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Candidal Balanoposthitis

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Candidal Balanoposthitis

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Candidal balanoposthitis is the inflammation of the head of the penis and foreskin caused by the fungus Candida albicans and is very common among diabetic men.

Medically reviewed by

Dr. Shreyansh Talesra

Published At June 13, 2019
Reviewed AtApril 2, 2024

What Is Candidal Balanoposthitis?

Balanoposthitis is the inflammation of both the glans penis and the foreskin. When the fungus Candida albicans causes this inflammation, it is called candidal balanoposthitis or candidal balanitis or thrush in men. Different species of Candida are responsible for causing most types of yeast infections.

What Is the Difference Between Balanoposthitis and Balanitis?

Balanitis is only the inflammation of the glans penis, but balanoposthitis is the swelling of the glans along with the foreskin.

Who Is Susceptible to Balanophosthitis?

A frequent illness disorder affecting the prepuce and glans is called balanoposthitis. Up to 12 percent to 20 percent of male children and adults are affected. Some skin illnesses, like psoriasis and some rare skin conditions, can affect the penis and can either cause or be mistaken for balanitis.

What Causes Candidal Balanoposthitis?

The most common cause is fungal infection with Candida albicans. Candida is normally found on the surface of the skin and mucous membrane. But in immunocompromised individuals and people with poor hygiene, this fungus starts growing too much and causes symptoms.

What Are the Signs and Symptoms of Candidal Balanoposthitis?

It does not cause any symptoms in the initial stages, but the following signs and symptoms are seen if inflammation occurs:

  • Itching.

  • Soreness.

  • Small papules or white patches on the head of the penis.

  • The skin on the head of the penis appears dull red and glazed.

  • Swelling.

  • Irritation.

  • Foul-smelling, white, and lumpy discharge is seen under the foreskin and skin folds.

  • Inability to pull the foreskin back (phimosis).

  • Pain or burning on urination.

  • Pain during sex.

What Are the Risk Factors for Candidal Balanoposthitis?

Some of the factors that increase the risk of an individual are:

  • Uncircumcised penis.

  • Immunocompromised conditions like HIV.

  • Uncontrolled blood sugar levels.

  • Indiscriminate use of broad-spectrum antibiotics.

  • Using corticosteroids and chemotherapy, which suppress the immune system.

  • Poor hygiene.

  • Obesity.

  • Dehydration.

  • Dry skin.

  • Eczema.

  • Using scented soap, moisturizers, and lubricants can irritate the skin.

  • Poor diet.

  • Not drying the private areas properly after washing them.

Can Candidal Balanoposthitis Be Transmitted Sexually?

No, it is usually not transmitted through sexual activity. However, it is advisable to refrain from unprotected sex until the infection is treated. Men do not "catch" vaginal thrush from women, and women do not "catch" balanitis from men. Excessive proliferation of organisms that are naturally present on the glans' skin leads to balanitis. Men with a foreskin (i.e., those who have not had circumcision) are typically affected.

What Are the Complications of Candidal Balanoposthitis?

In people with a weak immune system, a candidal infection can cause the following complications:

Invasive candidiasis - The blood gets infected with the fungal infection, which infects other organs like the heart, brain, and liver. It is a life-threatening condition and needs immediate medical attention.

How Is Candidal Balanoposthitis Diagnosed?

This condition is usually diagnosed from the glazed appearance of the head of the penis and the whitish lesions. The doctor will first rule out the possibility of sexually transmitted infections. To confirm the diagnosis, the doctor might conduct the KOH test. KOH test or potassium hydroxide preparation or KOH prep is done by lightly scraping the infected area, and viewing the sample under the microscope to look for Candida spores and colonies.

  • Skin Test: To identify bacteria, viruses, and fungi, a skin test can be performed. A cotton swab will be gently rubbed over the foreskin by the healthcare provider. The cotton swab will thereafter be sent to a lab for examination.

  • Swab for Urethral Discharge: A urethral discharge swab is useful for diagnosing viruses and bacteria. A cotton swab, measuring approximately 3/4 of an inch (2 cm), will be carefully inserted and gently rotated into the urethral aperture, which is the hole at the tip of the penis, by the healthcare professional. After that, the healthcare provider will send the cotton swab to a lab for analysis.

How Is Candidal Balanoposthitis Treated?

If the infection is mild, it does not require treatment. the doctor might prescribe a single dose of oral Fluconazole 150 milligram.

Topical creams that contain Clotrimazole, Miconazole, or Nystatin, take a longer time to show effect. They are generally prescribed for 7 to 14 days.

If the inflammation is severe, then along with the topical antifungal cream, topical corticosteroids are also prescribed.

Oral antifungal medicine is recommended for people with diabetes or immune system problems or if the symptoms are severe.

How Is the Prognosis of Candidal Balanoposthitis?

The outcome of balanoposthitis is good and some people recover without treatment. Treatment with antifungals shows a cure rate of 95 percent. Relapse is common if the underlying problem is not identified and treated. If the rate of recurrence is high, then circumcision is advised.

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How to Prevent Candidal Balanoposthitis?

Maintaining good personal hygiene helps prevent and treat this condition. A few tips that you can follow are:

  • The penis head should be washed carefully with warm water after retracting the foreskin.

  • Avoid using scented or hard soap on the genitals.

  • Pat dry the penis and glans penis with a soft towel after retracting the foreskin.

  • Wear loose underpants to keep the genitals cool and dry.

How Are Candidal Balanoposthitis and Diabetes Related?

Candidal balanoposthitis is challenging to treat in diabetic patients, and the infection recurs if the blood sugar level is not controlled. This is because high blood sugar levels increase the sugar levels in the urine. When this urine containing sugar dribbles and stays on the glans penis and foreskin, it becomes a friendly place for yeast and bacteria to feed and grow, which results in an infection.

Can Probiotics Be Used to Treat Candidal Balanoposthitis?

There is not much evidence suggesting the effectiveness of probiotics containing Lactobacillus in treating candidal infections. A study showed it reduces the number of Candida cells in a certain type of candidal infection, but more research is needed to confirm this finding.

If this is the first time you are experiencing symptoms of this disease, it is better to consult a doctor before using any medicine. And if you have recurrent infections, the underlying cause has to be identified and treated.

Conclusion:

Balanoposthitis is a disorder that is frequently seen in STD centers. Balanoposthitis has a complex aetiology and numerous predisposing variables. It is most frequently observed in sexually active age groups, and most of the time, exposure to STDs is a significant factor. The several triggers, such as smegma, urine, alkaline vaginal discharge, clothing friction, and vaginal pathogens from unsanitary encounters.

Frequently Asked Questions

1.

What causes candidal balanitis?

It is a penile yeast infection caused by the fungus called candida. This fungus is normally present on the human body, which in certain situations, overgrows and results in infections. Poor hygiene and excessive sweating make a person more susceptible.

2.

Is candidal balanitis an STD?

No, candidal balanitis is not an STD (sexually transmitted disease), as it is usually not transmitted through sexual intercourse. But refrain from unprotected sex until the infection settles.

3.

Can candidal balanoposthitis cure itself?

Yes, it does. If the infection is mild, it will get managed with maintaining proper hygiene. Only in severe cases, your doctor might prescribe oral or topical antifungals.

4.

What happens if candidal balanoposthitis goes untreated?

It generally does not result in any complications and heals on its own. But if the person’s immune system is weak, it can result in invasive candidiasis. In this condition, the fungal infection spreads to the blood, and other organs also get infected. This needs immediate medical attention as it can be fatal.

5.

Can candidal balanoposthitis lead to cancer?

Although very rare, inflammation of the glans penis and foreskin due to infection does slightly increase the risk of skin cancer.

6.

Can antibiotics be used to treat candidal balanoposthitis?

Antibiotics are only used to treat infections caused by bacteria. As this is a fungal infection, antibiotics will be of no use. If the doctor suspects your symptoms are due to bacterial infection, then he or she will prescribe antibiotics after running the required tests.

7.

What does candidal balanoposthitis look like?

This infection does not result in any lesions during the early stage. Later, they can result in white bumps on the penis head, the foreskin might appear red and glazed, and white foul-smelling discharge might be seen under the skin folds.

8.

Can candidal balanoposthitis come back?

In case proper hygiene is not maintained and if the patient has a tight foreskin, then candidal balanoposthitis can keep recurring. In such cases, the doctor might suggest circumcision.

9.

Does Neosporin help candidal balanoposthitis?

Neosporin contains Neomycin, Polymyxin B, and Bacitracin, and is a triple antibiotic ointment. As it is a topical antibiotic, it will not help in the treatment of candidal balanoposthitis.
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Dr. Shreyansh Talesra

Dermatology

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fluconazolecandidal balanoposthitisbalanitiscandida albicansglans inflammation
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