Everything you need to know about posthitis

Posthitis is inflammation of the foreskin. The foreskin is a thin layer of skin that covers the head of the penis.

Inflammation of the foreskin may result from bacterial or fungal infections. Alternatively, poor hygiene, allergies, or skin conditions may also cause posthitis.

In most cases, posthitis is not a major source of concern. However, a person may require treatment to address the underlying cause.

This article defines posthitis, looks at how it differs from other forms of inflammation in the penile area, and discusses symptoms, causes, and how to treat it.

Definition

Posthitis is a condition where a person’s foreskin becomes inflamed.

Posthitis is when the foreskin becomes uncomfortable or painful due to inflammation. This may be due to infection, skin conditions, or poor hygiene.

The foreskin, or prepuce, is a layer of skin that covers the head of the penis. When a person is born, the foreskin does not retract; however, it begins to retract at around 2–6 years old.

Some parents may decide to circumcise their child. This is a medical procedure where a surgeon will remove the foreskin.

Although circumcision rates in the United States are dropping, circumcision remains relatively common with the national rate of new-born circumcision being approximately 58.3%.

While it is less common, some adults may decide to undergo this surgery. The circumcision procedure takes longer than it does for children and may involve physical or psychological complications. However, it may reduce the risk of certain conditions.

Similar conditions

Different conditions may affect the foreskin or surrounding penile areas. Some of these include:

Phimosis

Phimosis is a condition where a person’s foreskin is too tight. Due to this tightness, a person cannot pull the foreskin over the head of the penis. This can make urination difficult and may make sexual intercourse uncomfortable. While it can affect adult men, it most often occurs in babies and toddlers.

Paraphimosis

Paraphimosis is similar to phimosis, but the foreskin becomes stuck when a person pulls it back behind the head of the penis. The retracted foreskin and penis become swollen, meaning the foreskin cannot return to its original position.

While phimosis is not usually a serious condition, it is a medical emergency that requires treatment. This is because it can affect blood flow to the penis and cause permanent damage.

Balanitis

Balanitis refers to an inflammation of the glans penis, or head of the penis. When a person experiences balanitis, the foreskin may become tight due to the inflammation. However, balanitis does not directly affect the foreskin.

Balanoposthitis

Balanoposthitis is a combination of balanitis and posthitis. A person experiencing balanoposthitis will have inflammation both at the head of the penis and on the foreskin. It occurs in approximately 6% of uncircumcised males.

Causes

There are many possible causes of posthitis. Some of these may include:

• Bacterial: Posthitis may occur due to a bacterial infection. In some cases, this may be from fecal matter.
• Fungal: The area under the foreskin is warm and moist. If a person does not maintain proper hygiene, a fungal infection, such as candidiasis, may cause posthitis. As well as poor hygiene, a fungal infection may develop from using perfumed soaps.
• Sexually transmitted infection (STI): STI’s, such as gonorrhea, can infect the penis, leading to posthitis.
• Dermatological: Certain skin conditions such as psoriasis, eczema, and dermatitis may cause inflammation of the foreskin.
• Allergies: If a person has an allergic reaction to a hygiene product or latex condoms, this could cause the foreskin to swell.

Symptoms

If a person has balanoposthitis, the symptoms may extend to the head of the penis. Some of these symptoms include:

• swelling of the foreskin
• redness of the foreskin
• possible itching
• smelly discharge
• pain during urination or ejaculation
• tenderness

Diagnosis

Diagnosing posthitis usually involves a physical examination. A doctor can assess whether the person is experiencing posthitis, balanoposthitis, or another form of penis inflammation.

In some instances, a doctor may do a swab test to determine the cause of the inflammation. A swab test involves a doctor or urologist taking a long cotton swab and gently rubbing it around the foreskin.

If the doctor believes that an STI has caused posthitis, they may insert the swab into the penis opening and gently rub the area. Some people may need to take a urine test.

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Treatment

If a person believes they have posthitis, they may consider visiting a pharmacy in the first instance. The pharmacist may be able to suggest over-the-counter (OTC) treatment to help.

However, receiving the right treatment depends on the underlying cause of the posthitis. Possible treatments include:

• Antibiotics: If bacteria cause posthitis, a person may require antibiotics to treat the infection.
• Anti-fungal medication: If a person is experiencing posthitis due to a fungal infection, they will likely need anti-fungal medication to target the infection and reduce symptoms.
• Antihistamine: If the posthitis results from an allergic reaction, a person may need to take antihistamines.
• Steroid ointments: If the cause of posthitis is due to a skin condition, a person may require steroid ointments. These can help reduce inflammation and soothe the foreskin.

As well as these treatments, a person may need to avoid potential irritants. For example, they may need to avoid engaging in sexual intercourse as the friction may irritate the foreskin further.

While the person is experiencing posthitis symptoms, they may also consider bathing the penis twice a day using a weak saline solution. This may provide some relief from the pain.

When to see a doctor

A person may consider seeing a doctor in the following circumstances:

• the symptoms persist after a week of OTC treatment
• the symptoms worsen
• a person is also experiencing discharge or bleeding
• a person is regularly experiencing posthitis

In some cases where a person is regularly experiencing posthitis, the doctor may recommend circumcision.

Summary

Posthitis is a condition where a person’s foreskin becomes inflamed. There are many potential causes of posthitis, and treatment will depend on the underlying reason for the inflammation.

In the first instance, a person may consider using OTC medications from a pharmacist. However, if symptoms worsen, do not improve after a week, or the penis is bleeding or leaking discharge, a person will need to see a doctor.