The Problem With Common Balanitis Treatments
4 reasons why they fail to cure balanitis
When you first consider the fact that 2 out of 3 balanitis patients fail to find permanent relief from their condition, you might assume that most of these people simply ignored their problem until it grew worse.
This isn't the case at all.
The truth is, most of these patients saw their condition grow worse despite actively treating it. That includes people who tried over-the-counter creams, prescription ointments, medicinal oils, home remedies, etc.
So why do most people fail to permanently clear their balanitis despite trying different treatments?
Here are the 4 main reasons why balanitis treatments often fail:
- Anti-inflammatory/Steroid creams (for ex. hydrocortisone) - While these creams may help in easing your balanitis symptoms, this relief comes at a cost. Anti-inflammatory creams can increase your chances of developing fungal and bacterial infections. If you have an existing infection, using these creams can worsen your condition.Even worse is that these creams were not really meant to be applied to your genitals in the first place and for good reason. Our glans tissue absorbs steroids into our bloodstream at a 300 times higher rate than the skin on our palms and repeated use can suppress your adrenal gland function.
Steroid creams also cause a thinning of the top layer of your glans, which already lacks a tough outer surface. The end result is that it leaves your glans more vulnerable to irritants, which can make your balanitis flare-up worse.
The biggest issue with steroid creams is that they do nothing to stop the underlying cause of your balanitis. Since inflammation is only an external symptom of the ongoing damage underneath, masking this symptom simply allows the damage to continue unchecked. As soon as the steroid cream use has stopped, the inflammation comes back aggressively and the true extent of the damage is finally revealed.
The solution: The key to solving this problem is to use anti-inflammatory compounds that are gentler on penile skin and prevent the absorption of damaging substances into the blood stream. Even more important is to boost your glans' resistance to harmful bacteria and fungi since they are commonly the cause of opportunistic infections during steroid cream use.
- Antifungal creams (for ex. clotrimazole) - Since many balanitis cases are caused by yeast infections, antifungal creams are often used to treat the problem. Over-the-counter creams that are formulated for athletes foot and jock itch are often prescribed off-label to treat balanitis.
The issue with applying these common anti-fungals directly to your genitals is that it damages your glans tissue. This is because yeast cells are very similar to human cells and anything that can kill fungus efficiently has the capacity to damage our cells as well. While this may not be a major concern for fungal infections affecting the tough skin on our feet, it can prove very damaging to our sensitive glans.
The solution: Use gentler antifungals that limit injury to your glans tissue. It is also essential to provide your glans with substances that constantly soothe any injury as it occurs and reinforce the 4 defense barriers of your penile tissue so that once your antifungal use has stopped, your penile tissue returns to a healthy state.
- Antibiotic ointments (for ex. bacitracin) - Besides fungal infections, bacterial infections are another common cause of balanitis. The use of over-the-counter antibacterial ointments is often recommended to help clear these infections.
The biggest issue with these ointments is that they only target a narrow range of harmful bacteria and their repeated use can disrupt your normal penile flora, wiping away healthy bacteria that are essential for maintaining normal glans physiology. This can make your glans even more vulnerable to future bouts of balanitis and can lead to more serious secondary bacterial infections.
The solution: When eliminating harmful pathogens from your glans, it is crucial to target broad varieties of harmful bacteria that could be causing your balanitis. However, even more important is to minimize the loss of healthy bacteria normally found on our glans since they are a very effective means of keeping harmful pathogens away long term.
The bigger problem with using any single one of these treatment options is that it employs a one dimensional approach to treating your balanitis. Remember, there are 3 types of triggers that cause balanitis (biological, chemical and physical) and in most cases multiple triggers are involved at the same time. To find complete relief, you have to neutralize all underlying triggers simultaneously or else the ignored trigger will pick up where a neutralized trigger leaves off.
- Antifungal creams do nothing to treat bacterial infections
- Antibacterial creams do nothing to curb fungal infections
- Anti-inflammatory creams simply mask the ongoing damage
- Neither of these creams eliminate chemical and physical triggers of balanitis.
Unless your treatment takes aim at every possible trigger, you will be leaving the door open for the inflammation to find its way back.
There is a reason why contact dermatitis is a common cause of balanitis. Our glans is extremely sensitive to a wide variety of things that our normal (non-penile) skin can handle just fine.
Indeed, one of the biggest drawbacks of using creams formulated for normal skin is that they often include substances that themselves lead to glans inflammation. These substances are usually found among the inactive ingredients in creams and include irritants such as perfumes, dyes, harsh preservatives etc. These irritants act as chemical triggers for balanitis by initiating an allergic response on your glans. So while the active ingredient may be providing a certain benefit, other accompanying ingredients may be feeding into the cycle of balanitis damage. In essence, a cream that may seem to have calmed your balanitis flare-up could very well have set the stage for your next relapse.
The solution: Always make sure that any product you apply to your glans is specifically intended to be used on penile tissue (especially mucocutaneous tissue). This ensures that the formulators considered the specific physiology of your glans to ensure the product's efficacy and more importantly, your safety.
Our glans has 4 specific defensive barriers that play a crucial role in protecting our penile tissue from harmful substances. These barriers begin to fall apart during balanitis, creating a vicious cycle where your glans keeps getting more vulnerable and the trigger keeps causing greater damage.
Most common balanitis treatments focus on either easing the inflammation or neutralizing the triggers (fungus or bacteria). However, this only addresses half the problem. The other half of the battle lies in reestablishing these weakened defense barriers. That's because once your penile defenses begin to fail, your body has a very hard time reestablishing them. This means even if your flare-up subsides, your penile tissue remains unprotected and your balanitis is likely to relapse.
Remember, balanitis tends to seek out the weakest point in your penile defenses and then exploits it to cause inflammation. A weakness in any single one of your 4 defensive barriers is enough to cause a domino effect that depletes all other barriers. Unless your balanitis treatment addresses this issue, the relief it will provide will be temporary at best.
The solution: To find complete and long lasting relief from balanitis, you have to not just neutralize your balanitis triggers but alsorestore all 4 defensive barriers of your glans. This means making sure the moisture level on your glans is optimal, the pH on your glans surface is within a normal range, healthy bacteria are able to flourish on the glans surface and there is enough lysozyme present to guard your penile tissue. This approach will not just resolve your existing flare-up but also allow your glans to guard itself from any future relapses.
One of the biggest issues with common balanitis treatments is that they don't address the long term implications of inflammation on your penile tissue. Remember, balanitis damage is cumulative - it adds up with each episode and not all the damage is visible. A narrowing of the urethra or a low level infection can go unnoticed for years and continue to cause tissue damage that can go beyond the glans and affect your bladder, kidneys and prostate.
However the biggest risk of balanitis comes from the free radicals and tissue scarring that result from balanitis flare-ups. Both these factors
increase your lifetime risk of developing penile cancer. Since studies have shown that 80% of penile cancer patients have had a history of balanitis, it seems crucial that your treatment efforts should go beyond just short term goals and address your increased risk of developing more serious problems years into the future.
The solution: Besides addressing the inflammation and reinforcing the penile defense barriers, it is vital to start a regimen of penile care that consistently neutralizes the threat of carcinoma of the penis. This means making lifestyle changes that prevent exposing your penile tissue to harsh substances (such as soaps, body washes), cleansing the glans carefully, avoid smoking and introducing therapeutic substances to your penile tissue that are known to prevent cancer cell growth.
Overcoming balanitis isn't just about easing your current discomfort. It requires choosing a treatment option that addresses all these crucial issues and provides lasting relief.