Dr Varinder Attri – Urologist, Andrologist and Laparoscopic surgeon

Balanitis is the redness and inflammation of the glans penis.

Zoon balanitis is clinical entity where there are well demarcated red coloured patches, without discharge, present over the glans penis near coronal sulcus and onto the inner prepucial skin of uncircumcised men. Tight foreskin/Phimosis – causes, symptoms and treatment

Symptoms

• Well defined red patches over the glans and inner prepucial skin in middle aged to elderly men
• Usually painless or associated with mild pain or discomfort
• Can be single or multiple; typically described as opposing or kissing lesions
• These lesions usually have tendency of recurrence

Causes

• This is non infectious condition typically present in men who are uncircumcised and believed to be due to reaction to trapped smegma, urine, dead skin cells, soap particles etc. Zoon balanitis is not associated with STD. Sometimes it is associated with lichen sclerosis of foreskin.

Diagnosis

• The diagnosis is made after ruling out other common causes; and by appearance and the pattern of the lesions.

• Investigations such as Tzanck smear, biopsy, STD panel etc are rarely required; may be advised in selected patients by doctor.

Treatment

• Since this condition is common in uncircumcised men, circumcision is the definitive way to get rid from these recurring lesions. Read about circumcision at Tight foreskin/Phimosis – causes, symptoms and treatment and ZSR Circumcision – what you need to know

• Topical creams and ointments like steroids,calcineuron inhibitors (tacrolimus, pimecrolimus), imiquimid 5%, mupirocin etc are sometimes prescribed for this condition and found beneficial in resolving the red patches; however they may recur later.
• Laser therapy using CO2 and Er:YAG leads to superficial ablation of lesions with minimal thermal damage and low risk of scarring and pain.

• Photodynamic therapy is recently proposed for refractory lesions.