CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.
Balanitis - Management
How should I assess an adult with balanitis to identify the cause?
- For a list of causes in adults, see Causes in adults.
- Ask about:
- Hygiene practices (for example, how often is the penis cleaned?) — lack of hygiene predisposes to non-specific dermatitis.
- Exposure to irritants — such as soaps or creams.
- Trauma — for example, during sexual intercourse or vigorous cleaning.
- Exposure to infections — has the man's partner had bacterial vaginosis or a vaginal candidal infection?
- A history of diabetes or immunosuppression — which predisposes to infection.
- Look for clinical features of balanitis and for other skin conditions elsewhere (such as seborrhoeic dermatitis), which suggest a specific underlying cause.
- Take a sub-preputial swab if balanitis is:
- Severe.
- Recurrent.
- Mild, but persists despite treatment.
- Only swab for Gardnerella-associated balanitis if this is suspected clinically. State 'gardnerella' on the laboratory form when requesting the test, as most laboratories will not routinely test for the organism.
- Check blood glucose levels or urine for glycosuria if balanitis is severe, persistent, or recurrent (especially if candidal balanitis is present).
© NHS Institute for Innovation and Improvement