What Causes Balanitis In Children And How To Treat It?

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Balanitis is the inflammation of the glans or head of the penis. It is an inflammation that can occur at any age and usually resolves within two to three days. The condition tends to be more common among boys younger than five years since they cannot retract and clean under their foreskin.

Conservative methods can help manage balanitis in most cases. Recurrent balanitis may require surgical intervention, such as circumcision. Read this post to know more about the causes, symptoms, complications, diagnosis, treatment, and prevention of balanitis in children.

Causes Of Balanitis In Children

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

Balanitis may occur in children due to the following reasons (1).

  • 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 foreskin) that may irritate the skin
  • Irritation from urine
  • Irritation from soaps, shower gels, and other products
  • Phimosis (tight foreskin)
  • Skin problems, such as eczema or psoriasis
  • Diabetes may increase the risk

Balanitis is usually seen in uncircumcised boys, meaning those who have an intact foreskin. Circumcised boys may develop inflammation of the foreskin known as posthitis with similar etiologic 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 retract adequately in uncircumcised boys.

The common symptoms and signs of balanitis may include (2):

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

Fever is one of the common signs of infected balanitis. You may seek medical care if your son has balanitis symptoms 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 urinary tract infections (3).

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 may help prevent balanitis in children. The preventive measures may include the following.

  • 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.

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. Bacterial or fungal infections are often diagnosed by analyzing urine samples or swabs from the secretions present on the penis.

Treatments For Balanitis In Children

Most cases of balanitis can be managed conservatively without any surgical procedures. Conservative management may include taking adequate hygiene measures and avoiding irritants. The other treatment options may include the following (1).

1. Medications

Antibiotics 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 a few days of treatment, but you may have to complete the full treatment course to avoid recurrence.

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 infected balanitis. Surgical balanitis treatment is chosen if the child has a recurrent infection and does not respond to other treatment options, such as medications. Circumcision, the removal of the foreskin, is the surgical treatment for balanitis.

Balanitis may cause discomfort but usually resolves with conservative treatment. Adequate penile hygiene can help avoid the condition and also recurrence. Infected balanitis can be treated with medications, and surgery is seldom needed. Teach your son correct penile hygiene and take the help of a pediatrician if needed.

References:

1. Balanitis; National Health Service
2. Balanitis; DermNet NZ
3. Balanitis In Children; London Children’s Surgery

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