What is balanoposthitis?
Balanitis is inflammation of the head of the penis, and posthitis is inflammation of the foreskin. They often occur together and are called balanoposthitis. About 3–6% of uncircumcised boys have it at least once in childhood, most often at 2–5 years of age.
Causes
- irritation from soap, bubble bath, diapers or moisture (most common),
- bacteria (staphylococcus, streptococcus),
- fungus (Candida), especially in babies in diapers and after antibiotics,
- forcing the foreskin back or washing too much.
Symptoms
- redness and swelling of the foreskin and the head of the penis,
- pain, itching, burning when urinating,
- white or yellow pus coming from under the foreskin.
Home care
- Warm water baths: 2–3 times a day for 10–15 minutes, without soap.
- Do not force the foreskin back.
- If diapers are used, change them often and allow diaper-free time.
- Avoid bubble baths and scented soaps.
Most cases clear up within 3–5 days once irritants are removed and this care is followed.
Medical treatment
- if redness spreads, swelling increases or there is a fever (bacterial cellulitis), the doctor prescribes antibiotics by mouth or IV after an examination,
- for a fungal (Candida) infection, an antifungal cream,
- an antibiotic cream is not the usual choice and is rarely needed,
- for pain, an age-appropriate pain reliever.
If it keeps coming back
If the inflammation keeps coming back despite proper care and treatment, cream treatment of phimosis or circumcision is discussed individually. The decision depends not on the number of episodes but on how severe they are, the child’s symptoms and the response to treatment.
When to seek urgent care
If any of the following is present, do not wait for a routine appointment: call the doctor or go to the nearest emergency department.
- Unable to urinate
- Redness spreading to the abdomen or scrotum, high fever
- The foreskin has been pulled back and will not return (paraphimosis)
Note for pediatricians and family doctors
Most cases of balanoposthitis are related to nonspecific irritation and resolve with sitz baths and hygiene. Topical antibiotic cream is not a routine choice. If there is purulent discharge, a swab may be taken; when there are signs of bacterial cellulitis, a systemic antibiotic is chosen based on clinical assessment. If Candida is suspected, an antifungal cream. In recurrent balanoposthitis despite proper care and treatment, circumcision is discussed individually. If there is coexisting phimosis, a topical corticosteroid prescribed by the doctor may be used.
What happens at the visit?
- The foreskin and the head of the penis are examined; a swab is taken when needed.
- Hygiene rules, soaks and, when needed, the use of medicines are explained.
- If episodes keep coming back despite proper care, treatment of phimosis or circumcision is discussed individually.
Frequently asked questions
My child cries when he urinates. What should we do?
Urinating in a warm water bath can reduce the burning. If the child cannot urinate at all, see a doctor immediately.
Related topics
Sources
References to the EAU Paediatric Urology guidelines were checked against the 2026 edition (October 2026).
This information is for educational purposes and does not replace medical advice. Decisions about your child’s treatment are made with the doctor after an examination.
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