Candidal Balanoposthitis

What Is Candidal Balanoposthitis?

Balanoposthitis is the inflammation of both the glans penis and the foreskin. When the fungi Candida albicans cause 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 infection.

What Is the Difference Between Balanoposthitis and Balanitis?

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

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.

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• 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 condition 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. But it is advisable to refrain from unprotected sex until the infection is treated.

What Are the Complications of Candidal Balanoposthitis?

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

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.

How Is Candidal Balanoposthitis Treated?

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

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 problem or if the symptoms are severe.

How Is the Prognosis of Candidal Balanoposthitis?

Treatment with antifungals shows a cure rate of 95 %. Relapse is common if the underlying problem is not identified and treated.

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 your 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 also. 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 to reduce 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.