If you’ve never heard the word balanitis, that’s alright – it’s not exactly dinner table conversation. But it’s worth understanding, especially if you’re a parent weighing the pros and cons of newborn circumcision.
What Is Balanitis?
Balanitis is the medical term for inflammation of the glans (the head of the penis), and symptoms often include redness, swelling, tenderness, itching, or even a foul-smelling discharge. In some cases, especially in recurring infections, the foreskin can become tight or stuck, making it difficult and painful to retract. Left untreated, balanitis can lead to complications like phimosis (non-retractable foreskin), painful urination, or, in rare cases, more serious infections like cellulitis. Not fun. While it can affect anyone with a foreskin, it’s especially common in:
- Young boys (typically under 5)
- Uncircumcised males
- Men with naturally tight foreskin
- Individuals with diabetes
- People with poor genital hygiene
Balanitis affects about 4% of boys, particularly in the preschool years, and around 1 in 30 uncircumcised men over a lifetime.¹ Risk factors shoot up when the foreskin becomes tight or non-retractable – phimosis can trap moisture and bacteria, creating a frustrating cycle of repeat infections. In some cases, inflammation and swelling can lead to adhesions, or even penile cellulitis, a deeper and more painful infection that requires antibiotics.¹
Why does it happen in the first place? A combination of factors. Moisture, sweat, skin cells, and a natural lubricant called smegma can build up under the foreskin. That creates the perfect breeding ground for yeast, bacteria, and general irritation. Antibiotic overuse, friction, certain soaps, and even underlying skin conditions like psoriasis can also contribute.
Some medical conditions can increase vulnerability to complications as well. Over time, repeated inflammation and infection can take a toll on sexual function, emotional health, and physical well-being. Chronic or recurring balanitis has also been linked to more serious outcomes, including a more than threefold increase in the risk of developing penile cancer.²
Balanoposthitis occurs when both the glans and the foreskin become inflamed, and only affects uncircumcised males, since it involves tissue that’s no longer present after circumcision. It has the same symptoms as balanitis, just with additional foreskin involvement: red, swollen, painful, and possibly pus-like discharge. Depending on the severity, balanoposthitis tends to trigger a vicious cycle that can lead to scarring, which tightens the foreskin further and increases the risk of future infections.
Can Circumcision Help With Prevention?
Yes, it can. Multiple studies and meta-analyses show that circumcision significantly reduces the risk of developing balanitis. In fact, circumcised males have a 68% lower prevalence of balanitis than uncircumcised males.² Some studies also point out that circumcision reduces bacterial and fungal colonization long-term, which means fewer flare-ups and less medical intervention overall.²
After taking swabs of circumcised and uncircumcised penises, some researchers found significant microbial differences – the same microbes that can lead to infection. In one study, bacterial growth was found in 72% of uncircumcised boys before circumcision.² Another study found that fungus incidence was 44% in uncircumcised boys versus 18% in circumcised boys.² Other studies found similarly significant decreases in the presence of organisms like E. coli, Staphylococcus, and Klebsiella after circumcision.
Balanitis is often treated with topical antifungal or antibacterial creams, sometimes paired with steroids or oral medications, and always supported by good hygiene and regular cleaning around the foreskin. But in more severe or recurring cases, especially in adults, the condition might not respond to creams and medications alone. This is particularly true when phimosis is present, making it difficult to clean or apply treatment properly. In these cases, circumcision is the “definitive treatment” to prevent future episodes.²
Considering Circumcision
Circumcision as a newborn is less complicated than as an adult – it’s that simple. Not to mention that circumcised males tend to have lower rates of inflammation, bacterial and fungal colonization, and recurrent infections, reducing the risk of developing balanitis, phimosis, and other foreskin-related issues.
The case for choosing circumcision earlier in life is compelling for potential health benefits, but also for how the body responds to the procedure itself. When done in infancy, the procedure is less invasive because there’s less tissue to remove. Newborns also have a natural advantage when it comes to healing. Because the area is still developing, they recover faster, experience less post-operative discomfort, and require minimal aftercare.
Infants also aren’t as active, making the healing process more straightforward. They’re not mobile in the same way a crawling toddler, a sports-playing teen, or a busy adult might be, which limits trauma to the area during healing.
From a medical standpoint, earlier circumcision offers a range of advantages, from easier recovery to lower risk of future complications, that make it worth considering during the newborn stage.
At The Newborn Circumcision Center, we respect every family’s right to make the choice that feels right for them. Whether you’re just beginning to explore circumcision or feel ready to move forward, we’re here and happy to answer your questions.
References:
- Wray, A. A., Velasquez, J., Leslie, S. W., & Khetarpal, S. (2024, August 31). Balanitis. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK537143/.
- Morris, B. J., & Krieger, J. N. (2017). Penile Inflammatory Skin Disorders and the Preventive Role of Circumcision. International journal of preventive medicine, 8, 32. https://doi.org/10.4103/ijpvm.IJPVM_377_16.