevented? — Yes. To lower the risk of balanitis, keep the penis clean and never forcibly pull back the foreskin.

If your child is young, they will need help cleaning themselves. As they get older, they can learn to do this on their own.

After your child's symptoms have been cured:

●Wash the penis every day with water and a non-irritating soap. Use water that is warm but not hot. Do not scrub the area.

●If your child is younger than 6 months, do not try to pull the foreskin back over the penis.

●After age 6 months, gently pull back the foreskin to clean under it. Then, dry the skin there before putting the foreskin back.

What problems should I watch for? — If not treated, balanitis can lead to problems.

Go to the emergency department if:

●Your child's foreskin is stuck just below the head of the penis and won't move.

●Your child is unable to urinate.

Call your child's doctor or nurse for advice if:

●The foreskin cannot be pulled back.

●Your child has trouble urinating.

●Your child gets a fever.

●Your child has increased swelling, pain, or swollen lymph nodes in the groin area.

●Your child's symptoms do not get better after treatment.

More on this topic

Patient education: Care of the uncircumcised penis in babies and children (The Basics)