Treatment of balanitis: effective drugs, ointments

Before embarking on the treatment of balanitis, it is necessary to determine the site of localization of inflammation and determine the cause of the development of the pathological process. If we are talking about the non-infectious nature of the disease, we must do everything to remove irritation and prevent infection of the lesions with microdamages and wounds. To this end, the penis is washed with antiseptics, soothing and wound healing (anti-inflammatory) ointments are used. They also pay attention to the fact that the underwear was made from natural fabrics, did not contain rough seams and irritating chemical dyes, and the powders used for its washing were hypoallergenic.

High-quality  diagnostics and treatment of infectious balanitis is impossible without the participation of a medical specialist, because the selection of drugs to combat viruses, fungi and bacteria is considered to be a rather delicate matter and requires appropriate skills and knowledge. The use of antibiotics ineffective in each particular case leads to the development of antibiotic resistance and converts the acute process into a chronic one, which only complicates further treatment.[1]

To combat infection and inflammation, the doctor prescribes the following types of drugs and procedures:

• treatment of the penis with antiseptic solutions after each act of urination or sexual contact (the organ is washed with water and natural soap),
• 20-minute bath for the penis with saline or non-concentrated antiseptic solutions,
• antibacterial ointments and creams applied to the skin (when a bacterial infection and its sensitivity to antibiotics are detected), systemic antibiotic therapy (for an acute, complicated and generalized form of pathology),
• use of antifungal agents (if the causative agent of the disease is a fungal infection),
• the use of ointments with anesthetic and anti-inflammatory effect based on NSAIDs,
• hormone therapy (topical corticosteroid anti-inflammatory drugs), [2], [3]
• immunotherapy (vitamins and immunostimulating agents are useful for any type of infection, because all of them can only multiply against a background of reduced immunity, but for viral pathologies, this moment of treatment is most important, because only the body can cope with the virus). [4]

The scheme of treatment balanitis is chosen by the doctor in each case. Effective antiseptics are "Miramistin", "Chlorhexidine", "Chlorophyllipt", solutions of potassium permanganate (potassium permanganate) and hydrogen peroxide, "Furacilin", etc. Inflammation of the tissues of the penis is well removed nonsteroidal anti-inflammatory drugs (NSAIDs): "Ibuprofen", "Diclofenac" and others, but in severe cases, in the absence of contraindications, doctors can prescribe hormonal therapy ("Betamethasone").

In the presence of erosion and ulcers on the penis, anti-inflammatory, wound-healing antibiotic ointments (erythromycin, gentamicin, tetracycline, Levomekol, Triderm, Celestoderm, etc.) are recommended. Such lesions on the skin speak of the infectious nature of the disease, and local treatment does not always give good results, especially if balanitis has developed as a result of a systemic infection.

In severe cases, in the absence of a good effect from the use of external agents (with purulent-necrotic and gangrenous forms of balanitis, as well as an increase in the lymph nodes, indicating a generalization of the infection), systemic antibiotics are treated. Antimicrobial drugs are prescribed in the form of tablets and injections. The choice of antibiotics depends on the type and strain of the pathogen. These can be penicillin preparations that are effective for controlling opportunistic microflora, cephalosporins (Ceftriaxone, Cefuroxime, Zinnat, etc.), macrolides (Azithromycin), fluoroquinolones (Ofloxacin), Metronidazole "Etc. The dosage and duration of treatment with antibiotics are individual in each case.

Treatment of purulent ulcers may involve procedures performed in the surgical department of a hospital. We are talking about the rehabilitation of purulent wounds and areas of tissue necrosis, which poison the entire body.

As a means to combat candida infection, clotrimazole, fluconazole, and ketoconazole are most often used in the form of tablets and ointments in combination with anti-inflammatory and immunostimulating therapy to prevent recurrence of the disease. [5], [6], [7]

The treatment of atrophic and obliterating balanitis is carried out in accordance with a specific stage of the disease. At the initial stage of the disease, preference is given to using hormonal local agents that reduce the severity of inflammation. True, this treatment does not always help, and when they engage in the process of the foreskin or its constriction, surgical cutting is prescribed.

Surgical treatment is also shown in the subsequent stages of xerotic balanitis. For example, when the urethral canal is narrowed, its external opening (Meatus) is dissected, and when the entire penis is involved in the sloloz process and the fibrous tissue is actively formed, the organ is plasty. In some cases of severe progressive necrotic process, even the amputation of an organ has to be resorted to to save the patient's life.[8]

As for physiotherapy treatment, it is used very often with balanitis, as it allows to remove inflammation and disinfect the skin of the diseased organ without the use of unsafe chemicals. Among the effective procedures for this disease are: medicinal electrophoresis, which provides a deeper penetration of local hormonal preparations, ozone and UHF therapy, the use of magnetic fields and darsonval currents, therapeutic baths, laser and heliotherapy. The selection and appointment of physiotherapy procedures is performed by the attending physician, who determines the number and nature of the procedures.[9]

Effective drugs

In urological practice, there is no such thing as a “balanitis pill”. The disease is treated with the same medicines as many other infectious and inflammatory diseases. But in case of mild disease, the drugs are used mainly externally, and in case of severe complications, the therapy is supplemented with the intake of antifungal drugs and antibiotics.

It is clear that during systemic treatment of diseases, it is not necessary to speak about any universal schemes due to the diversity of pathogens of inflammation of the head of the penis. And since often there is not one, but several pathogens, preference is given to broad-spectrum antibiotics.[10]

One of these drugs is the 2-generation cephalosporin antibiotic Zinnat, whose active ingredient is cefuroxime. Tablets are effective against many aerobic and anaerobic bacteria, and therefore are often used to treat infectious diseases of the urogenital system, including gonorrhea.

For the treatment of balanitis, the drug is usually prescribed at a dosage of 125 mg twice a day for a week.

Contraindications to the use of medications are: hypersensitivity to its constituents, penicillin allergy, serious gastrointestinal tract pathology and gastrointestinal bleeding, ulcerative colitis. The drug is not prescribed for the treatment of infants up to 3 months.

During treatment with Zinnat, such side effects as nausea, vomiting, abnormal stools, jaundice, headache, hearing loss, and allergic reactions may occur. Long-term treatment in large doses can cause the multiplication of fungal infections.[11]

In most cases, the need for systemic antibiotic therapy is not, therefore, preference is given to local funds. When prescribing creams and ointments for balanitis, doctors rely on the form of the disease and its pathogen.[12]

In case of unspecified and combined forms of balanitis, complex preparations are considered effective. For example, Triderm cream contains 3 important components: the antibiotic gentamicin, the antifungal component clotrimazole and the corticoid betamethasone; therefore, it effectively fights inflammation, destroying the bacterial and fungal microflora.

The cream is recommended to be applied with a thin layer on the foci of inflammation and the healthy areas of the penis skin adjacent to them twice a day (in the morning and before bedtime). The duration of therapy depends on the degree of neglect of the infectious-inflammatory process.

This drug is not prescribed for hypersensitivity to its components, skin tuberculosis, skin symptoms of syphilis, ulcerative processes, psoriasis, varicose veins, viral nature of the disease. Ointment is not applied under occlusive dressings.

Applying the cream to the skin may be accompanied by irritation of delicate tissues, burning and itching, which happens rarely. Heavier side effects, including systemic reactions, are possible only with long-term treatment with high doses.

Unlike the “Triderm” preparation, “Celestoderm” cream is a single-component hormonal preparation with the active substance betamethasone. It can be used to treat inflammations of any etiology, but in the case of infectious diseases, antibiotic or antifungal therapy is additionally carried out.

Apply the cream from 1 to 3 times a day, applying it with a thin layer and gently rubbing into the affected skin. Treatment should not be delayed for more than 21 days.

When infected purulent wounds on the penis, the doctor may prescribe the popular wound-healing ointment "Levomekol" containing a broad-spectrum antibiotic chloramphenicol. The drug fights pathogenic microorganisms in the wound, promotes the absorption of wound exudate, reducing the inflammatory process, healing damage.

Within 4 days, the ointment is applied to the wounds as applications under the bandage, and then transferred to other drugs.

The ointment is not suitable for the treatment of children under 3 years and patients with hypersensitivity to the components of the drug. It is not prescribed for psoriasis, eczema and fungal infections. A side effect of the drug is the possibility of developing allergic reactions.

In the case of candidal balanitis, local antifungal agents will be effective, for example, Clotrimazole cream, which should be applied 2-3 times a day every day with a thin layer on the skin and rubbed slightly for 1-2 weeks.

Contraindications to the use of the drug is considered an individual sensitivity to the composition of the product, and side effects are reduced to local and allergic reactions, which usually occur in mild form.

The important point is that the diagnosis and treatment of infectious balanitis imply the examination and therapy of both sexual partners. Otherwise, it is possible to re-infection.

Alternative treatment of balanitis

Treatment of balanitis is usually carried out at home, although this is not a reason to make a diagnosis and prescribe treatment yourself. The prescription of drugs for the treatment of a particular form of the disease should be carried out by a specialist doctor, and the patient’s task is to strictly adhere to these prescriptions. However, drug treatment does not preclude the additional use of alternative methods and means of homeopathy. In the latter case, we are not talking about certain drugs, drugs are prescribed based on the nature and pathogen of the disease, the constitutional and mental characteristics of the patient.

Home treatment is possible if the disease proceeds without serious complications and is not accompanied by a narrowing of the foreskin (phimosis) requiring surgical intervention. Home treatment includes:

• the use of drugs as prescribed by a doctor,
• daily washing of the penis with water and natural soap (several times a day),
• cleaning the glans penis and prepucial sac from accumulated spegma and microbes, by moving away the foreskin,
• strengthening immunity by taking adatpogenov and vitamins, hardening, rejection of bad habits that have a detrimental effect on the immune system,
• moderate physical activity
• a balanced diet, and if necessary, compliance with a low-carb diet.
• taking homeopathic remedies (as prescribed by a homeopath) and the use of alternative methods of relieving inflammation.

Alternative treatment rather well helps to cope with non-infectious form of balanitis, but in the presence of infection it only helps to reduce the symptoms of inflammation and without antibiotics does not give a lasting effect. There are not many recipes for alternative medicine for the treatment of balanitis, and almost all of them involve the use of herbal raw materials.

For example, one of the popular recipes is to apply a compress from a gruel of fresh cabbage leaves and beans with vinegar to a sore head of the penis. Compress do for the night, and in the morning, wash off the skin with warm water and soap.[13]

To increase the body's defenses, it is recommended to use the juice of vitamin berries: viburnum, blackberry, rosehip, barberry. At the same time you need to drink juice every day at least 50 ml per day. A decoction of wild rose can be used as a traditional drink, consuming 1 or more liters per day.[14]

Wounds on the penis to speed up their healing can be lubricated with sea buckthorn oil, combining its use with antibiotic therapy. [15]

Especially popular in the treatment of balanitis is herbal therapy. For example, you can briefly fit a piece of peeled aloe leaf to the inflamed area twice a day or make applications from the sap of the plant by soaking a piece of bandage.[16], [17]

You can wash the inflamed penis with broths and infusions of sage, St. John's wort, train, chamomile. Usually take 1 tbsp. Vegetable raw materials to 1 cup of water. Raw materials pour boiling water and insist or boil for 5 minutes.[18], [19], [20]

The same compositions can be used as anti-inflammatory compresses.

Well suited for washing the sick organ and a decoction of oak bark (1 tablespoon dry raw materials for 0.5 liters of water). The composition must be boiled for 15-20 minutes, insist about half an hour, cool slightly and strain. Apply warm.

But the plantain with balanitis can be used fresh. Young clean leaves should be well kneaded until the juice appears and secured to the penis with a bandage. During the day, you need to spend more than 3 such procedures, replacing the sheets as they dry.[21]

Helps to relieve inflammation and decoction of dill roots (boil for about 10 minutes and let it brew). It is recommended to make medicinal poultices from it, if we are not talking about purulent inflammation.[22]

The presence of ulcers and erosion is a characteristic sign of infectious balanitis, for the treatment of which natural antiseptics can be used. One such plant is Calendula. [23]Freshly harvested or dry flowers of the plant should be insisted in a sunny place for a week in olive oil, after which the agent is filtered and the wounds are smeared on the sexual organ.

But the decoction of Hypericum (2 tablespoons of crushed raw materials for 0.5 liters of water) is useful in the form of therapeutic trays, dropping the penis for 15-20 minutes in a warm composition.

No matter what healing properties the medicinal herbs possess, they cannot cope with a serious venereal infection. In addition, you first need to identify the nature of this infection, which contributes to the diagnosis in the medical institution, then the treatment of balanitis will be more effective. At the same time, alternative prescriptions should be considered not as basic, but as an aid to the therapy of the disease, increasing the effectiveness of the use of traditional medicines.

Prevention and prognosis of balanitis

Balanitis in men is a disease that should not be considered as a sentence. But you shouldn't be careless about it either. Today, effective treatment regimens have been developed for most forms of this disease, and there are many antimicrobial agents that can cope with its pathogens.

The prognosis for treating most varieties of balanitis is good. The hardest thing to deal with those forms of the disease, whose etiology remains unknown. Thus, the treatment of obliterating xerotic balanitis is usually performed surgically in combination with anti-inflammatory hormone therapy. Other treatments remain ineffective.

Treatment of gangrenous balanitis is hampered by the rapid progression of the symptoms of the disease, and the cause of the atrophic form is not always accurately determined, which also complicates the treatment of the disease. However, in most cases, manhood can preserve and restore potency, and physicians resort to surgical intervention and removal of the penis only in severe cases that threaten the patient’s life.

For a successful outcome of treatment, it is very important to seek help in time and follow all doctor's instructions, including the requirement to treat both sexual partners and the infectious form of the disease. The doctor should clarify and ask if you can have sex with balanitis? With a non-infectious form of the disease, this is not forbidden, because the patient does not pose a danger to his sexual partner. And if sexual intercourse does not cause serious discomfort, a man can enjoy it. True, it is worth refraining from using questionable lubricants and spermicides capable of increasing inflammation.

But with infectious balanitis, and especially in the case of sexually transmitted infections, both partners face treatment. Moreover, his period of sexual intercourse will have to refrain.

The prevention of balanitis, which includes:

• Regular hygiene using water and soap. It is very important to pay attention to the quality cleaning of the glans penis under the foreskin. You need to wash not only daily, but after each sexual contact.
• Daily change of underwear after taking a shower or bath.
• Rejection of promiscuous sex. It is necessary to give preference to a permanent sexual partner. If loyalty is difficult, you should always remember about condoms, which are considered reliable protection against STDs.
• You need to regularly pay attention to your health, strengthening the immune system and maintaining a healthy lifestyle. Pharmaceutical vitamins and adaptogens (tinctures of ginseng, echinacea, eleutherococcus, Rhodiola rosea, etc.) help to maintain immunity at a sufficient level in spring and winter.
• Paying attention to men's health, you should not forget about the treatment of associated common pathologies that complicate the course and treatment of balanitis.
• Very important and moderate physical activity that prevents the development of stagnation in the pelvic organs.
• The role of male circumcision in the prevention of STIs, including HIV / AIDS, has been proven. [24], [25], [26]

Professional diagnostics and treatment of balanitis by a qualified doctor is a guarantee that the disease can be stopped, returning the man joy, self-confidence and sexual power. But it is much more important to do everything to prevent the development of the disease, because any disease, especially chronic, is a blow to the body’s defenses, and it’s not a fact that another, more serious pathology will not develop against its background.