Balanoposthitis (Child)

The tip or head of the penis is known as the glans penis. In uncircumcised people, the foreskin covers and protects the glans. Sometimes both the glans and foreskin can become inflamed or infected. This condition is called balanoposthitis.

Balanoposthitis may be caused by bacteria, fungus, or yeast. It may also be caused by chemicals or medicines. Cleaning the penis too much or too little can cause balanoposthitis. Babies can develop balanoposthitis when they have diaper rash.

Symptoms of balanoposthitis include pain, redness, and swelling. Fluid may leak from the glans and have a foul odor. The area may itch. In severe cases, it may be hard to urinate. Balanoposthitis caused by bacteria causes the skin to be bright red. Yeast can cause white spots, as well as fluid leaking.

The condition is treated first by cleaning the area. It may be soaked in warm water to reduce symptoms. Your child's doctor will prescribe medicine to treat an infection. This may be an antibiotic or antifungal medicine. Hydrocortisone cream may be used to reduce inflammation. Children who aren't able to urinate may need a urinary catheter. This is a thin, flexible tube put into the opening of the penis.

Symptoms often go away 3 to 5 days after treatment is started. If the problem keeps coming back, your child may need to have his foreskin removed. This is called circumcision. Your child's doctor will tell you more about this procedure if it's needed.

Follow these guidelines when caring for your child at home:

• Your child's doctor may prescribe medicines to treat the infection and swelling. Follow all instructions when giving these to your child. Give all of the medicine as prescribed, even if your child feels better or the symptoms go away.
• Wash your hands with soap and warm water before and after caring for your child's penis. This is to prevent the spread of infection. Teach your child to wash their hands before and after touching their penis.
• Have your child soak in a bathtub with clean, warm water and a teaspoon of salt. The water should be deep enough to cover the penis. This will help reduce inflammation. Repeat the soak 2 to 3 times a day, or as advised by your child's doctor.
• In babies and young children, clean the area daily or as needed. If there is foreskin, gently pull it back from the glans. The foreskin will pull back (retract) only slightly, so don't force it. Rinse the area with clean water. Use a cotton swab to gently clean any drainage. Don't use soap, bubble bath oils, or talc powder. They may cause irritation.
• Teach your child how to clean the area daily.
• If your child has a foreskin, gently retract it regularly when your child is young. Have older children gently retract their foreskin regularly, even after the infection is cleared. The foreskin will be fully retractable by age 10. If the foreskin gets trapped in a retracted position, get medical care right away.

Follow up with your child's doctor, or as advised.

If you have any questions or concerns about how to care for your child's penis, talk with the doctor.

Unless your child's doctor advises otherwise, call the doctor right away if:

• Your child has a fever (see Fever and children below).
• The foreskin becomes trapped in a retracted position.
• Your child has trouble urinating.
• You see signs of infection, such as warmth, redness, swelling, or foul-smelling fluid leaking from the penis.

Use a digital thermometer to check your child's temperature. Don't use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years, a rectal temperature is the most accurate.
• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The doctor may want to confirm with a rectal temperature.
• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.
• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The doctor may want to confirm with a rectal temperature.
• Mouth (oral). Don't use a thermometer in your child's mouth until they are at least 4 years old.

Use a rectal thermometer with care. Follow the product maker's directions for correct use. Insert it gently. Label it and make sure it's not used in the mouth. It may pass on germs from the stool. If you don't feel okay using a rectal thermometer, ask the doctor what type to use instead. When you talk with any doctor about your child's fever, tell them which type you used.

Below is when to contact the doctor if your child has a fever. Your child's doctor may give you different numbers. Follow their instructions.

When to contact a doctor about your child's fever

For a baby under 3 months old:

• First, ask your child's doctor how you should take the temperature.
• Rectal or forehead: 100.4°F (38°C) or higher
• Armpit: 99°F (37.2°C) or higher
• A fever of ___________as advised by the doctor

For a child age 3 months to 36 months (3 years):

• Rectal or forehead: 102°F (38.9°C) or higher
• Ear (only for use over age 6 months): 102°F (38.9°C) or higher
• A fever of ___________ as advised by the doctor

In these cases:

• Armpit temperature of 103°F (39.4°C) or higher in a child of any age
• Temperature of 104°F (40°C) or higher in a child of any age
• A fever of ___________ as advised by the doctor