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==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 should be avoided.<ref name="Birley1991" >{{REFjournal
|last=Birley
|first=HDL
|author-link=
|coauthors=Wasker MM, Luzzi GA, ''et al''.
|title=Clinical Features and management of recurrent balanitis; association with atopy and genital washing
|journal=Genitourin Med
|date=1993-10-01
|volume=69
|issue=5
|pages=400-3
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1195128/pdf/genitmed00029-0074.pdf
|quote=
|pubmedID=8244363
|pubmedCID=1195128
|DOI=10.1136/sti.69.5.400
|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. Fleiss, Hodges and Van Howe (1997) report the foreskin has both protective and immunological functions that help to prevent disease.<ref name="Fleiss1997">{{REFjournal
|last=Fleiss
|first=P
|author-link=Paul M. Fleiss
|coauthors=Hodges GM, Van Howe RS
|title=Immunological functions of the human prepuce
|journal=Sex Trans Inf
|date=1998-10-01
|volume=74
|issue=5
|pages=364-7
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1758142/pdf/v074p00364.pdf
|quote=
|pubmedID=10195034
|pubmedCID=1758142
|DOI=10.1136/sti.74.5.364
|accessdate=2019-10-07
}}</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'' an indication for circumcision.
==Diabetic males==
Diabetic males who have high sugar in their urine may have recurrent yeast infections. Better control of sugar levels is indicated. Recurrent yeast infections that are not responsive to better management of diabetes may be relieved by circumcision.
|trans-title= |language= |last= |first= |publisher= |website=Circumcision Information Reference Library[[CIRP]]
|format=
|quote=
|trans-title=
|language=
|first=
|publisher=
|trans-title= |language= |last= |first= |publisher=[[Doctors Opposing Circumcision |website=Doctors Opposing Circumcision(D.o.C.)]]
→Yeast infections and diabetic males: Add link in SEEALSO section.
{{GraphicWarning}}[[File:Inflammation of the glans penis and the preputial mucosa.jpg|thumb|Inflammation of the [[glans penis]] and the [[preputial mucosa]] of a [[circumcised]] penis (''balanitis'')]]'''Balanitis''' is an inflammation of the [[glans ]] (AKA ''balanus''), but is not necessarily an [[infection]]. Balanitis may occur together with <b>[[posthitis ]]</b> (inflammation of the [[foreskin]], AKA ''posthe''), when it is known as '''balanoposthitis'''.<ref name="edwards1996">{{REFjournal
|last=Edwards
|first=Sarah
|init=S
|author-link=
|title=Balanitis and balanoposthitis: a review
|journal=Genitourin Med
|DOI=10.1136/sti.72.3.155
|accessdate=2019-10-07
|format=PDF}}</ref> Balanitis xerotica obliterans (BXO) is a separate and distinct condition. For more information on BXO, see [[Balanitis xerotica obliterans]]. Balanitis can occur in both [[circumcised ]] and [[intact ]] (non-circumcised) males.
It has many causes, including fungal, yeast, virus, or bacterial infection, environmental irritants, excess sugar in [[urine]], and others.The treatment of balanoposthitis requires accurate diagnosis of the cause of the balanoposthitis because different treatments are required for different causes. Abdennader ''et al''. (1996) observe that such dermatological conditions as psoriasis, lichen planus, lichen sclerosus, fixed drug eruptions, and bullous diseases are ''not '' balanitis.<ref>{{REFjournal
|last=Abdennader
|firstinit=S
|author-link=
|coauthorslast2=Casin |init2=I, |last3=Janier |init3=M, |last4=Morel |init4=P
|title=Balanitis and balanoposthitis: a review
|journal=Genitourin Med
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==
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
|firstinit=RS |author-link=Robert S. Van Howe |coauthors=
|title=Variability in penile appearance and penile findings: a prospective study
|journal=Brit J Urol
|DOI=10.1046/j.1464-410x.1997.00467.x
|accessdate=2019-10-01
}}</ref> Boys Infant boys who have been [[circumcised ]] are likely to experience balanitis caused by exposure to ammoniacal diapers (nappies).<ref>{{REFjournal
|last=Simpson
|firstinit=E
|author-link=
|coauthorslast2=Baraclough |init2=P
|title=The management of the paediatric foreskin
|journal=Australian Family Physician
|issue=5
|pages=381-3
|url=http://www.cirp.org/library/hygiene/simpson1/
|quote=
|pubmedID=9613002
|DOI=
|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 2,149 [[intact]] boys,<ref>{{REFjournal
|last=Hsieh
|init=TF
|author-link=
|last2=Chang
|init2=CH
|last3=Chang
|init3=SS
|title=Foreskin development before adolescence in 2149 schoolboys
|journal=Int J Urol
|date=2006
|volume=13
|issue=7
|pages=968-70
|url=https://onlinelibrary.wiley.com/doi/full/10.1111/j.1442-2042.2006.01449.x
|quote=
|pubmedID=16882064
|pubmedCID=
|DOI=10.1111/j.1442-2042.2006.01449.x
|accessdate=2019-10-09
}}</ref> which suggests a protective effect for the [[foreskin]].
==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
|last=Birley
|init=HDL
|author-link=
|last2=Wasker
|init2=MM
|last3=Luzzi
|init3=GA
|etal=yes
|title=Clinical Features and management of recurrent balanitis; association with atopy and genital washing
|journal=Genitourin Med
|date=1993-10-01
|volume=69
|issue=5
|pages=400-3
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1195128/pdf/genitmed00029-0074.pdf
|quote=
|pubmedID=8244363
|pubmedCID=1195128
|DOI=10.1136/sti.69.5.400
|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.
Balanoposthitis is ''not'' usually an indication for circumcision.
==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
|last=Verma
|first=Shyam B.
|init=SB
|author-link=
|last2=Molina
|first2=Uwe
|init2=U
|author2-link=
|etal=no
|title=Looking through the cracks of diabetic candidal balanoposthitis!
|journal=Int J Gen Med
|location=
|date=2011-07-07
|volume=4
|issue=
|pages=511-3
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150172/
|archived=
|quote=
|pubmedID=21845057
|pubmedCID=3150172
|DOI=10.2147/IJGM.S17875
|accessdate=2020-06-23
}}</ref> Better control of sugar levels is indicated. Recurrent yeast infections that are not responsive to better management of diabetes may be relieved by [[Adolescent and adult circumcision| circumcision]].
Yeast infections may cause adult-onset [[phimosis]]. Yeast infections may usually be successfully treated by application of topical clotrimazole.<ref>{{REFjournal
|last=Crowley
|first=
|init=PD
|author-link=
|last2=Galagher
|first2=HC
|init2=
|author2-link=
|etal=no
|title=Clotrimazole as a pharmaceutical: past, present and future
|trans-title=
|language=
|journal=J Appl Microbiol
|location=
|date=2014-09
|volume=117
|issue=3
|article=
|page=
|pages=611-7
|url=https://sfamjournals.onlinelibrary.wiley.com/doi/full/10.1111/jam.12554
|archived=
|quote=
|pubmedID=24863842
|pubmedCID=
|DOI=10.1111/jam.12554
|accessdate=2021-05-31
}}</ref>
{{SEEALSO}}
* [[Immunological and protective function of the foreskin]]
* [[Issues with American urologists and the practice of male circumcision]]
* [[Penis]]
* [[Preputial sac]]
* [[Regret men]]
* [[Smegma]]
{{LINKS}}
* {{REFweb
|url=http://www.cirp.org/library/disease/balanitis/
|title=Balanitis
|date=2008-02-14
|accessdate=2019-10-07
}}
* {{REFweb
|url=https://web.archive.org/web/20041030063437/http://www.bashh.org/guidelines/2002/balanitis_0901b.pdf
|archived=yes
|title=2001 National Guideline on the Management of Balanitis
|last=Clinical Effectiveness Group
|website=Wayback Machine
|date=2001
|accessdate=2019-10-07
|format=PDF}}* {{REFweb |url=https://www.nhs.uk/conditions/balanitis/ |title=Balanitis |publisher=National Health Service |date=2017-05-31 |quoteaccessdate=2020-01-10
}}
|url=https://www.doctorsopposingcircumcision.org/for-professionals/alleged-medical-benefits/phimosis-balantis/
|title=Phimosis and Balanitis
|date=2019
|accessdate=2019-10-07
{{REF}}
[[Category:DiseaseMedical condition]][[Category:Medical conditionsterm]][[Category:Penile disorder]][[Category:Penile illness]]
[[Category:From Intactipedia]]
[[Category:From IntactWiki]]
[[de:Balanitis]]