What is the cure for candida infection causing balanitis?
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I am a 35 year old uncircumcised white male. I have often been prone to candida infection causing balanitis. Normally this is accompanied by the usual smells formation and bad smell. It normally clears with clotrimazole cream topically and fluconazole. My glans has been particularly itchy but with no smegma.this has been going on since December. I changed soap and went on a un perfumed one. No difference. I am now using a ph 3.5 soap designed for intimate hygiene, a little better but unresolved. I thought I had a candida reoccurrence and tried the cream for two weeks, plus a fluconazole tablet. Got seen twice by my doctor, who thought the cream would clear it, although he could see no sign of candida (neither could I). I did two more weeks of clotrimazole. As the redness around the glans and on the foreskin remained, together with the itchiness, I visited the local hospital's sex clinic. I got tested for everything from chlamydia, to gonorrhoea, to HIV, to syphilis, all negative and no sign of candida after a swab and a look under the microscope. The redness and itchiness remains. I'm now using a light liquid paraffin based soap which seems to help. However the itchiness returns, together with the redness. What should I do? Would hydrocortisone 1% be a good idea? What could it be?
Posted Tue, 4 Feb 2014 in Sexually Transmitted Diseases
Answered by Dr. Kakkar S. 8 hours later
Brief Answer: Irritant dermatitis with ?superimposed candida Detailed Answer: Hi. Thanks for posting your concern at XXXXXXX After going through your query i would first keep a possibility of irritant dermatitis of glans and adjacent prepuce to ?soaps ?Antiseptics. My second possibility would be of superimposed candida. Classical Candidal Balanitis presents with the following signs and symptoms: itching, redness, edema, white deposition/curdy white patches. Going through your query and after having a look at the picture, i could relate this type of presentation to few of my patients who practice over enthusiastic hygiene of the delicate skin of glans e.g repeated washing with soaps, using either dettol or savlon for cleansing etc thus leading on to an irritant dermatitis which confuses both the patient as well as the clinician, as to what is the real cause?? without realising that the overaggressive hygiene that they practice is itself the cause If i was your treating doctor i would have definitely asked you to apply a moderately potent topical steroid like beclomethasone, (hydrocortisone 1% is very mild) preferably in combination with an anti-fungal like clotrimazole, because while the steroid would take care of the dermatitis, the anti-fungal would take care of any superimposed candidal infection over the already irritated skin. General measures: -Avoid soaps to clean the delicate skin of foreskin and glans. Instead you can use just plain water for gentle cleansing. Specific treatment for balanitis: -If i was your treating doctor i would have advised you to apply a topical steroid+antifungal cream(Clotrimazole+beclomethasone) twice daily for 7 days. -An oral antihistamine like cetrizine once daily will help you with the itch. Hope i have answered your query take care regards
Follow-up: What is the cure for candida infection causing balanitis? 2 hours later
Hello Dr Kakkar! Thank you for your message. I think you are correct in assuming that there is dermatitis; I believe that the combination of the clotrimazole 2%, and the soap I have been using daily could have made things worse. I cannot easily get hold of Lotriderm in the UK without a prescription, and for that I will have to go and see my GP (unless you're aware of how I can obtain a private prescirption). In the meanwhile, would you say that I can start using the Canesten HC (Clotrimazole 1%, Hydrocortisone 1%), or is there no point to that? Finally, I have used an Aloe Vera cream yesterday to try and relieve the itchiness and it has worked. Would you advise against that? I will use your advice and stop using soap in the area altogether. Many thanks for your help once more.
Answered by Dr. Kakkar S. 5 minutes later
Brief Answer: Canesten-HC is fine. Detailed Answer: Hi. Canesten-HC would be ok. Aloe vera is a NO from my side. Use just plain lukewarm water for cleansing. take care regards