What Causes Balanitis In Children And How To Treat It?

Balanitis in children usually doesn’t need treatment unless it is quite severe.

Medically reviewed by Maria Carmela Villania-Mamauag, MD Maria Carmela Villania-Mamauag Maria Carmela Villania-MamauagMD MomJunction on Facebook Specialty: PediatricsExperience: 9 years
Written by , Medical Doctor Dr Bisny T. Joseph Medical Doctor Follow MomJunction on Linkedin Specialty: Health and Medical TreatmentsExperience: 5 years
Edited by , BDS, CLC Dr. Ritika Shah BDS, CLC Follow MomJunction on Linkedin Specialty: Dental and General Health, LactationExperience: 10 years
Fact-checked by , M.Tech Shinta Liz Sunny M.Tech Follow MomJunction on Linkedin Specialty: Health & WellnessExperience: 4 years
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Child With Balanitis Symptoms

Image: Midjourney/ MomJunction Design Team

Balanitis refers to inflammation of the head or glans of the penis (1). Balanitis in children generally self-resolves within two to three days. The condition may occur at any age but is frequently seen in uncircumcised boys below the age of four years, as they may not be able to retract or clean under the foreskin of a penis (2).

Conservative interventions may be helpful for managing balanitis in most children. However, recurrent balanitis may require surgical intervention, such as circumcision.

This post tells you about the causes, symptoms, treatment, complications, and prevention methods for balanitis in children.

In This Article

Key Pointers

  • Balanitis or inflammation of the head or glans of the penis in children may occur due to a reaction from soaps or other irritants.
  • Other factors such as infections and skin problems may also contribute to the swelling, itching, or other symptoms of Balanitis.
  • Recurrent Balanitis may cause urinary tract infection.
  • Mild symptoms may resolve in a few days, but severe ones may require medicines or medical treatment.

Causes Of Balanitis In Children

Children are more likely to develop chemical balanitis, a mild redness due to irritation from soaps or other irritants (3). Approximately 5% of boys younger than five years may develop infectious balanitis (4).

Fungal or yeast infections in children are a common cause of Balanitis. Some other possible factors that may contribute to this condition include (5) (6) (7).

  • Pulling or touching the foreskin frequently
  • Bacterial infections
  • Fungal (yeast) infections
  • Poor hygiene, resulting in the build-up of smegma (secretion of oil glands under the foreskiniA double-layered fold of skin that covers the glans and urethral opening of the penis. ) that may irritate the skin
  • Irritation from urine
  • Irritation from soaps, shower gels, and other products
  • Phimosis (tight foreskin)
  • Skin or dermatological problems, such as eczemaiA common inflammatory skin condition causing dry, itchy, and red patches. or psoriasisiA chronic autoimmune condition where skin cells multiply too quickly, creating thick, scaly patches.
  • Allergic reactions to certain clothing materials, detergents, or diapers
  • Injury to the foreskin or glans
  • Prolonged exposure of the foreskin to urine
  • DiabetesiCharacterized by high blood sugar levels as the body either doesn't produce enough insulin, an organic substance. may increase the risk
  • Excessive washing or scrubbing can irritate the sensitive skin of the genital area, leading to balanitis.

Balanitis is usually seen in boys who are uncircumcised, meaning those who have an intact foreskin. They may develop inflammation of the foreskin known as posthitis with similar etiologici Causing the disease or contributing to a disease’s development factors.

Symptoms And Signs Of Balanitis In Children

Balanitis may cause penile discomfort and itching in children. You may also notice redness and inflammation of the glans. The foreskin may appear tight and may not be able to retractiWhen the foreskin of the penis separates from the glans. adequately in uncircumcised boys.

The common symptoms and signs of balanitis may include (6)(8):

  • Erythema (redness)
  • Whitish spots
  • Swelling and soreness
  • Itching
  • Burning
  • Thick fluid build-up
  • Discharge or pus
  • Foul smell
  • Increased tightness of the foreskin
  • Pain during urination
  • Fever
  • Increased irritability or discomfort

Fever is one of the common signs of infectious balanitis. You may seek prompt pediatric care from a specialist if your son has symptoms of balanitis since the infection may spread to the urinary tract. Usually, balanitis does not cause severe problems in children. However, repeated infections may warrant surgical treatments.

Complications Of Balanitis In Children

In rare cases, balanitis may occur with posthitis, an inflammation of the foreskin. If balanitis and posthitis occur together, it is called Balanoposthitis. Recurrent balanitis with phimosis (tight foreskin) may cause phimosis to last longer if balanitis is left untreated. It may also increase the risk of frequent urinary tract infections (4). According to a report by the American Academy of Pediatrics (AAP), phimosis, or a foreskin that cannot be pulled back, can be normal (physiologic) or caused by an underlying issue (pathologic) (9).

If balanitis is not treated, localized swelling (edema) may develop. The combination of swelling and inflammation can cause the foreskin to stick to the glans (head of the penis). In more severe cases, this can progress to penile cellulitis (a skin infection) and adhesions (scar tissue that causes the foreskin and glans to stick together) (6).

Although most cases may resolve within a few days without any treatment, recurrent balanitis may cause severe pain, penile discharge, and scarring in children. Scarring may interfere with urine flow and cause discomfort. You may seek medical care if your child has balanitis more than once.

Prevention Of Balanitis In Children

Ensuring good personal hygiene for kids is an effective way to prevent balanitis in children. Some other preventive measures that may help prevent this condition include (10) (11):

  • Do not frequently retract the foreskin.
  • Keep the penile area as dry and clean as possible.
  • Wash with lukewarm water regularly.
  • Avoid soaps, gels, and other products that may irritate the skin.

Parents may ensure penile hygiene for young boys. You may also teach your child to keep the area clean from an early age. Speak to a doctor to learn more about good penile hygiene.

protip_icon Quick fact
Nappy rash can irritate a child’s penis and may cause balanitis. Changing their nappies often can avert this risk (12).

Diagnosis Of Balanitis In Children

Symptoms and physical examination of the penis could help diagnose balanitis in children. Additional tests are often ordered to exclude the diagnosis of certain infections that may cause similar symptoms. Tests may include (2) (6) (13):

  • Urine samples or swabs from the affected area to check for bacterial or fungal infections. This helps identify the presence of Candida (yeast) or bacterial infections.
  • Blood tests may be ordered if the balanitis is severe, recurrent, or difficult to treat.
  • HSV (Herpes Simplex Virus) testing if there are vesicular (blister-like) or ulcerative lesions.
  • A potassium hydroxide (KOH) test to identify fungal infections like Candida.
  • Allergy tests, if allergies are suspected.
protip_icon Quick fact
A doctor may advise a blood test for diabetes if the treatment for balanitis is ineffective, its cause is unclear, or the infection is severe, and thrush is present (5).

Treatments For Balanitis In Children

Most cases of balanitis can be managed conservatively without any surgical procedures. Conservative managementiUse of oral and topical medical treatment and other non-invasive procedures. may include taking adequate hygiene measures and avoiding irritants. The other treatment options may include the following (5).

1. Medications

Antibiotics oral or topical antibiotic creams are prescribed for bacterial infections. Fungal infections are treated with topical antifungal creams. Steroid creams are often prescribed to reduce the severity of symptoms.

The condition usually improves within three to five days of treatment, but you may have to complete the full treatment course to avoid recurrence (14).

protip_icon Quick tip
Having the child soak in a bathtub containing warm water and a teaspoon of salt may help reduce the inflammation (7). You can repeat the soak two to three times a day or follow expert advice.

2. Balanitis surgery

Children may have a second episode of infection if the earlier infection is not treated properly. Failure to ensure good hygiene could also increase the risk of another bout of infectious balanitis. Surgical treatment is chosen if the child has a recurrent infection and does not respond to other treatment options, such as medications. CircumcisioniSurgical removal of the foreskin of the penis. , the removal of the foreskin, is the surgical treatment for balanitis. Approximately 35% of circumcised children worldwide are affected by Balanitis Xerotica Obliterans, a chronic, progressive inflammatory condition affecting the foreskin and glans penis (15).

Frequently Asked Questions

1. What can be mistaken for balanitis?

Genital herpes in children is often mistaken for balanitis. Skin conditions such as psoriasis and other uncommon conditions of the penile skin may also be mistaken for balanitis (6). Dr. Luke Prest, a board-certified pediatrician from Ardmore, Pennsylvania, says, “Diseases such as nummular eczema, a reaction to medications, a human papillomavirus (HPV) infection, and scabies can be mistaken for balanitis.”

2. How do I know if my child has balanitis and whether it’s bacterial or fungal?

It can be ascertained only if the doctor orders specific tests to identify the causative organism.

3. Can I use Vaseline for balanitis?

You can apply soft white paraffin ointment (petroleum jelly or Vaseline® ointment) under the foreskin after bathing or showering (16). This may help with balanitis. However, ensure the area is thoroughly cleaned daily, as petroleum jelly may attract dust and dirt.

4. Is Epsom salt good for balanitis?

Add a teaspoon of the regular table salt to a bathtub of clean, warm water. Have your child soak in it and ensure that the water is deep enough to cover the penis (7). Repeat two to three times a day. However, consult a doctor about using Epsom salt for this purpose.

5. What are the different types of balanitis?

Balanitis has several main types. Zoon balanitis shows as shiny red patches with “cayenne pepper” spots in older uncircumcised men, circinate balanitis appears as small painless ulcers related to reactive arthritis, and pseudoepitheliomatous keratotic and micaceous balanitis causes scaly growths in men with late-life circumcision (6). While these specific types mainly affect adults, general balanitis is common in young boys.

Balanitis in children mainly occurs due to poor hygiene or certain infections and usually resolves by itself within a day or two. However, if the symptoms persist and cause irritation, it is advised to consult the doctor for a proper diagnosis. If left untreated, balanitis might lead to severe urinary tract infection. Teach your boys to regularly clean the penile area with lukewarm water and keep the area as dry as possible to avoid complications.

Infographic: Identify And Cure Balanitis In Children

Balanitis can be uncomfortable, and as a parent, you may like to resolve the problem soon. Take a look at the following infographic, which provides the following information about balanitis.

  • What causes balanitis
  • Symptoms of balanitis
  • Preventive measures for balanitis
identify and cure balanitis in children (Infographic)

Illustration: Momjunction Design Team

References

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.
  1. S Edwards; (1996); Balanitis and balanoposthitis: a review.
    https://pmc.ncbi.nlm.nih.gov/articles/PMC1195642/
  2. Balanitis.
    https://my.clevelandclinic.org/health/diseases/21186-balanitis
  3. Suzanne Lippert and N. Ewen Wang; Pediatric Genitourinary and Renal Disorders.
    https://www.sciencedirect.com/topics/medicine-and-dentistry/balanitis
  4. Balanitis In Children.
    https://www.londonchildrensurgery.co.uk/balanitis.php
  5. Balanitis.
    https://www.nhs.uk/conditions/balanitis/
  6. Balanitis.
    https://www.ncbi.nlm.nih.gov/books/NBK537143/
  7. The penis and foreskin.
    https://www.rch.org.au/clinicalguide/guideline_index/the_penis_and_foreskin/
  8. Balanitis.
    https://dermnetnz.org/topics/balanitis
  9. Phimosis (Chapter 312).
    https://publications.aap.org/pediatriccare/book/348/chapter-abstract/5785109/Phimosis-Chapter-312?redirectedFrom=fulltext
  10. Balanitis.
    https://www.columbiadoctors.org/health-library/condition/balanitis/
  11. Balanitis and balanoposthitis.
    https://www.chusj.org/getmedia/70164122-ac4d-4422-972f-dcd24649f061/depliant-F-7058A-Balanitis-and-balanoposthitis_web.pdf.aspx?ext=.pdf
  12. Penis and foreskin care.
    https://www.rch.org.au/kidsinfo/fact_sheets/Penis_and_foreskin_care/
  13. Balanitis.
    https://www.sexualhealthsheffield.nhs.uk/wp-content/uploads/2015/03/Balanitis.pdf
  14. Balanitis.
    https://www.health.harvard.edu/a_to_z/balanitis-a-to-z
  15. Soledad Celis et.al; (2014); Balanitis xerotica obliterans in children and adolescents: A literature review and clinical series.
    https://www.sciencedirect.com/science/article/abs/pii/S147751311300288X
  16. Balanitis & Balano-posthitis.
    https://www.dermcoll.edu.au/atoz/balanitis-balano-posthitis-2/

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Maria Carmela Villania-Mamauag
Maria Carmela Villania-MamauagMD, DPPS
Maria Carmela Villania-Mamauag is a board certified diplomate of the Philippine Pediatric Society with a degree of Doctor of Medicine from Our Lady of Fatima University, Valenzuela City and a Bachelor in Science in Psychology from Saint Louis University, Baguio City which was augmented by a year of Bachelor in Science in Family Life and Child development at the University of the Philippines, Diliman, Quezon City.

Read full bio of Maria Carmela Villania-Mamauag
  • Dr. Luke Prest
    Dr. Luke PrestMD Dr. Luke Prest is a general pediatrician who has been providing medical care to children and adolescents since 2019. He graduated in medicine from the University of Iowa in 2016 and has worked with the Children's Hospital of Philadelphia.
    Dr. Luke Prest is a general pediatrician who has been providing medical care to children and adolescents since 2019. He graduated in medicine from the University of Iowa in 2016 and has worked with the Children's Hospital of Philadelphia.
Dr Bisny T. Joseph
Dr Bisny T. JosephMedical Doctor
Dr. Bisny T. Joseph is a Georgian Board-certified physician. She has completed her professional graduate degree as a medical doctor from Tbilisi State Medical University, Georgia. She has around 5 years of experience in various sectors of medical affairs as a physician, medical reviewer, medical writer, health coach, and Q&A expert.

Read full bio of Dr Bisny T. Joseph
Dr. Ritika Shah
Dr. Ritika ShahBDS, CLC
Dr. Ritika Shah is a certified lactation counsellor (CLC) from iNational Health Care Academy, Singapore and a dental surgeon with more than seven years of clinical experience across various cities in India. She did her graduation in Dentistry from KM Shah Dental College.

Read full bio of Dr. Ritika Shah
Shinta Liz Sunny
Shinta Liz SunnyM.Tech
Shinta is a biotechnologist who is highly intrigued by science and technology. She holds a master's degree in Biotechnology from Karunya Institute of Technology and Sciences and a PG Diploma in cellular and molecular diagnostics from Manipal University.

Read full bio of Shinta Liz Sunny
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