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 To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?'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
Basis for recommendation
These recommendations are based on expert advice from review articles [Orden et al, 1996; Schwartz and Rushton, 1996].
Predisposing factors
- Non-specific dermatitis is thought to be the most common cause of balanitis. However, occasionally, specific irritants may be identified that will require avoidance [Schwartz and Rushton, 1996].
Sub-preputial swab
- A swab can be useful to confirm, or exclude, an infectious cause of balanitis. However, most children with balanitis presenting in primary care probably have mild non-specific dermatitis (with or without candidal or bacterial colonization), which usually responds quickly to empirical treatment — making it unnecessary to swab all children.
- A case series investigating boys (n = 32) with balanitis presenting in secondary care suggests that more severe balanitis (increased erythema and exudate) indicates a bacterial infection [Escala and Rickwood, 1989]. Therefore, it seems sensible to swab when balanitis is severe, or not responding to treatment with a combined topical corticosteroid and antifungal.
© NHS Institute for Innovation and Improvement