Q. I have noticed that my penile skin is peeling off, leaving behind small but painful cuts on the skin. Is this some sort of skin infection? What should I do?
A. You could be suffering from balanoposthitis (balallitis: inflammation of the glans penis; posthitis: inflammation of the foreskin; balanoposthitis: inflammation of the glans penis and foreskin). While any man can suffer from balanitis, the condition is most likely to occur in men who have a tight foreskin that is difficult to pull back or who have poor bodily hygiene. Diabetes can make balanitis more likely, especially if the blood sugar levels are poorly controlled, because this makes it more difficult for the body to resist infections. It results from an overgrowth of organisms which are normally present on the skin of the glans. The environment under the foreskin is warm and moist, and these conditions often favor the growth of the organisms that cause balanitis. These organisms are especially likely to multiply and cause inflammation if moisture is allowed to persist under the foreskin for a while. This may happen if you have not washed yourself thoroughly for a couple of days, or sometimes after sexual activity. One common organism associated with balanitis is a yeast known as Candida albicans.
Balanitis presents with irritation or pain in the penis and discharge from beneath the foreskin. There is visible inflammation. Recurrent balanitis may cause a phimosis (inability to retract the foreskin) with difficulty in passing urine. If you have an infection with skin bacteria use an antibiotic cream and make sure you clean the area thoroughly. Occasionally, antibiotic pills may be necessary, especially for balanitis caused by sexually transmitted infections. If your problem is caused by a yeast infection, you may be advised to use an antifungal cream. When the skin is inflamed but not infected, you should keep the area clean and dry and avoid any soaps or skin lotions that may aggravate the condition. Sometimes a cortisone cream can help the condition to heal faster. However, cortisone can worsen certain infections; so it is best to avoid this type of medication unless prescribed by a physician. Circumcision often prevents repeated infections, especially in uncircumcised men who have a tight, difficult-to-retract foreskin. Once effective treatment begins, you usually do not need to avoid sex, although sexual contact can chafe or inflame the affected area. Rarely does sexual contact pass an infection back and forth between partners. If this occurs, both partners may require treatment at the same time to prevent recurrence.
