Balanitis (Jock itch or Men fungal infection)
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AT A GLANCE

WHO SHOULD GET TESTED FOR BALANITIS?

Only a person with a penis can get Balanitis.

Balanitis screening or routine test

Screening for candidal Balanitis (men fungal infection or thrush) is not necessary

Males:

With symptoms of itchiness, red spots, whitish discharge, redness of the tip of the penis (glans penis), and fishy smell

BALANITIS TEST TYPES

Physical examination in the doctor’s office:
- Most Balanitis (thrush) diagnoses are established during a physical exam, just by examining the area since most of the symptoms are visible.
Swab
- Can be performed if there is discharge.
Biopsy
- Biopsy is performed for a chronic fungal infection.

BALANITIS TEST PREPARATION

Most of the time, no test preparation is necessary since diagnosis can be established by visual examination.
Stop using creams 24 hours prior to examination since swabbing of the penile skin surface might be necessary.

TREATMENT FOR BALANITIS

Treatment depends on the cause but mostly entails over-the-counter antifungal medication: clotrimazole and miconazole topical antifungal cream or fluconazole pills.

Frequently Asked Questions

How are different Balanitis tests performed?

Office examination

The office evaluation consists of looking at the penile skin, assessing the extent of the infection, and looking for the potential cause of Balanitis.

Male penile surface swab

Ideally, the test is performed by a healthcare provider. Self-swabbing is possible. A sample of discharge from the surface of the penis will be collected by a thin sterile cotton swab.

Remember: You should not use any creams 24 hours before being tested.
How long does it take to get Balanitis test results?

If the swab test is performed, which is not very common, then results are usually back in 4 business days.

What treatments are available?

If another sexually transmitted infection (STI) is promoting Balanitis by keeping the area wet, the treatment should be directed at the primary cause.

Causative factor	Treatment option
Yeast infection (Candidiasis)	Clotrimazole (1%) or Miconazole (2%) cream 2-3 times a day for 10 days
Herpes Simplex Virus	Acyclovir (400mg) oral tablets 3 times in a day during 7-10 days OR Acyclovir (200mg) oral tablets 5 times a day during 7-10 days
Chlamydia Trachomatis	A single-dose of Azithromycin (1g) oral tablets OR Doxycycline (100mg) oral tablets 2 times a day for a week
Human Papillomavirus (genital warts)	Podophyllotoxin (0.5%) application twice a day for 3 days OR Cryotherapy performed by a doctor OR Surgical removal of the lesions
Gardnerella Vaginalis	Metronidazole (500mg) oral tablets twice a day for a week OR Metronidazole gel (0.75%) application once a day for 5 days OR Clindamycin (2%) cream every night for a week
Treponema Pallidum	A single dose of an intramuscular injection of Benzathine Penicillin (2.4 MU)
Trichomonas Vaginalis	A single-dose of Metronidazole (2g) oral tablets OR Metronidazole (400mg) oral tablets 2 times a day for a week

If Balanitis resulted from a non-infectious factor (check the list below), maintenance of good hygiene of the genital area is recommended. Washing the affected area with saline solution (twice a day) is also suggested. Patients should not use any type of aromatized lotions and soaps. Those who have chronic illnesses (diabetes, heart and kidney disease, reactive arthritis) that might be the reason for the Balanitis development should discuss possible disease management options with their doctors.

How soon does the treatment work?

Balanitis has an excellent prognosis. It is most important to identify the causative factor and start the treatment as soon as possible. Usually, patients start to feel better within 3-5 days of treatment onset.
Should sexual partners of those who tested positive be tested and treated?

If the primary cause of Balanitis is another infection, the sexual partner(s) of the patient are recommended to get tested for the corresponding infection and undergo treatment. Otherwise, it is not recommended to treat or test the partners of people diagnosed with Balanitis.
Is it necessary to get tested after treatment?

After-treatment testing is recommended only for those individuals who continue to experience symptoms of Balanitis infection.
What is the recommended treatment for Balanitis recurrence?

The chance of Balanitis recurrence among uncircumcised men is roughly 0.7 %. None of the circumcised men developed a Balanitis recurrence within a 1.5 year follow-up period.

The primary cause of Balanitis needs to be determined and addressed. Circumcision can be one of the options for severe and recurrent Balanitis, Balanoposthitis (when the foreskin is involved in inflammation along with the glans of the penis), and/or phimosis (difficulties to pull back the penile foreskin). However, circumcision should not be performed during the active inflammation stage of the disease.
What are the symptoms of Balanitis?
The list of Balanitis symptoms and signs includes:
- Pain and/or tenderness of the head of the penis (glans penis)
- Penile discharge (white or yellowish), also known as smegma
- Itching and redness of the head of the penis
- Ulcers on the head of the penis (in case of reactive arthritis or Herpes Simplex Virus)
- An inflamed and/or swollen head of the penis
- Painful urination (if the urethra is involved in the process)
- Rash on the head of the penis (red or white)
How is it transmitted?
The health condition itself (Balanitis) may not be transmitted. The most common cause of Balanitis is the excessive growth of the Candida Albicans (a fungus that is a part of the genital microflora).
Other underlying reasons may include stress, suppressed immunity, diabetes,, antibiotic use, poor hygiene, or trauma.

However, sometimes Balanitis results from infections that are transmitted through genital, oral and anal sex. For instance:
Also, several non-infectious factors may increase the chance of Balanitis development. Some of them are:
- Poor hygiene among uncircumcised males
- Having tight foreskin
- Washing the genitals with aromatized soaps and shower gels
- Uncontrolled diabetes
- Obesity
- Reactive arthritis
- Allergy to condom latex and/or lubricants
- Corticosteroids
- Heart and kidney diseases
- Skin conditions such as psoriasis and lichen planus
Where can I get tested or treated for a Balanitis infection?

The test can be performed in OB/GYN clinics, primary care offices, dermatology clinics or our specialized STD clinic.
Where is the STDcenterNY clinic located?

Our walk-in clinic for STD testing and treatment is conveniently located on the east side of Midtown Manhattan near the Grand Central Terminal and the Main branch of the New York City public library.
Despite it being our only STD testing center, we offer health services to New Yorkers from all zip codes across all 5 NYC boroughs: Manhattan, Brooklyn, Queens, Bronx, and Staten Island.
Our certified STD center offers testing services for Balanitis and sexually transmitted diseases (including syphilis, chlamydia, gonorrhea, vaginal yeast infection, herpes, HIV (also rapid HIV testing), HPV (genital warts), mycoplasma, ureaplasma, trichomoniasis, hepatitis B, and hepatitis C), along with effective treatment and follow-up care.