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One can’t properly treat balanoposthitis until one knows what is causing it.  Different causes require different treatments.  When one knows the cause, then an appropriate treatment can be selected.<ref name="edwards1996" />
Diagnosis requires an accurate history, and such tests as biopsy and a swab with a culture.<ref name="edwards1996" /> In the absence of a diagnosis, any prescription for treatment is a guess and is likely to fail.


==Childhood==
==Childhood==


The [[foreskin]] is protective of the glans penis in childhood.<ref>{{GairdnerDM 1949}}</ref> [[Robert S. Van Howe|Van Howe]] (1997) reported data collected in his pediatric practice on 468 boys up to 18 years of age. Among boys less than three years of age, [[circumcised]] boys were significantly more likely to have a reddened meatus or balanitis.<ref>{{REFjournal
The [[foreskin]] is protective of the [[glans penis]] in childhood.<ref>{{GairdnerDM 1949}}</ref> [[Robert S. Van Howe|Van Howe]] (1997) reported data collected in his pediatric practice on 468 boys up to 18 years of age. Among boys less than three years of age, [[circumcised]] boys were significantly more likely to have a reddened meatus or balanitis.<ref>{{REFjournal
  |last=Van Howe
  |last=Van Howe
  |init=RS
  |init=RS
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  |DOI=10.1046/j.1464-410x.1997.00467.x
  |DOI=10.1046/j.1464-410x.1997.00467.x
  |accessdate=2019-10-01
  |accessdate=2019-10-01
}}</ref> Boys who have been [[circumcised]] are likely to experience balanitis caused by exposure to ammoniacal diapers (nappies).<ref>{{REFjournal
}}</ref> Infant boys who have been [[circumcised]] are likely to experience balanitis caused by exposure to ammoniacal diapers (nappies).<ref>{{REFjournal
  |last=Simpson
  |last=Simpson
  |init=E
  |init=E
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  |DOI=
  |DOI=
  |accessdate=2019-07-10
  |accessdate=2019-07-10
}}</ref> Hsieh et al. (2006), working in Taiwan, where boys are not [[circumcised]], examined 2,149 elementary pre-adolescent schoolboys. Hsieh et al. found ''only'' one case of balanitis in the [[intact]] 2,149 boys,<ref>{{REFjournal
}}</ref> Hsieh et al. (2006), working in Taiwan, where boys are not [[circumcised]], examined 2,149 elementary pre-adolescent schoolboys. Hsieh et al. found ''only'' one case of balanitis in the 2,149 [[intact]] boys,<ref>{{REFjournal
  |last=Hsieh
  |last=Hsieh
  |init=TF
  |init=TF
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  |accessdate=2019-10-09
  |accessdate=2019-10-09
}}</ref> which suggests a protective effect for the [[foreskin]].
}}</ref> which suggests a protective effect for the [[foreskin]].
A boy's [[foreskin]] should not be retracted until the boy does it for himself.<ref name="Wright1994">{{REFjournal
|last=Wright
|init=JE
|title=Further to the "Further Fate of the Foreskin"
|journal=Med J Aust
|volume=160
|issue=
|pages=134-135
|url=http://www.cirp.org/library/normal/wright2/
|quote=
|pubmedID=8295581
|pubmedCID=
|DOI=
|date=1994-02-07
|accessdate=2024-11-05
}}</ref>


==Excessive washing and non-specific dermatitis==
==Excessive washing and non-specific dermatitis==


Birley et al. (1993) report excessive washing, especially with the use of soap, will dry the oils out of tissues and cause a balanitis like inflammation. The use of soap (including body wash, shower gel, and shampoo) should be avoided.<ref name="Birley1991" >{{REFjournal
Birley et al. (1993) reported excessive washing, especially with the use of soap, will dry the oils out of tissues and cause a balanitis like inflammation. The use of soap (including body wash, shower gel, and shampoo) should be avoided and emollients should be applied.<ref name="Birley1991">{{REFjournal
  |last=Birley
  |last=Birley
  |init=HDL
  |init=HDL
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  |DOI=10.1136/sti.69.5.400
  |DOI=10.1136/sti.69.5.400
  |accessdate=2019-10-07
  |accessdate=2019-10-07
}}</ref> Although it is commonly believed that the human [[foreskin]] is the source of infection so must be constantly washed to prevent infection, that is not true. [[Paul M. Fleiss|Fleiss]], [[Frederick M. Hodges| Hodges]] & [[Robert S. Van Howe|Van Howe]] (1998) reported the foreskin has both [[Immunological and protective function of the foreskin| protective and immunological functions]] that help to prevent disease.<ref name="Fleiss1997">{{FleissP HodgesF VanHoweRS 1998}}</ref>  Washing removes the protective substances and leaves the [[penis]] prone to [[infection]], so washing should be limited and soap should not be used.
}}</ref> One [[intact]] man recommends applying a "thin layer of jojoba oil" to one's [[glans]] and inner [[foreskin]] daily.<ref>{{REFweb
|url=https://www.reddit.com/r/balanitis/comments/walcbh/the_jojoba_oil_solution/
|title=The jojoba oil solution
|last=Anonymous
|first=
|init=
|author-link=
|publisher=REDDIT
|date=2022
|accessdate=2025-01-07
}}</ref>
 
Although it is commonly believed that the human [[foreskin]] is the source of infection so must be constantly washed to prevent [[infection]], that is not true. [[Paul M. Fleiss|Fleiss]], [[Frederick M. Hodges| Hodges]] & [[Robert S. Van Howe|Van Howe]] (1998) reported the foreskin has both [[Immunological and protective function of the foreskin| protective and immunological functions]] that help to prevent disease.<ref name="Fleiss1997">{{FleissP HodgesF VanHoweRS 1998}}</ref>  Washing removes the protective substances and leaves the [[penis]] prone to [[infection]], so washing should be limited and soap should not be used.


Balanoposthitis is ''not'' usually an indication for circumcision.
Balanoposthitis is ''not'' usually an indication for [[adult circumcision]].


==Yeast infections and diabetic males==
==Yeast infections and diabetic males==


Diabetic males who have high sugar in their [[urine]] may have recurrent yeast infections. Verma & Molina (2011) report that balanoposthitis caused by yeast infection is prevalent in India where circumcised men are rare and the rate of diabetes is high.<ref name="verma2011">{{REFjournal
Diabetic males who have high sugar in their [[urine]] may have recurrent yeast infections. Verma & Molina (2011) report that balanoposthitis caused by yeast infection is prevalent in [[India]] where [[circumcised]] men are rare and the rate of diabetes is high.<ref name="verma2011">{{REFjournal
  |last=Verma
  |last=Verma
  |first=Shyam B.
  |first=Shyam B.
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  |accessdate=2021-05-31
  |accessdate=2021-05-31
}}</ref>
}}</ref>
==Diagnosis and treatment==
Balanitis has many possible instigators. Diagnosis requires an accurate history, and such tests as biopsy and a swab with a culture.<ref name="edwards1996" /> In the absence of a diagnosis, any prescription for treatment is a guess and is likely to fail.


One can’t properly treat balanoposthitis until one knows what is causing it.  Different causes require different treatments.  When one knows the cause, then an appropriate treatment can be selected.<ref name="edwards1996" />
==Video==
===Penis pain and inflammation? Balanitis Explained: Symptoms, Causes, and Treatment Options===
<youtube>v=7ybvTaMQn10</youtube>
{{SEEALSO}}
{{SEEALSO}}


* [[Fungal infection]]
* [[Immunological and protective function of the foreskin]]
* [[Immunological and protective function of the foreskin]]
* [[Issues with American urologists and the practice of male circumcision]]
* [[American urologists and the practice of male circumcision]]
* [[Penis]]
* [[Preputial sac]]
* [[Preputial sac]]
* [[Regret men]]
* [[Regret men]]
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[[Category:Medical condition]]
[[Category:Medical condition]]
[[Category:Medical term]]
[[Category:Penile disorder]]
[[Category:Penile disorder]]
[[Category:Penile illness]]
[[Category:Penile illness]]
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