Balanitis Guidelines

Updated: Nov 28, 2018
  • Author: Mark J Leber, MD, MPH; Chief Editor: Erik D Schraga, MD  more...
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Guidelines Summary

European guidelines have been published regarding management of specific balanitides [5] :

  • Candidal balanitis: clotrimazole cream 1%; miconazole cream, 2%; apply twice daily until symptoms resolve.
  • Anaerobic infection: metronidazole 400-500 mg twice daily for 1 wk.
  • Aerobic infection: trimovate cream applied once daily; erythromycin 500 mg qds for 1 wk; co-amoxiclav 375 mg 3 times daily for 1 wk.
  • Lichen sclerosus: ultrapotent topical steroids such as clobetasol proprionate applied once daily until remission, then gradually reduced.
  • Lichen planus: moderate to ultrapotent topical steroids depending on severity.
  • Zoon balanitis: circumcision; topical steroids with or without antibacterials applied once or twice weekly.
  • Psoriasis: moderate-potency topical steroids with or without antibiotic and antifungal.
  • Eczema: hydrocortisone 1% applied once or twice daily until resolution of symptoms.
  • Seborrheic dermatitis: antifungal cream with a mild to moderate steroid.
  • Bowenoid papulosis: imiquimod 5% cream; laser resection.
  • Premalignant conditions: surgical excision.
  • Nonspecific balanoposthitis: circumcision is curative.