Balanitis in Children – Causes, Signs, and Treatment

If your child has been complaining about irritation or pain in the genital area, the chances are he might have an infection known as “Balanitis.” Balanitis in children is a very common condition, particularly in boys who are not circumcised, and it can usually be treated effectively with proper care. This infection occurs when the foreskin or head of the penis becomes inflamed, often due to poor hygiene, irritants, or an overgrowth of bacteria or yeast. To learn more about this condition, read this article. Find out what is balanitis, its symptoms, and how it can be treated effectively to provide relief for your child.

What Is Balanitis?

Balanitis is the irritation and inflammation of the foreskin and is mostly seen in uncircumcised boys. The inflammation is relatively mild in most situations. Balanitis in children can be caused by a simple irritation or it can be a result of an infection.

Different Types of Balanitis

Balanitis in children is an inflammation of the head of the penis, which can occur due to infections or irritation. There are different types of balanitis, each with specific causes that may affect boys, particularly those who are uncircumcised.

1. Candida Balanitis

Candida balanitis in children is caused by a yeast infection, commonly due to an overgrowth of Candida. This type of balanitis can happen if a child is on antibiotics or if there’s excess moisture, leading to irritation and redness.

2. Bacterial Balanitis

Bacterial balanitis in children results from bacterial infections, often linked to poor hygiene or the buildup of smegma under the foreskin. This can lead to swelling, redness, and discomfort and is typically treated with antibiotics and improved hygiene practices.

Causes of Balanitis in a Child

Boys who have an intact foreskin are at a higher risk of this infection. However, most cases of balanitis are mild. Most children only get chemical balanitis, which turns the area red and is associated with the foreskin releasing. Only about 5% of boys under 5 years of age would be severely affected by it.

A few common causes of balanitis in children are:

• Irritation from shower gels, soaps, or other products.
• Poor hygiene. This leads to the build-up of smegma under the foreskin.
• Irritation caused by urine that did not dry after peeing.
• Skin conditions like eczema or psoriasis.
• Fungal or bacterial infections.
• Irritation due to children touching or pulling the foreskin too much.
• Tight or improperly fitting diapers causing friction.
• Allergic reactions to certain fabrics or laundry detergents.

Though balanitis is common in children with an intact foreskin, children who have been circumcised can also get the infection from the inflammation of the glans. When both the glans and the foreskin are affected, the condition is called the ‘balanoposthitis’.

Boys with diabetes are more likely to develop this condition. It can also occur in boys who have skin conditions like eczema. Balanitis can also be associated with ‘phimosis’, a condition that happens when the foreskin remains too tight to retract. It usually becomes retractable and separates from the glans between 2 and 6 years of age. Balanitis usually occurs before it has retracted or when the foreskin remains tight for a long time. Balanitis can affect any boy but is particularly common in children under 5 years of age.

Symptoms of Balanitis in Babies and Kids

Balanitis symptoms can be recognized easily, but they can also be very uncomfortable. Most boys would experience penile discomfort. The foreskin may also appear tight. Some of the most common symptoms of balanitis are:

• Redness
• Pain while urinating
• Whitish spots
• Soreness
• Swelling
• Itchiness
• Unpleasant smell
• A build-up of thick fluid
• Tight foreskin

You should definitely take your child to the doctor if you notice any of these symptoms or if your boy is experiencing discomfort or soreness. Your doctor would be able to find out the cause of these symptoms and provide treatment accordingly. If an infection is responsible for the symptoms above, then there is a risk of the infection spreading further into the urinary tract. You may also notice other symptoms like fever.

Diagnosis of Balanitis in Kids

Balanitis in kids is typically diagnosed through a physical examination and a review of symptoms. The doctor may also perform certain tests to identify the exact cause of the inflammation.

1. Physical Examination

The doctor will examine the affected area to check for redness, swelling, or discharge. They will also ask about any hygiene habits or irritants that may have triggered the condition.

2. Swab Test

A swab of the affected area may be taken to identify the type of infection, whether bacterial, fungal, or yeast, to ensure the correct treatment is provided.

3. Urine Test

In some cases, a urine test may be performed to check for signs of infection or underlying conditions such as diabetes, which can contribute to recurrent balanitis in children.

Complications of Balanitis in Kids

If left untreated, balanitis in kids can lead to various complications that may require more intensive treatment. Here are a few potential complications:

1. Phimosis

Phimosis is a condition where the foreskin becomes too tight to retract, which can occur if balanitis causes scarring. This can lead to further infections and difficulty with urination.

2. Recurrent Infections

Untreated balanitis can lead to repeated episodes of infection, which may cause long-term irritation, discomfort, and damage to the sensitive tissues of the genital area.

3. Scarring

Severe or chronic balanitis may cause scarring of the foreskin or the head of the penis, which could result in long-term issues, such as pain during urination or increased sensitivity.

4. Urinary Retention

In rare cases, swelling from balanitis can obstruct the urethra, making it difficult for the child to urinate. This condition, known as urinary retention, may require medical intervention.

Treatment Options for Balanitis in Children

Wondering how to treat balanitis in babies? Most cases of balanitis in infants and little boys would not require surgery and can be managed conservatively. It is very important to stay hygienic—keep the area very clean, and it is important to avoid retracting the foreskin frequently. The penis should always be kept dry and clean, and it should be washed with lukewarm water. Using soap and other such products is not suggested to avoid irritation on the delicate skin of the area. Before getting dressed, the penis should be dried properly and carefully. It should also be properly dried after peeing. The area underneath the foreskin could also be dried carefully if the foreskin has retracted, but if the foreskin has not retracted, it is best to avoid that area. You should also wash your child’s clothes with antiseptic to prevent further spread. If antiseptic is unavailable, soak the clothes for 10-15 minutes in salt water before washing thoroughly.

Parents must ensure that the area is cared for properly and teach their children to take care of their bodies properly as they grow older and continue good hygiene practices. Balanitis symptoms can be relieved by making sure that the penis is always kept clean. Good hygienic practices would also help reduce the chances of the infection coming back again in the future.

Occasionally, healthcare providers might suggest topical creams or antibiotics. Different balanitis pediatric treatment options would be suggested based on the cause of the irritation. For example, doctors may suggest antifungal creams to treat yeast infections while antibiotics would be used to get rid of the bacterial infection causing balanitis in baby boys. A steroid cream may be recommended as part of the treatment to soothe the symptoms.

If the doctor has prescribed medicines, then it is important to complete the course even when the symptoms begin reducing after a few days. Treatment for balanitis in 5-year-old boys and below are usually very effective and when paired with good personal hygiene, the symptoms can be relieved very quickly.

Balanitis would not be severe in most children and it can be cured with little treatment and personal hygiene. However, if the condition is very problematic, circumcision would be necessary. The surgery can reduce the chances of the condition coming back again in the future though it cannot entirely eliminate the risks of infection and inflammation. Practising good personal hygiene is important to avoid irritation or infection.

How to Prevent Balanitis in Children

The following procedures can be followed in order to prevent the infection:

• By maintaining hygiene: All the clothes must be washed thoroughly. It is best to use natural clothing materials like cotton that would not irritate the infected foreskin. Children who are sensitive to soaps can avoid its usage. The genital area must always be kept clean.
• By making your child wear clean undergarments: Make sure your child wears clean undergarments and use only dried garments instead of wet and moist ones.
• By completing antibiotic dose: If the doctor has prescribed antibiotics then it is important to complete the course to avoid recurrent attacks.
• By changing your baby’s diapers: If you have a baby, make it a point to change his diapers frequently if he has balanitis and even otherwise.
• By drying his skin after bathing: After the child is done bathing, make sure that all the parts of his body are dried thoroughly.
• By using emollients: Emollients are soaps and creams that can help retain moisture on the skin and these can be used if the child is sensitive to soaps.

When to See a Doctor

If you notice the symptoms of balanitis, including fever, various signs of infection such as redness, warmth, swelling, or foul-smelling fluid leaking from the child’s penis, or if your child has trouble urinating, then you must check with a doctor. The doctor can help find the reason for these symptoms and manage the condition accordingly. Although the infection is not very serious, it still needs treatment since it can be very uncomfortable for your son. If left untreated, it can lead to various other complications such as scarring. If the symptoms last longer than a few days or if the infection keeps recurring, visit the doctor again as your child may require additional treatment to prevent it.

FAQs

1. Can antibiotic use lead to balanitis in kids?

Yes, prolonged or frequent use of antibiotics can disrupt the natural balance of bacteria in a child’s body, potentially leading to fungal overgrowth, such as Candida, which may cause balanitis.

2. Can dehydration contribute to balanitis in children?

Although rare, dehydration may lead to more concentrated urine, which can irritate the foreskin and the head of the penis, increasing the risk of balanitis, especially if hygiene practices are not followed.

3. Is it possible for balanitis to cause bedwetting in children?

In some cases, the discomfort or pain caused by balanitis may lead to avoidance of urination, resulting in bedwetting as the child tries to delay going to the bathroom due to discomfort.

4. Can children develop balanitis from playing in sandboxes?

Yes, sand particles trapped under the foreskin or on the genital area can cause irritation and contribute to the development of balanitis, especially if proper hygiene isn’t maintained after playtime.

Balanitis is a common condition and if your son has this infection, there is nothing to worry about. Your child’s healthcare provider can guide you and provide the right treatment for the same. All you have to do is maintain proper hygiene and complete the course of the treatment.

References/Resources:

1. Balanitis; DermNet; https://dermnetnz.org/topics/balanitis

2. Balanitis; NHS; https://www.nhs.uk/conditions/balanitis/

3. Penis and foreskin care; The Royal Children’s Hospital Melbourne; https://www.rch.org.au/kidsinfo/fact_sheets/Penis_and_foreskin_care/

4. Balanitis; Sexual Health Sheffield; https://www.sexualhealthsheffield.nhs.uk/wp-content/uploads/2015/03/Balanitis.pdf

5. Balanitis & Balano-posthitis; The Australasian College of Dermatologists; https://www.dermcoll.edu.au/atoz/balanitis-balano-posthitis-2/

6. Balanitis; Cleveland Clinic; https://my.clevelandclinic.org/health/diseases/21186-balanitis

7. Balanitis; Harvard Health Publishing; https://www.health.harvard.edu/a_to_z/balanitis-a-to-z

Also Read:

Acne in Kids
Skin Tags in Children
Common Skin Conditions in Kids
Protein in Child’s Urine (Proteinuria)
Blood in Urine (Hematuria) in Children