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Balanoposthitis Medication

  • Author: Vladimir O Osipov, MD; Chief Editor: Dirk M Elston, MD  more...
Updated: Nov 20, 2015

Medication Summary

Topical medications are the treatment of choice in this condition. The primary goal is elimination of various pathogenic organisms and control of inflammation.



Class Summary

The mechanism of action usually involves inhibiting pathways (enzymes, substrates, transport) necessary for sterol/cell membrane synthesis or altering the permeability of the cell membrane (polyenes) of the fungal cell.

Clotrimazole (Lotrimin, Mycelex, Femizole-7, Gyne-Lotrimin)


Imidazoles have broad-spectrum antifungal action and are used to treat dermal infections caused by various species of pathogenic dermatophytes, yeasts, and Malassezia furfur. Clotrimazole inhibits yeast growth by altering cell membrane permeability, causing death of fungal cells. Reevaluate the diagnosis if no clinical improvement is seen after 4 weeks. Use 1% cream.



Class Summary

These agents tend to destroy microbes, to prevent their multiplication or growth, or to prevent their pathogenic action.

Metronidazole (1% Noritate cream, 0.75% MetroGel cream or lotion)


Metronidazole is an imidazole with the ability to inhibit fungi, protozoa, and anaerobic bacteria. Anti-inflammatory effects include modulation of leukocyte activity.

Contributor Information and Disclosures

Vladimir O Osipov, MD Pathologist In Charge, QML Townsville

Vladimir O Osipov, MD is a member of the following medical societies: American Society for Clinical Pathology, United States and Canadian Academy of Pathology, Royal College of Pathologists of Australasia, College of American Pathologists

Disclosure: Nothing to disclose.


Milton W Datta, MD Assistant Professor, Departments of Pathology, Urology, and Hematology-Oncology, Emory University School of Medicine

Milton W Datta, MD is a member of the following medical societies: College of American Pathologists, United States and Canadian Academy of Pathology

Disclosure: Nothing to disclose.

Peter Langenstroer, MD Associate Professor, Department of Urology, Medical College of Wisconsin

Peter Langenstroer, MD is a member of the following medical societies: American Urological Association

Disclosure: Nothing to disclose.

Scott M Acker, MD Associate Professor, Director of Dermatopathology, Departments of Dermatology and Pathology, University of Alabama at Birmingham

Scott M Acker, MD is a member of the following medical societies: Alpha Omega Alpha, American Medical Association, American Society for Clinical Pathology, Southern Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael J Wells, MD, FAAD Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Jeffrey Meffert, MD Associate Clinical Professor of Dermatology, University of Texas School of Medicine at San Antonio

Jeffrey Meffert, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Abdul-Ghani Kibbi, MD Professor and Chair, Department of Dermatology, American University of Beirut Medical Center, Lebanon

Disclosure: Nothing to disclose.

  1. Fornasa CV, Calabro A, Miglietta A, Tarantello M, Biasinutto C, Peserico A. Mild balanoposthitis. Genitourin Med. 1994 Oct. 70(5):345-6. [Medline].

  2. Chen J, Zhou YX, Jin XD, Chen SW. Expression of interleukin-2 in Candidal balanoposthitis and its clinical significance. Chin Med J (Engl). 2011 Sep. 124(17):2776-8. [Medline].

  3. Burdge DR, Bowie WR, Chow AW. Gardnerella vaginalis-associated balanoposthitis. Sex Transm Dis. 1986 Jul-Sep. 13(3):159-62. [Medline].

  4. Kinghorn GR, Jones BM, Chowdhury FH, Geary I. Balanoposthitis associated with Gardnerella vaginalis infection in men. Br J Vener Dis. 1982 Apr. 58(2):127-9. [Medline].

  5. Rovira-López R, García-Martínez P, Martín-Ezquerra G, Pujol RM, Aventín DL. Balanoposthitis and Penile Edema: Atypical Manifestations of Primary Syphilis. Sex Transm Dis. 2015 Sep. 42 (9):524-5. [Medline].

  6. Mayser P. Mycotic infections of the penis. Andrologia. 1999. 31 Suppl 1:13-6. [Medline].

  7. Wakatsuki A. [Clinical experience of streptococcal balanoposthitis in 47 healthy adult males]. Hinyokika Kiyo. 2005 Nov. 51(11):737-40. [Medline].

  8. Fuzi M, Csizik E, Gubacs G. [Balanoposthitis caused by Streptococcus pyogenes following sexual intercourse]. Orv Hetil. 1984 Jan 22. 125(4):217-9. [Medline].

  9. Minami M, Wakimoto Y, Matsumoto M, Matsui H, Kubota Y, Okada A, et al. Characterization of Streptococcus pyogenes isolated from balanoposthitis patients presumably transmitted by penile-oral sexual intercourse. Curr Microbiol. 2010 Aug. 61(2):101-5. [Medline].

  10. Petersen CS, Zachariae C. Acute balanoposthitis caused by infestation with Cordylobia anthropophaga. Acta Derm Venereol. 1999 Mar. 79(2):170. [Medline].

  11. Lincopan N, Neves P, Mamizuka EM, Levy CE. Balanoposthitis caused by Pseudomonas aeruginosa co-producing metallo-beta-lactamase and 16S rRNA methylase in children with hematological malignancies. Int J Infect Dis. 2010 Apr. 14(4):e344-7. [Medline].

  12. Birley HD, Luzzi GA, Walker MM, Ryait B, Taylor-Robinson D, Renton AM. The association of human papillomavirus infection with balanoposthitis: a description of five cases with proposals for treatment. Int J STD AIDS. 1994 Mar-Apr. 5(2):139-41. [Medline].

  13. Petersen CS, Larsen J, Albrectsen JM. [Human papillomavirus--(HPV)/balanoposthitis--a new disease?]. Ugeskr Laeger. 1991 Apr 1. 153(14):1000-1. [Medline].

  14. Wikstrom A, von Krogh G, Hedblad MA, Syrjanen S. Papillomavirus-associated balanoposthitis. Genitourin Med. 1994 Jun. 70(3):175-81. [Medline].

  15. Lyttle PH. Ulcerative colitis and balanoposthitis. Int J STD AIDS. 1994 Jan-Feb. 5(1):72-3. [Medline].

  16. Wijesurendra CS, Singh G, Manuel AR, Morris JA. Balanoposthitis--an unusual feature of Crohn's disease?. Int J STD AIDS. 1993 May-Jun. 4(3):184. [Medline].

  17. Yusuke H, Yoshinori H, Kenichi M, Akio H. Granulomatous balanoposthitis after intravesical Bacillus-Calmette-Guerin instillation therapy. Int J Urol. 2006 Oct. 13(10):1361-3. [Medline].

  18. Kayaba H, Tamura H, Kitajima S, Fujiwara Y, Kato T, Kato T. Analysis of shape and retractability of the prepuce in 603 Japanese boys. J Urol. 1996 Nov. 156(5):1813-5. [Medline].

  19. Hsieh TF, Chang CH, Chang SS. Foreskin development before adolescence in 2149 schoolboys. Int J Urol. 2006 Jul. 13(7):968-70. [Medline].

  20. Dockerty WG, Sonnex C. Candidal balano-posthitis: a study of diagnostic methods. Genitourin Med. 1995 Dec. 71(6):407-9. [Medline].

  21. Kato S, Ohnishi S, Saka T, Nakajima H, Tanda H. [Clinical statistics on outpatients during the 5 years period (from 1978 Nov. 1st to 1983 Dec. 31st) after the opening of the Urological Clinic of East Sapporo Sanjukai Hospital (II)]. Hinyokika Kiyo. 1984 Nov. 30(11):1677-84. [Medline].

  22. Duerden BI. Black-pigmented gram-negative anaerobes in genito-urinary tract and pelvic infections. FEMS Immunol Med Microbiol. 1993 Mar. 6(2-3):223-7. [Medline].

  23. Alsterholm M, Flytstrom I, Leifsdottir R, Faergemann J, Bergbrant IM. Frequency of bacteria, Candida and malassezia species in balanoposthitis. Acta Derm Venereol. 2008. 88(4):331-6. [Medline].

  24. Mallon E, Hawkins D, Dinneen M, et al. Circumcision and genital dermatoses. Arch Dermatol. 2000 Mar. 136(3):350-4. [Medline].

  25. Sonnex C, Croucher PE, Dockerty WG. Balanoposthitis associated with the presence of subpreputial "smegma stones". Genitourin Med. 1997 Dec. 73(6):567. [Medline].

  26. Linden-Castro E, Pelayo-Nieto M, Alias-Melgar A. Penile tuberculosis after intravesical bacille Calmette-Gue´rin immunotherapy. Urology. 2014 Aug. 84(2):e3. [Medline].

  27. Wollina U. Ablative erbium:YAG laser treatment of idiopathic chronic inflammatory non-cicatricial balanoposthitis (Zoon's disease)--a series of 20 patients with long-term outcome. J Cosmet Laser Ther. 2010 Jun. 12(3):120-3. [Medline].

  28. Arumainayagam JT, Sumathipala AH, Smallman LA, Shahmanesh M. Flat condylomata of the penis presenting as patchy balanoposthitis. Genitourin Med. 1990 Aug. 66(4):251-3. [Medline].

  29. Hejase MJ, Bihrle R, Castillo G, Coogan CL. Amebiasis of the penis. Urology. 1996 Jul. 48(1):151-4. [Medline].

  30. Val-Bernal JF, Azcarretazábal T, Garijo MF. Pilonidal sinus of the penis. A report of two cases, one of them associated with actinomycosis. J Cutan Pathol. 1999 Mar. 26(3):155-8. [Medline].

  31. Cree GE, Willis AT, Phillips KD, Brazier JS. Anaerobic balanoposthitis. Br Med J (Clin Res Ed). 1982 Mar 20. 284(6319):859-60. [Medline].

  32. Waugh MA, Evans EG, Nayyar KC, Fong R. Clotrimazole (Canesten) in the treatment of candidal balanitis in men. With incidental observations on diabetic candidal balanoposthitis. Br J Vener Dis. 1978 Jun. 54(3):184-6. [Medline].

  33. Pandya I, Shinojia M, Vadukul D, Marfatia YS. Approach to balanitis/balanoposthitis: Current guidelines. Indian J Sex Transm Dis. 2014 Jul-Dec. 35 (2):155-7. [Medline].

  34. [Guideline] Edwards S, Bunker C, Ziller F, van der Meijden WI. 2013 European guideline for the management of balanoposthitis. Int J STD AIDS. 2014 May 14. 25(9):615-626. [Medline].

  35. Steinbach F, Essbach U, Florschütz A, Gruss A, Allhoff EP. Ulcerative balanoposthitis as the initial manifestation of acute promyelocytic leukemia. J Urol. 1998 Oct. 160(4):1430-1. [Medline].

  36. Agrawal SK, Singal A, Pandhi D. Mondor's phlebitis of penis following recurrent candidal balanoposthitis. Int J Dermatol. 2005 Jan. 44(1):83-4. [Medline].

Dermis with lymphoplasmacytic infiltrates and dilated blood vessels.
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