eMedicine Specialties > Dermatology > Reactive & Inflammatory Dermatoses

Balanoposthitis: Treatment & Medication

Author: Vladimir O Osipov, MD, Assistant Professor, Department of Pathology, Section of Bone and Soft Tissue Pathology, Section of Gastrointestinal Pathology, Medical College of Wisconsin
Coauthor(s): Scott M Acker, MD, Associate Professor, Director of Dermatopathology, Departments of Dermatology and Pathology, University of Alabama at Birmingham; Peter Langenstroer, MD, Associate Professor, Department of Urology, Medical College of Wisconsin; Milton W Datta, MD, Assistant Professor, Departments of Pathology, Urology, and Hematology-Oncology, Emory University School of Medicine
Contributor Information and Disclosures

Updated: Mar 30, 2009

Treatment

Medical Care

  • Topical antibiotics (metronidazole cream) and antifungals (clotrimazole cream) or low-potency steroid creams for contact dermatitides often lead to clearing of the lesion.26,27
  • Proper hygiene with frequent washing and drying of the prepuce is an essential preventive measure.

Surgical Care

Circumcision may be advocated in recurrent and recalcitrant cases.

Medication

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

Antifungals

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. Inhibits yeast growth by altering cell membrane permeability, causing death of fungal cells. Reevaluate diagnosis if no clinical improvement after 4 wk. Use 1% cream.

Adult

After washing, gently massage into affected area and surrounding skin areas bid

Pediatric

Children: Not established
Adolescents: Apply as in adults

Pregnancy

B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals

Precautions

Not for treatment of systemic fungal infections; avoid contact with the eyes; if irritation or sensitivity develops, discontinue use and institute appropriate therapy

Antimicrobials

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)

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

Adult

After washing, apply and rub a thin film on entire affected area qd/bid

Pediatric

Not established

Pregnancy

B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals

Precautions

Avoid contact with eyes; discontinue or reduce dosing frequency with local irritation (lotion and cream forms less irritating)

More on Balanoposthitis

Overview: Balanoposthitis
Differential Diagnoses & Workup: Balanoposthitis
Treatment & Medication: Balanoposthitis
Follow-up: Balanoposthitis
Multimedia: Balanoposthitis
References
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References

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Further Reading

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Keywords

balanoposthitis, inflammation of the foreskin and glans, glans penis inflammation, foreskin inflammation

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Contributor Information and Disclosures

Author

Vladimir O Osipov, MD, Assistant Professor, Department of Pathology, Section of Bone and Soft Tissue Pathology, Section of Gastrointestinal Pathology, Medical College of Wisconsin
Vladimir O Osipov, MD is a member of the following medical societies: American Society for Clinical Pathology, College of American Pathologists, and United States and Canadian Academy of Pathology
Disclosure: Nothing to disclose.

Coauthor(s)

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, and Southern Medical Association
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.

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 and United States and Canadian Academy of Pathology
Disclosure: Nothing to disclose.

Medical Editor

Abdul-Ghani Kibbi, MD, Chairman and Professor, Department of Dermatology, American University of Beirut Medical Center, Lebanon
Disclosure: none None None

Pharmacy Editor

Michael J Wells, MD, Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center
Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Texas Medical Association
Disclosure: Nothing to disclose.

Managing Editor

Jeffrey Meffert, MD, Assistant Clinical Professor of Dermatology, University of Texas Health Science Center-San Antonio
Jeffrey Meffert, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Association of Military Dermatologists, and Texas Dermatological Society
Disclosure: Nothing to disclose.

CME Editor

Joel M Gelfand, MD, MSCE, Medical Director, Clinical Studies Unit, Assistant Professor, Department of Dermatology, Associate Scholar, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania
Joel M Gelfand, MD, MSCE is a member of the following medical societies: Society for Investigative Dermatology
Disclosure: AMGEN Consulting fee Consulting; AMGEN Grant/research funds None; Genentech Consulting fee Consulting; Centocor Consulting fee Consulting; Centocor Grant/research funds None; Covance Consulting fee Consulting; Shire  Consulting

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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