Zoon Balanitis; at a glance
- Best Results1-10 weeks
- Treatment RecoveryNA
- Procedure TimeNA
- Skin SpecialistDr Sarath Bodapati at Cutis Dermatology
- Duration of ResultsVariable
- AnaestheticNA
- Back to WorkNA
- Cost$ Medical
About Zoon's Balanitis
Zoon’s balanitis is a relatively common condition affecting the glans or head of the penis in uncircumcised males. It presents as a reddish patch that can be mistaken for other skin conditions including skin cancer, STDs & other forms of skin inflammation. Dermatologists can diagnose & treat Zoon. My colleague, Dr Sarath at Cutis Dermatology Brisbane treats this condition.
FactsFacts On Zoon's Balanitis
- Zoon balanitis presents as a red to brown patch on the head of the penis
- It is more common in uncircumcised males
- Zoon’s may mimic other inflammatory & infective conditions, hence it is important to see a dermatologist for a definitive diagnosis
- The use of topical corticosteroids & good hygiene can improve most cases of Zoon’s
- Laser have a role in recalcitrant cases
- Circumcision maybe curative
What is Zoon’s balanitis & what does it look like?
Zoon balanitis is due to chronic inflammation of the head of the penis (glans penis) and foreskin. It usually affects middle-aged to elderly uncircumcised men.
This lesion is typically red & shiny. It occasionally is spotty in the middle. Despite looking red & angry, symptoms are rarely encountered.
How do dermatologists treat Zoon’s balanitis?
The mainstay of treatment is with pulsed topical corticosteroids. Dr Sarath will prescribe a treatment plan based upon the severity of your balanitis.
Other treatments that may be considered include-
- Tacrolimus
- Pimecrolimus
- Topical antibacterial or antifungals
- Erbium laser resurfacing*
Disclaimer: I do not perform laser resurfacing in the context of genital conditions. My colleague, Dr Sarath at Cutis Dermatology Brisbane will guide you as to the treatments.
How to clean the area of Zoon’s?
Cleaning is super important as it reduces the chances of skin infection with bacteria or yeasts.
A simple guide is-
- Soap substitutes such as QV wash or aqueous cream
- Retract the foreskin to clean twice a day, including after urination
- Thoroughly rinse shampoo off the area
- Application of miconazole & or Bactroban ointment to the area
- Avoidance of friction with the use of lubricants
What is the natural history of Zoon’s balanitis?
This condition is chronic & persistent, however with appropriate treatment, it can resolve & in many cases cured.
What symptoms does Zoon’s cause?
Given the marked appearance of Zoon’s, the symptoms are mild in most. Itch & mild stinging can be experienced, the latter occurs during intercourse or irritation due to urine. In most cases it is asymptomatic.
What causes balanitis to flare up?
The three main flare factors are –
- Infection, hence the requirement for hygiene & topical antifungals & antibacterials.
- Friction, you get the drift. Lube up.
Irritation; secondary do urine & topical expedients, hence you got to know what to put on, & what to avoid. See below for cleaning instructions.
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Can a diagnosis be made via an online virtual consultation?
A differential diagnosis can be made online, however in some cases a biopsy & swab is required. On this basis it is important to see a dermatologist in real time.
Disclaimer: I do not treat male genital conditions. My colleague at Cutis Dermatology will review your case. Please book an appointment with Dr Sarath.
What else can look like Zoon’s & is a biopsy required?
Zoon’s can be diagnosed clinically, however in some cases the diagnosis can be tricky & hence a biopsy is required. Under the microscope, Zoon lesions are packed with plasma cells, hence the name Plasma Cell Balanitis.
Dr Sarath will guide you through the process as he may need to exclude other conditions that look like Zoon’s. This includes-
- Lichen planus (ulcerative)
- Genital psoriasis
- Sebopsoriasis or seborrheic dermatitis
- Fixed drug eruptions
- Recurrent infections, HSV or herpes simplex – STD
- Behcet’s disease
- IEC or Bowen- Skin cancer
Can Zoon’s occur in both sexes & is it transmissible?
A similar condition can occur in women. This is known as plasma cell vulvitis. This condition is not sexually transmissible.
What about circumcision, will it cure balanitis?
Yup, you do have a good chance that circumcision will cure balanitis. Most patients would consider non-surgical options prior to circumcision. Take that for a tip- no pun intended.
Davin viewpoint: Zoon’s balanitis
Zoon’s is a common inflammatory dermatitis affecting uncircumcised males. Though alarming, symptoms are rarely encountered. Every dermatologist will know this condition, including the characteristic changes under the microscope, namely packed with plasma cells. The salient points of Zoon’s are as follows-
- A solid diagnosis has to be made, especially in elderly males to exclude other causes, in particular IEC/Bowen’s disease of the penis. In the younger age group, conditions such as ulcerative lichen planus, seb derm, sebopsoriasis & infections are common. Your dermatologist may take a shave or punch biopsy.
- Conservative treatment is actioned & is often successful. The most common treatment is with moderate to potent CS ointment or creams in a pulsed manner. Failing that, calcineurin inhibitors such as tacrolimus (Protopic) can be useful. Most dermatologists will ‘pulse’ CS with this ointment.
- Some cases just go, usually within a few months. Other cases require long term management, including the use of antifungals to treat secondary infection.
- Lasers are not the first solution. CO2 & erbium lasers can help resistant cases. Dr Sarath will discuss this with you. Resurfacing takes approximately 15 minutes. We use various ablative lasers from Scition, Candela, Lumenis, & Lutronic. It takes 7 to 9 days to heal from resurfacing.
Disclaimer: Though I know this condition well (as do all dermatologists), I do not treat male genital conditions. My colleague, Dr Sarath, is an awesome dermatologist who has an interest in treating genitall disorders.
Davin viewpoint: Zoon’s balanitis
Zoon’s is a common inflammatory dermatitis affecting uncircumcised males. Though alarming, symptoms are rarely encountered. Every dermatologist will know this condition, including the characteristic changes under the microscope, namely packed with plasma cells. The salient points of Zoon’s are as follows-
- A solid diagnosis has to be made, especially in elderly males to exclude other causes, in particular IEC/Bowen’s disease of the penis. In the younger age group, conditions such as ulcerative lichen planus, seb derm, sebopsoriasis & infections are common. Your dermatologist may take a shave or punch biopsy.
- Conservative treatment is actioned & is often successful. The most common treatment is with moderate to potent CS ointment or creams in a pulsed manner. Failing that, calcineurin inhibitors such as tacrolimus (Protopic) can be useful. Most dermatologists will ‘pulse’ CS with this ointment.
- Some cases just go, usually within a few months. Other cases require long term management, including the use of antifungals to treat secondary infection.
- Lasers are not the first solution. CO2 & erbium lasers can help resistant cases. Dr Sarath will discuss this with you. Resurfacing takes approximately 15 minutes. We use various ablative lasers from Scition, Candela, Lumenis, & Lutronic. It takes 7 to 9 days to heal from resurfacing.
Disclaimer: Though I know this condition well (as do all dermatologists), I do not treat male genital conditions. My colleague, Dr Sarath, is an awesome dermatologist who has an interest in treating genitall disorders.
