Treatment of balanitis: effective drugs, ointments

Before starting treatment of balanitis, it is necessary to determine the location of the inflammation and determine the cause that caused the development of the pathological process. If we are talking about the non-infectious nature of the disease, everything must be done to relieve irritation and prevent infection of foci with microdamage and wounds. For this purpose, 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 is made of natural fabrics, does not contain rough seams and irritating chemical dyes, and the powders used for washing it are hypoallergenic.

High-quality diagnostics and treatment of infectious balanitis is impossible without the participation of a specialist doctor, because the selection of drugs to combat viruses, fungi and bacteria is considered a rather delicate matter and requires the appropriate skills and knowledge. The use of antibiotics that are ineffective in each specific case leads to the development of antibiotic resistance and turns 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 first washed with water and natural soap),
• 20-minute baths for the penis with saline or non-concentrated antiseptic solutions,
• application of antibacterial ointments and creams to the skin (if a bacterial infection is detected and it is sensitive to antibiotics), systemic antibiotic therapy (for acute, complicated and generalized forms of pathology),
• the use of antifungal agents (if the causative agent of the disease is a fungal infection),
• the use of ointments with analgesic and anti-inflammatory effects based on NSAIDs,
• hormonal therapy (local application of anti-inflammatory drugs from the corticosteroid category), [ 2 ], [ 3 ]
• immunotherapy (vitamins and immunostimulants are useful for any type of infection, since they can only multiply against the background of reduced immunity, but for viral pathologies this moment of treatment is most important, since only the body itself can cope with the virus). [ 4 ]

The treatment regimen for balanitis is selected by a doctor in each specific case. Effective antiseptics include Miramistin, Chlorhexidine, Chlorophyllipt, potassium permanganate (manganese) and hydrogen peroxide solutions, Furacilin, etc. Inflammation of the genital tissues is well relieved by non-steroidal anti-inflammatory drugs (NSAIDs): Ibuprofen, Diclofenac, etc., but in severe cases, in the absence of contraindications, doctors can also prescribe hormonal therapy (Betamethasone).

If there are erosions and ulcers on the penis, anti-inflammatory, wound-healing ointments with antibiotics are recommended (erythromycin, gentamicin, tetracycline, Levomekol, Triderm, Celestoderm, etc.). Such skin lesions indicate an infectious nature of the disease, and local treatment does not always give good results, especially if balanitis developed as a result of a systemic infection.

In severe cases, when there is no good effect from the use of external agents (in purulent-necrotic and gangrenous forms of balanitis, as well as enlarged lymph nodes, indicating generalization of the infection), treatment with systemic antibiotics is carried out. Antimicrobial drugs are prescribed in the form of tablets and injections. The choice of antibiotics depends on the type and strain of the causative agent of the disease. These can be penicillin drugs, effective in combating opportunistic microflora, cephalosporins (Ceftriaxone, Cefuroxime, Zinnat, etc.), macrolides (Azithromycin), fluoroquinolones (Ofloxacin), Metronidazole, etc. The dosage and duration of antibiotic treatment are individual in each specific case.

Treatment of purulent ulcers may involve procedures performed in a hospital surgical department. This involves sanitizing festering wounds and areas of tissue necrosis that poison the entire body.

Clotrimazole, Fluconazole, and Ketoconazole in the form of tablets and ointments are most often used as means to combat candidal infection in combination with anti-inflammatory and immunostimulating therapy to prevent relapses of the disease. [ 5 ], [ 6 ], [ 7 ]

Treatment of atrophic and obliterating balanitis is carried out in accordance with a certain stage of the disease. At the initial stage of the disease, preference is given to the use of hormonal local agents that reduce the severity of inflammation. However, such treatment does not always help, and if the foreskin is involved in the process or narrows, surgical circumcision is prescribed.

Surgical treatment is also indicated at later stages of xerotic balanitis. For example, if the urethral canal is narrowed, its external opening (meatus) is dissected, and if the entire penis is involved in the sclerotic process and fibrous tissue is actively forming, organ plastic surgery is performed. In some cases of severe progressive necrotic process, organ amputation is even necessary to save the patient's life. [ 8 ]

As for physiotherapy, it is used very often for balanitis, since it allows to relieve inflammation and disinfect the skin of the diseased organ without using unsafe chemicals. Among the effective procedures for this disease, we can highlight: medicinal electrophoresis, which ensures deeper penetration of local hormonal drugs, 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 carried out by the attending physician, who determines the number and nature of the procedures. [ 9 ]

Effective medicines

In urological practice, there is no such thing as "balanitis pills". The disease is treated with the same medications as many other infectious and inflammatory diseases. But with a mild course of the disease, the drugs are used primarily externally, and with severe complications, the therapy is supplemented by taking antifungal drugs and antibiotics orally.

It is clear that in systemic therapy of diseases it is impossible to talk about any universal schemes due to the diversity of pathogens causing inflammation of the glans penis. And since there is often not one, but several pathogens, preference is given to broad-spectrum antibiotics. [ 10 ]

One of these drugs is the 2nd generation cephalosporin antibiotic "Zinnat", the active ingredient of which is cefuroxime. The tablets are effective against many aerobic and anaerobic bacteria, so they are often used to treat infectious diseases of the genitourinary system, including gonorrhea.

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

Contraindications to the use of the drug are: hypersensitivity to its components, allergy to penicillins, serious gastrointestinal pathologies and gastrointestinal bleeding, ulcerative colitis. The drug is not prescribed for the treatment of infants under 3 months.

During treatment with Zinnat, side effects such as nausea, vomiting, bowel disorders, jaundice, headache, hearing loss, and allergic reactions may occur. Long-term treatment in large doses may provoke the proliferation of fungal infections. [ 11 ]

In most cases, there is no need for systemic antibiotic therapy, so preference is given to local remedies. When prescribing creams and ointments for balanitis, doctors rely on the form of the disease and its pathogen. [ 12 ]

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

It is recommended to apply the cream in a thin layer to the inflammation sites and adjacent healthy areas of the penis skin twice a day (in the morning and before bedtime). The duration of therapy depends on the degree of neglect of the infectious and inflammatory process.

This drug is not prescribed for hypersensitivity to its components, tuberculosis of the skin, skin symptoms of syphilis, ulcerative processes, psoriasis, varicose veins, viral nature of the disease. The 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. More severe side effects, including systemic reactions, are possible only with long-term treatment with high doses.

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

The cream is applied 1 to 3 times a day, applying a thin layer and gently rubbing it into the skin affected by the disease. Treatment should not last longer than 21 days.

For infected purulent wounds on the penis, the doctor may prescribe the popular wound-healing ointment "Levomekol", which contains the broad-spectrum antibiotic chloramphenicol. The drug fights pathogenic microorganisms in the wound, promotes the absorption of wound exudate, reduces inflammation, and heals damage.

For 4 days, the ointment is applied to the wounds as an application under the bandage, after which they switch to other drugs.

The ointment is not suitable for treating children under 3 years of age 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 case of candidal balanitis, local antifungal agents will be effective, for example, Clotrimazole cream, which should be applied in a thin layer to the skin 2-3 times a day and rubbed in a little for 1-2 weeks.

Contraindications to the use of the drug include individual sensitivity to the composition of the product, and side effects are limited to local and allergic reactions, which are usually mild.

An important point is that the diagnosis and treatment of infectious balanitis involves examination and therapy of both sexual partners. Otherwise, re-infection is possible.

Folk treatment of balanitis

Treatment of balanitis is usually carried out at home, although this is not a reason to diagnose yourself and prescribe treatment yourself. Prescription of drugs for the treatment of a specific 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 exclude the additional use of folk methods and homeopathic remedies. In the latter case, we are not talking about specific drugs, drugs are prescribed based on the nature and causative agent of the disease, constitutional and mental characteristics of the patient's body.

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

• use of medications as prescribed by the doctor,
• daily washing of the penis with water and natural soap (several times a day),
• cleaning the head of the penis and preputial sac from accumulated sebum and microbes by pushing back the foreskin,
• strengthening the immune system by taking adatpogens and vitamins, hardening, giving up bad habits that have a detrimental effect on the immune system,
• moderate physical activity,
• a balanced diet, and if necessary, a low-carbohydrate diet.
• taking homeopathic remedies (as prescribed by a homeopath) and using traditional methods to relieve inflammation.

Traditional medicine is quite good at helping to cope with the non-infectious form of balanitis, but in the presence of an infection it only helps to reduce the symptoms of inflammation and does not provide a long-term effect without antibiotics. There are not many traditional medicine recipes for treating balanitis and almost all of them involve the use of herbal raw materials.

For example, one popular recipe involves applying a compress of fresh cabbage leaves and beans with vinegar to the inflamed head of the penis. The compress is made at night and washed off the skin with warm water and soap in the morning. [ 13 ]

To increase the body's defenses, it is recommended to drink juices of vitamin berries: viburnum, blackberry, rose hips, barberry. In this case, you need to drink juice daily at least 50 ml per day. And rosehip decoction can be used as a traditional drink, drinking 1 or more liters per day. [ 14 ]

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

Herbal treatment is especially popular in the treatment of balanitis. For example, a piece of peeled aloe leaf can be applied to the inflamed area twice a day for a short time or an application of plant juice can be made by soaking a piece of bandage in it. [ 16 ], [ 17 ]

You can wash the inflamed penis with decoctions and infusions of sage, St. John's wort, succession, chamomile. Usually take 1 tbsp. of plant material per 1 glass of water. Pour boiling water over the raw material and leave to infuse or boil for 5 minutes. [ 18 ], [ 19 ], [ 20 ]

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

A decoction of oak bark (1 tablespoon of dry raw material per 0.5 l of water) is also well suited for washing the diseased organ. The composition should be boiled for 15-20 minutes, infused for about half an hour, cooled slightly and filtered. Apply warm.

But plantain can be used fresh for balanitis. Young clean leaves should be thoroughly crushed until juice appears and secured to the penis with a bandage. More than 3 such procedures should be carried out during the day, changing the leaves as they dry out. [ 21 ]

A decoction of dill roots also helps to relieve inflammation (boil for about 10 minutes and let it brew). It is recommended to make medicinal poultices from it, unless it is a purulent inflammation. [ 22 ]

The presence of ulcers and erosions is a characteristic sign of infectious balanitis, for the treatment of which natural antiseptics can be used. One of these plants is calendula. [ 23 ] Freshly picked or dried flowers of the plant should be infused in a sunny place for a week in olive oil, after which the remedy is filtered and used to lubricate wounds on the genitals.

But a decoction of St. John's wort (2 tablespoons of crushed raw material per 0.5 liters of water) is useful to use in the form of medicinal baths, dipping the penis into a warm solution for 15-20 minutes.

No matter what healing properties medicinal herbs have, they are not able to cope with a serious venereal infection. In addition, first it is necessary to identify the nature of this infection, which is facilitated by diagnostics in a medical institution, then the treatment of balanitis will be more effective. At the same time, folk recipes should be considered not as the main ones, but as auxiliary means for the treatment of the disease, increasing the effectiveness of traditional drugs.

Prevention and prognosis of balanitis

Balanitis in men is a disease that should not be considered a death sentence. But it should not be treated carelessly 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 the treatment of most types of balanitis is favorable. The most difficult forms of the disease to combat are those whose etiology remains unknown. Thus, treatment of obliterating xerotic balanitis is usually performed surgically in combination with anti-inflammatory hormonal therapy. Other treatment methods remain ineffective.

Treatment of gangrenous balanitis is complicated by the rapid progression of the symptoms of the disease, and the cause of the atrophic form cannot always be accurately determined, which also complicates the treatment of the disease. However, in most cases, male dignity can be preserved and potency restored, and doctors 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. It is also worth asking the doctor whether it is possible to have sex with balanitis. With a non-infectious form of the disease, this is not prohibited, 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. However, it is worth refraining from using questionable lubricants and spermicides that can increase inflammation.

But in case of infectious balanitis, and especially in case of sexually transmitted infections, both partners are at risk of treatment. Moreover, during this period they will have to abstain from sexual contact.

Prevention of balanitis, which includes:

• Regular hygiene procedures using water and soap. It is very important to pay attention to the high-quality cleaning of the head of the penis under the foreskin. You need to wash not only daily, but also after each sexual contact.
• Change your underwear daily after taking a shower or bath.
• Refusal of promiscuous sexual relations. It is worth giving preference to a regular sexual partner. If fidelity is difficult, you should always remember about condoms, which are considered reliable protection against STDs.
• You need to pay regular attention to your health, strengthening your immunity and maintaining a healthy lifestyle. In spring and winter, pharmacy vitamins and adaptogens (tinctures of ginseng, echinacea, eleutherococcus, rosea, etc.) help maintain immunity at a sufficient level.
• When paying attention to men's health, one should not forget about the treatment of concomitant general pathologies that complicate the course and treatment of balanitis.
• Moderate physical activity is also very important, preventing the development of congestion 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 joy, self-confidence and sexual potency to a man. But it is much more important to do everything to prevent the development of the disease, because any disease, especially a chronic one, is a blow to the body's defenses, and it is not a fact that another, even more serious pathology will not develop against its background.