What is balanoposthitis?
Balanitis is inflammation of the head of the penis, and posthitis is inflammation of the foreskin. They often occur together and are called balanoposthitis. About 3–6% of uncircumcised boys have it at least once in childhood, most often at 2–5 years of age.
Causes
- irritation from soap, bubble bath, diapers or moisture (most common),
- bacteria (staphylococcus, streptococcus),
- fungus (Candida), especially in babies in diapers and after antibiotics,
- forcing the foreskin back or washing too much.
Symptoms
- redness and swelling of the foreskin and the head of the penis,
- pain, itching, burning when urinating,
- white or yellow pus coming from under the foreskin.
Home care
- Warm water baths: 2–3 times a day for 10–15 minutes, without soap.
- Do not force the foreskin back.
- If diapers are used, change them often and allow diaper-free time.
- Avoid bubble baths and scented soaps.
Mild cases clear up within 3–5 days.
Medical treatment
- for a bacterial infection, an antibiotic cream, sometimes antibiotics by mouth,
- for a fungal infection, an antifungal cream,
- for pain, an age-appropriate pain reliever.
If it keeps coming back
If the inflammation comes back several times a year, cream treatment of phimosis or circumcision is discussed. Recurrent balanoposthitis is one of the medical indications for circumcision in children.
When to seek urgent care
If any of the following is present, do not wait for a routine appointment: call the doctor or go to the nearest emergency department.
- Unable to urinate
- Redness spreading to the abdomen or scrotum, high fever
- The foreskin has been pulled back and will not return (paraphimosis)
Note for pediatricians and family doctors
Most cases of balanoposthitis are related to nonspecific irritation and resolve with sitz baths and hygiene. If there is purulent discharge, a swab may be taken; for streptococcal and staphylococcal infections, topical or systemic antibiotics are prescribed. If Candida is suspected, an antifungal cream. Recurrent episodes (3 or more per year) are an indication for circumcision. If there is coexisting phimosis, a steroid cream may be used as prescribed by the doctor.
What happens at the visit?
- The foreskin and the head of the penis are examined; a swab is taken when needed.
- Hygiene rules and the use of baths and creams are explained.
- In recurrent cases, treatment of phimosis or circumcision is discussed.
Frequently asked questions
My child cries when he urinates. What should we do?
Urinating in a warm water bath can reduce the burning. If the child cannot urinate at all, see a doctor immediately.
Related topics
Sources
- EAU Guidelines on Paediatric Urology, 2025: Phimosis.
This page is for education. Decisions about your child’s treatment are made together with the doctor after an examination.