What is Zoon’s balanitis?
Zoon’s balanitis describes inflammation of the head of the penis (glans penis) and foreskin. It usually affects middle-aged to older men who have not been circumcised.
What causes Zoon’s balanitis?
It is thought that Zoon’s balanitis is a reaction to another underlying condition. Dead skin cells, droplets of urine, soap particles, and skin flora ordinarily present on the skin are trapped by the foreskin that is not functioning normally.
This condition leads to irritation and inflammation of the foreskin and the glans penis underneath it. Zoon’s balanitis is not caused by an infection and cannot be passed on to a sexual partner.
A similar condition has also been described in women affecting the vulva (Zoon’s vulvitis). Zoon’s balanitis may be present on its own, or more often, is a sign of an underlying skin condition such as lichen sclerosus or lichen planus. Lichen sclerosus can make the foreskin tight and more difficult to retract.
Is Zoon’s balanitis hereditary?
No, Zoon’s balanitis is not hereditary.
What are the symptoms of Zoon’s balanitis?
Zoon’s balanitis usually causes no symptoms and looks worse than it feels. It may cause itching and discomfort. How does Zoon’s balanitis look like? Glistening, moist, bright red or autumn brown patches are sharply demarcated (defined) from the surrounding normal-looking skin.
Some dark red or brownish stippling (numerous small dots or specks) may be seen. The distribution is often symmetrical, affecting the glans penis and adjacent foreskin, described as ‘kissing’ lesions.
How is Zoon’s balanitis diagnosed?
A doctor can make the diagnosis after carefully examining your skin. Sometimes a small skin sample may be taken from the skin of the penis and checked under the microscope to confirm the diagnosis and check for possible underlying conditions, as mentioned above. This procedure is called a skin biopsy and requires a local anesthetic injection and possibly stitches to close the wound. A small scar may result.
Can Zoon’s balanitis be cured?
Zoon’s balanitis may last for several years and can flare intermittently. Sometimes it can be improved with altered washing habits and the use of treatments described below. Zoon’s balanitis may be cured by circumcision, a surgical procedure to remove the foreskin.
How can Zoon’s balanitis be treated?
Steroid creams or ointments of mild to potent strength, with or without the addition of anti-bacterial or anti-yeast agents, may be prescribed by your doctor and can be used for short periods intermittently. Your doctor will discuss with you how to use these treatments. Surgical lasers such as the Erbium: YAG or carbon dioxide lasers have been reported to help some cases. The affected skin will require local anesthetic injections or creams.
Layer by layer of skin is lasered away until all the affected skin has gone. The area is then left to heal, which may take several weeks. Treatment availability in the NHS varies, depending on whether there is expertise in this area.
Self-care (What can I do?)
The skin of the glans penis needs to be washed regularly, after fully retracting the foreskin. Instead of using soap, washing with a soap substitute such as a bland moisturizing cream can help. It may help to retract your foreskin whenever possible, to allow any moisture to dry out naturally. This is particularly the case before and after urinating. Regularly applying a bland ointment (e.g., plain Vaseline) to the glans penis and foreskin may provide a protective barrier. It is good practice to keep an eye on your skin. Anything unusual, for example, deeper sores which do not heal, or areas of lumpiness, should be reported to your doctor.