Dealing with balanitis since March - suggestions?

[Kalessin2]

Hi all - looking for some advice on what to do.

I've been suffering from recurrent balanitis since March. Same pattern as others: treatments offer relief, but it eventually comes back once stopping them (sometimes even while treatment is ongoing).

Symptoms in my case seem milder than what I've read online: redness, red dots (sometimes), soreness/discomfort, NO discharge, NO white substance.

Have been seen by 3 urologists:

Uro #1: Cream with miconazol + steroid + topical antibiotic. Use once a day for 1 week. Worked after a few days, but one/two weeks later it was back.

Uro #2: Cream with steroid + topical antibiotic + nystatin. Use twice a day 2 weeks, once a day week 3, once every 2 days week 4. Worked, but two weeks later back to square 1 + after this the cream didn't even seem to be having effect. Also tested for STDs just in case, all negative.

Uro 1 had cautioned me that this seemed fungal and that meant it would be hard to shake off. Uro 2 was very cavalier.

Uro #3 (much more competent than the prior ones) - first time we seemed to make real progress. Told me 3 things:

a. Try fluconazol 150mg one dose b. Do the equivalent of sitz baths daily with dissolved sodium perborate (Ie. Hydrogen Peroxide) c. Try to keep skin retracted.

He said he does NOT like creams to treats balanitis (think they're more harm than good). He also said that skin retraction is key and that if not the way to end this is circumcision.

I've done this course twice. The Hydrogen Peroxide bath seems to be a game changer (second time I did it much more thoroughly and also for roughly 20 days). No issues, feeling better than ever. But once I halt the baths, roughly one week later the problem restarts. At this stage (I think) it is milder than before, but I'm psychologically very tired of it.

Will see uro #3 again to understand what are my options. Not keen on circumcision but won't discard it.

MY QUESTIONS TO THE FORUM:

1) Any thoughts on hydrogen peroxide as an ongoing approach (Not very keen on it but not sure if it would be harmful to this as a 2-3 month bridge to circ).

2) Any other treatment? (read about fucidin)

3) Any retraction techniques? (My foreskin always goes back. Have tried taping but not practical).

[Kalessin2]

Some additional context:

-Not diabetic

-No visible immunity problems. Had a full panel (not just CBC) and results better than ever.

-Very low added sugar consumption (have cut back given this to max 12g per day, many days just 0g).

[Hidden in reply to Kalessin2]

Hey man sorry to hear about the issues you’ve been suffering from. Believe it or not I was going through the exact same thing. I got circumcised 34 days ago. I got it done as a last resort. I’m regretting getting it done due to the fact that I’m suffering more from the procedure more than the recurrent Balanitis and Phimosis I had. Sometimes putting all those creams on your foreskin can actually make the problem worse and not better. I’m no doctor, I’m just speaking from experience. Introducing different chemicals to your skin can irritate it even more.

Hang in there man, trust me this isn’t something that you’re only going through. There are a lot of men suffering from the same issue and believe it or not even worse than yours. At some point you get tired of putting all of that foreign stuff on your genitals and desperately seeking a solution that actually works. My advice would be to use a circumcision as a last resort. Just know that you’ll deal with a lot of issues from the procedure itself. Some doctors won’t tell you that.

If you decide you want to get the procedure be sure to do your research on it first, then research a Urologist who has plenty of experience in that area rather than just getting it done by the first doctor who says they can perform the procedure. It helps if you have health insurance that way you won’t have to pay alt of money out of pocket. I’m hear for support man, just know you’re not alone.

[Kalessin2 in reply to Hidden]

Thanks!

What’s the issue with circumcision - post wound pain? I had a frenulectomy many years ago and remember the recovery being painful. I’m assuming circumcision would be the same but worse.

[Hidden in reply to Kalessin2]

Yes circumcision will be worse. You’ll experience bleeding from the incision site, swelling, possible infection especially the area under the frenulum (blister or bubble like forms filled with fluids), your penis head and incision area will be extremely sensitive especially to the touch so you won’t be able to cleanse the area like you want. Not to mention the meds they put you on which will cause constipation. When urinating it’ll feel extremely weird so it’ll be best to urinate sitting down.

The first two weeks after surgery will be the roughest. If you’re being put to sleep under anesthesia you might experience side effects like nausea, vomiting, head ache, light headedness, amongst others. Once the anesthesia wears off, you start feeling discomfort a few hours after. Trust me it’s rough. You’ll also be given a local anesthesia where they will inject anesthesia at the base of your penis so that you don’t feel anything during the procedure.

Erections will be the worst. It’ll feel like your skin is tearing apart, although I was told that erections can help speed up the healing process. Your stitches will stick to your dressing and possibly pull out one of your stitches causing the wound to reopen mostly under he frenulum area. It’s just so man complications that could transpire.

[Hidden in reply to Kalessin2]

By the way, when I was prescribed Nystatin it burned once I applied it. Made my phimosis worse. I’d discontinue use of it.

[Velcro93]

1) As a whole I don't like any chemicals on my glans so even if my doc were to suggest it , I would use it only as a final last resort .

2) and 3) To be honest once you get Balanitis it keeps recurring . This happened to me too. I kept getting Balanoposthitis recurrently even though it seemed to subside for the first few times with medication . My presentation was different than yours , it inculded redness of the glans and pain and burning sensation which was associated with the foreskin. I finally met a urologist after several gps and several antibiotics regimens , he got me circed and I have been without infection ever since. This is just what happened for me .

After taking too many medications and ointments and stuff , I feel that in the end since they all didn't work and it keept recurring , the circ was the the final answer for me. Like you I was also psychologically tired and kept anticipating the symptoms to recur every time I took medications and even after the circ but I am 2months post circ now and I don't have any Balanitis symptoms.

Hope this helps !

[Hidden in reply to Velcro93]

I experienced redness and swelling as well? How was your circumcision journey, the good, the bad, and the ugly? Are you completely healed yet. Have you resumed any sexual activity?

[Velcro93 in reply to Hidden]

For me immediately after the circ , the healing time was uncomfortable with the hypersensitivity and still little inflamed glans . But with time around 1 month or so , the inflammation redness all stopped reappearing. Immediately after the circ the burning sensation and pain while urinating were relieved and since they were caused due to the foreskin I was really happy for getting the circ done. Over time with the circ the much dreaded hypersensitivity has also been rectified now and I am comfortable now . So this was all that were good .

The only one bad thing I felt is that there is a small decrease in size although dramatic at first . I lost a lot of length immediately after circ but thankfully regained it back over the 2nd month but maybe it's just my mind playing tricks but I feel I am a little shorter now even though the foreskin contributed only little to the length .

The best thing however is that my glans appears significantly larger and without my indications of BP and short frenulum , I am finally appreciating it in its full glory when erect . Haha..

Hope this helps !

[Hidden in reply to Velcro93]

Man that’s great. Do you have any tips to help me with my recovery. Anything suggestions will be greatly appreciated.

[Velcro93 in reply to Hidden]

For me , warm water baths helped with the swelling so definitely would advise you to bath twice a day minimum . After you have healed well you can apply bio oil on the incision line for it to become little lighter . Since you are 5 weeks past there is nothing more that will be of a nuisance to you much I guess. Also just make sure to keep the area hygienic and don't use any chemicals on the head . Use mild soap to not irritate the glans . Also if you are still healing wait till 6-8 weeks before resuming any sexual activities ! hope this helps !

[Hidden in reply to Velcro93]

Have you resumed sexual activity?

[Velcro93 in reply to Hidden]

I have although it is just me and myself for now !

[Hidden in reply to Velcro93]

Any issues?

[Velcro93 in reply to Hidden]

Nope nothing and I seem to last longer as well ! =)

[Hidden in reply to Velcro93]

That’s good to know.

[shaannsn]

I had a mild case of this and it sped up my otherwise cosmetic circumcision. I had about 3 or 4 bouts of fungal infection which I ended up giving to my partners. the first couple were difficult with the entire foreskin and glans swollen and peeling off in a white layer every day. however after applying beclomethasone, miconazole and neomycine based cream it used to go away. I can't put my mind to putting it twice a day for a month so I used to stop it after a week or two but it returned.

I got circumcised for 90% cosmetic and 10% the above reason.

the journey has been literally painless and smooth. everything going according to plan and virtually uneventful. I'm just waiting it out for the stitches to fall off.

if you had a perfectly loose foreskin which can go back and forth even at full erection I think circumcision will be a very straightforward procedure with super quick recovery time and no side effects.

[Kalessin2 in reply to shaannsn]

Great thanks. Likely will end in circumcision once COVID-19 tapers off in my neck of the woods and things are somewhat smoother.

Foreskin is 100% like you described. So hopefully it’ll make things easier.

[shaannsn]

getting it fully healed of infections for 2 weeks will help prior to the circumcision. and I think lockdown is a good time to do it since you will be restricted in moving around. ideally this is a good time to get a circumcision as your movements are limited.

[Mike84642]

Hey, I am wondering about this condition. I am circumcised and I have this, is this going to be a recurring thing for the rest of my life?

[Kalessin2 in reply to Mike84642]

Hi I just posted an update in a reply to another comment in case. you're interested. Best of luck.

[BalanitisHellHelp]

Did you ever resolve this? I'm in a similar boat... Mine went away for 2 months and is now back.

[Kalessin2 in reply to BalanitisHellHelp]

Hi!Knock on wood...but I've been pretty clear of balanitis for a few months now.

It did come and go once after posting but while uncomfortable, the physical symptoms were not as bad as the first time.

I'm not entirely sure this will not flare up again. But here are some thoughts on my journey:

- If I were to start over, I would avoid steroid creams like the plague. My feeling is that they disrupted way more than what they healed and broke the whole balance.

- Dissolved sodium perborate was a gamechanger. I discussed at length with my urologist and he was very clear that it IS NOT a sustainable solution -Ie. It will damage skin if used consistently. However, it did turn the tide of the 2 major flare ups I had. After that I used it occassionally 1-2 days a week max when I thought balanitis was creeping back.

- Oral fluconazole was likely helpful for the first major flare up. But I didn't use it again afterwards.

- At one point, to move away from sodium perborate, I used saline solution as a preventive measure. Basically did daily baths in saline solution for 10' while showering. For 3 weeks. After cutting this off, I've been clean for a few months.

- I also feel being able to pick up on physical activity as quarantine eased was really helpful, but impossible to tell for sure.

IN SUMMARY - MY VIEW:

- I would avoid applying any cream in the glans/foreskin whatsoever.

- I would consider using oral fluconazole and sodium perborate for strong flare ups.

- I would consider using saline solution baths as a preventive/therapeutic measure once the worse part has passed.

- I AM NOT A DOCTOR. If considering any of this, please discuss with your doctor.

- I have not entirely ruled out circumcision if this recurrs and I can't seem to shake it off.

Hang in there. Don't give up. Hopefully unless there's a structural cause, this will eventually recede if cracked. And if there is a structural cause (Ie. Diabetes?) that can be addressed as well.

[BalanitisHellHelp in reply to Kalessin2]

You're a hero man. So detailed and well outlined. Thanks! I don't have diabetes or anything. I just didn't bathe or really move from my bed after I lost some family members and fell into a hard-to-describe depression for a week or so. So for me it was a hygiene issue... but that was 6 months ago. Did you ever get a culture swab or test done of any sort to identify whether it was fungal or bacterial? And if one or the other, what strain or type?

[Chriscalde12 in reply to Kalessin2]

saline solution baths ? Can you explain more what that is and what you would use for these baths.

[majorleehi]

Hey all, I'm a little late to this thread but in having dealt with balanitis myself for a good decade, I've learned a few things and after reading some accounts here, I've learned a bit more!

While I think I got this in my 20's (around 1998) from unprotected sex, it was only around 2011 or so that it started flaring up into a bigger issue and became severe to the point where my penis head would get quite red and irritated. The skin around the rim of the head especially where I'd get open sores. Quite painful. Not fun. Fast forward to today, I have it under control but not eradicated though I've managed to go up to a few months without having to deal with it. Some treatments worked well, one works very well and most did nothing or made it worse. I had my doctor do a swab a while back but it didn't show anything out of the ordinary though I'm not sure what they actually tested for.

The number one cream that made all the difference in the world (for me) was one called Suragel which you can get from their website. Your mileage will vary with this one as for some men it made it WORSE and for others did nothing. For me, suragel brought it under control from when it used to get REALLY bad. I never had issues with smega so my hint was this was more of a fungal issue than bacterial. It's at the point now where I can even go a few days without using but this will lead to a flare up.

During the pandemic, this stuff (like so many other things) became hard to get due to supply shortages so my backup is Canestan cream. Yeah it's fun getting this in a pharmacy as people ALWAYS assume you are getting it for your woman so you ending getting some funny looks. This one worked ok to keep it under control but upon stopping usage, things would flare. Sure as hell better than nothing!

I tried Emuaid and it did nothing. In fact, it made it worse! Others have said the opposite so definitely one to try. Coconut oil was a no go. Makes my skin red anywhere I use it oddly enough. Olive oil could be one to try perhaps?

My doctor prescribed another type of cream who's name eludes me but was supposed to be an anti-fungal. Prescription only (in Canada). Came in a red bottle? IDK, it was slightly better than Canestan but 5x the cost.

I had read about UV-C treatments for various skin conditions many years ago so something I tried that worked VERY well was spending time at a salt water based beach. Years ago (pre-pandemic) I spent 2 weeks in Italy at the beach in August, we (my partner and I) found a nice secluded beach and I was able to take my bird out, pull back the foreskin and let the sun hit it directly for 1-2 minutes all around. Then I would swim in the salty water for extended periods of time with my foreskin always pulled back so it would get that salty goodness. Well, I kid you not, about a week after coming home, my little guy looked all but normal... and stayed that way for a good couple of months before it came back with a vengeance! Sadly where I live, we get plenty of sunny months but there is no salt water ocean within even 4 hours of here. However even just letting the sun hit it during the summer seems to help but not always. It's always a coin toss.

I am going to try using a light hydrogen peroxide soloution, I just thought about that today which led me to doing a google search and landing here!

Hope this info helps others. It's a crappy condition to deal with.