What Happens During Balanitis?
The 3 stages of balanitis damage
Balanitis usually follows a predictable path from the time you have your first flare-up right through to your next relapse (and every flare-up after that). Uncovering this path will give you a clear picture of what is really happening during balanitis and help you decide on the best way to treat it.
There are 3 things that are involved in the progression of balanitis:
- 1. The Trigger that launches the first immune system attack
- 2. The Domino Effect that throws your glans defenses off balance
- 3. The Cycle of Damage that keeps the balanitis going long term
With each step, balanitis gains more ground by making your glans tissue more vulnerable to damage. The only way to permanently cure your balanitis is to understand what happens during each step and interrupt it effectively.
For balanitis to occur, there has to be an initial trigger that gets the inflammation going. Typically there are 3 main types of triggers for balanitis:
- Biological triggers - A biological trigger can be a virus, fungus or harmful bacteria that begins to quickly multiply on your glans and harm your penile tissue. Your glans can be exposed to these microbes either from another person, contaminated surfaces, because of low immunity or even from poor penile hygiene.
- Chemical triggers - Our glans tends to be especially sensitive to compounds found in many consumer products such as soaps, laundry detergents and creams. Many of these compounds contain harsh chemicals that can lead to an allergic response by our glans tissue and it takes very little contact (direct or indirect) to set off the balanitis chain of events.
- Physical triggers - This can be anything that physically irritates your glans surface to the point of causing inflammation. Physical triggers can include irritable clothing surfaces, a tight foreskin and aggressive sexual or masturbatory behaviors.
Regardless of what the initial trigger for your balanitis, the end result is always an immune system response which opens the door to the next step - the domino effect.
Once the trigger has activated an immune system attack on your glans, a domino effect is set in motion that begins to take away your penile tissue's defense mechanisms one-by-one.
What are these defense mechanisms that are affected by the immune system attack?
Even though our glans lacks a protective outer surface (like normal skin), our body makes up for this vulnerability by arming it with 4 defensive barriers:
- The moisture barrier - The top surface of our glans produces oils that form a thin protective layer over its sensitive surface. This barrier keeps the glans moist and prevents irritation from dryness or friction.
- The acid barrier - Our body maintains a low pH on our glans surface as an effective means of preventing harmful bacterial and viral growth. This layer is known as the acid mantle and besides forming a microbial barrier it also acts to neutralize the effects of common chemical triggers commonly found in consumer products (which tend to be alkaline).
- The flora barrier - Not all bacteria are harmful to our glans. In fact, many are essential for protecting our penile skin by preventing the growth of harmful pathogens. These helpful bacteria maintain healthy penile flora by constantly competing with harmful pathogens for nutrients, releasing chemicals against them and by stimulating our immune system.
- The lysozyme barrier - Lysozyme is an enzyme found in penile fluids that plays a vital role in the local immunity of our glans. Even before our immune system becomes aware of a threat to our glans tissue, lysozyme begins to breakdown the cell walls of harmful bacteria and neutralizes their threat. Its antiseptic effect is an effective first line defense against many foreign pathogens.
These 4 barriers work together to shield our glans from potential threats, however for these barriers to be beneficial, they need to be maintained within narrow ranges. For example, too much moisture on the glans surface can lead to harmful bacterial growth or too low of a pH can in itself harm our sensitive penile tissue.
When a trigger activates the domino effect, the inflammation it causes interferes with these defensive barriers and throws our entire penile physiology off-balance.
As part of the domino effect...
- The moisture barrier of the glans becomes depleted
- Your penile pH gets altered
- Healthy penile flora gets disrupted
- Lysozyme levels on the glans surface begin to fall
The loss of any single one of these defense barriers is enough to disrupt all the other remaining barriers - thus the domino effect.
For example, an increase in surface pH1 can lead to an increase in harmful bacteria2 which in-turn can lead to inflammatory changes that strip away the moisture barrier3 and eliminate surface fluids that contain lysozyme4.
It doesn't matter what tips the first domino (barrier), the resulting effect is the progressive failure of all our glans' defense mechanisms.
Bear in mind, once the domino effect is in progress, you no longer need the initial trigger to keep your balanitis going. This brings us to the next step in the balanitis chain of events...
It would have been bad enough if a trigger was able to damage your glans tissue by simply eliminating your penile defenses through the domino effect. The inflammation from such a process would have been enough to cause severe penile tissue damage by itself.
However, the progression of balanitis involves one final step that escalates its capacity for damage to a whole new level. What happens next is the true reason why balanitis is such a painful, chronic and difficult to treat condition.
As the domino effect begins to dismantle the defensive barriers of your glans, your penile tissue becomes more vulnerable to the trigger. As a result, it becomes easier for the same trigger to restart the process of inflammation and domino effect all over again, but this time with greater intensity.
This last fact is so simple that its significance is easy to miss, yet it is the single most important reason why balanitis is so damaging.
Yes, the end result of the domino effect is that the damage repeats itself over and over again, except each time your trigger becomes stronger and your glans tissue becomes weaker.
This shows the devious relationship between the trigger and the domino effect where one feeds into the other and your penile tissue spirals into an endless cycle of injury.
Simply put, during the cycle of damage...
- A trigger activates an immune system attack
- The attack causes glans inflammation
- The glans inflammation causes a domino effect
- The domino effect strips away the glans' defense barriers
- This leaves your glans more vulnerable to the trigger
- And the cycle repeats itself
Even worse is that with each turn of the cycle your balanitis grows worse.
- 1. The intensity of the damage increases with each cycle - As the 4 defensive barriers get progressively depleted, your glans tissue becomes progressively weaker. Each turn of the cycle brings a new wave of inflammation that has greater destructive capabilities simply because your glans' ability to defend itself is further decreased.
- 2. New triggers begin to enter the cycle - With every turn of the cycle, your glans becomes more vulnerable to irritants. Triggers that once posed no threat suddenly worsen your immune system's attack. Now instead of dealing with a single cause, you are left with multiple triggers simultaneously fueling your balanitis, further complicating your treatment efforts.
- 3. Your glans tissue never gets a chance to heal completely - The end result of an increasingly strengthening trigger and progressively weakening glans is that the cycle of damage repeats faster and faster each time. This means relapses happen closer together and your remissions are shorter, which means your healing time gets shorter as well.
As the cumulative tissue damage increases, the problem begins to slowly get out of hand. At first the problem remains focused on your glans tissue. Then the scope of the damage widens to affect your urinary and sexual functions. Eventually the problem extends beyond the penis and can involve other organs. At its worst, this continuous cycle of damage can cause lasting changes on a genetic level which can even turn cells cancerous.
Note how at each step, the damage is amplified and our glans tissue falls deeper into a vicious cycle. This shows why a wait-and-see approach is so dangerous when it comes to balanitis. The longer you wait, the more the condition spirals out of control and the more defenseless your glans tissue becomes to potential irritants.
The key to overcoming balanitis is to target these destructive forces at all three levels (the trigger, the domino effect, the cycle of damage) and return the glans to a point where it can defend itself on its own. This is where most balanitis treatments completely miss the mark.
Let's take a closer look at why common balanitis treatments aren't very effective at interrupting the progression of balanitis...