Using Hydrocortisone For Balanitis (Inflammation Of the Glans Penis)

In our latest question and answer, our pharmacist discusses the potential risks of using hydrocortisone to treat balanitis.

Question

I was prescribed Daktacort Hydrocortisone Cream for balanitis on my penis about a month ago. I used the cream a little at a time for about 8/9 days, but I fear I have done some damage to my penis. it is very red and painful under the foreskin after sex a few days ago. I haven't used the cream for 2 days now, and it is getting easier but is still painful when I clean with water. I am applying Vaseline only, nothing else. Is there an ointment I can get to help the healing or is it just a matter of time? Also, am I OK to apply Vaseline?

Asked by Alan On Aug 18, 2022

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Aug 18, 2022
Last updated Aug 18, 2022

Key points

  • Hydrocortisone 1% cream is a very commonly prescribed treatment for balanitis. It is often used in combination with topical antifungals, like miconazole or clotrimazole.
  • If a topical steroid like hydrocortisone is used to treat balanitis, it should generally be used only for short periods of time.
  • Long-term use of topical steroids for balanitis can sometimes increase sensitivity and pain.

Thanks for reaching out to us and sorry to hear you're having problems with your treatment.

Balanitis And First-Line Treatments

First and foremost, balanitis (inflammation of the penis head or 'glands penis') can have many causes, and the best treatment varies on what is causing the issue. For example, Balanitis can be caused by:

  • Bacterial infections
  • Fungal infections
  • Eczema
  • Lichen planus
  • Lichen sclerosus
  • Plasma cell (Zoon’s) balanitis

The first-line treatment for most people (outside of hygiene measures like washing), even without a definitive diagnosis, is a topical antifungal (clotrimazole 1% cream or miconazole 2% cream twice daily for 7 to 14 days), and sometimes hydrocortisone 1%, a topical steroid.

The product you were prescribed is (Daktacort Cream) a combination of miconazole and hydrocortisone. As stated, miconazole is a topical anti-fungal while hydrocortisone is a topical corticosteroid, which helps to reduce inflammation. So, it sounds like you were prescribed a very common treatment regimen for balanitis.

Now, while hydrocortisone is very commonly used for the treatment of balanitis, it can sometimes make your symptoms worse, especially if used long-term (generally more than 7 days in a row). This may be what you are experiencing, especially since not using the cream has helped clear things up a little bit.

Caution With Hydrocortisone

While hydrocortisone may temporarily relieve the pain and inflammation from balanitis, it is often not a good choice for long-term use for numerous reasons:

  • Topical steroids can locally affect your immune system and they are well known for causing opportunistic infections (e.g. fungal and bacterial). In other words, steroids can increase the time it takes to recover from an infection and may even be the cause of one.
  • Steroids generally should not be applied to thin skin, mucous membranes, or sensitive areas of the body. These areas absorb steroids at an exponentially higher rate than the skin on other parts of your body. This absorption can lead not only to further thinning of the skin (which can be extremely painful on areas such as the penis) but also to adrenal function suppression. In addition, thinned skin on the penis due to topical steroid use will make it extremely sensitive to any irritant or minor contact.

Due to the issues above, hydrocortisone, if appropriate for your condition, should only be used for very short periods of time. As mentioned in your inquiry, the discontinuation of the medication appears to have helped.

This isn't to say that hydrocortisone shouldn't be used ever. It very often helps for many dermatological conditions that contribute the balanitis. In fact, some causes of balanitis, such as Lichen planus, are treated with higher potency steroids.

Use of Vaseline

In regard to further treatment, Vaseline can certainly help with the irritation symptoms as it is a good skin protectant. Just make sure that you still continue to clean regularly as vaseline can sometimes capture debris and make certain areas more prone to infection.

Final Words

I would advise you to reach out to your doctor again as well if the symptoms don't continually get better. You could still have the underlying condition that caused the balanitis in the first place. It is possible that you need an antifungal or antibiotic medication to appropriately treat an infection. Both antifungals and antibiotics are available without added hydrocortisone.

References

  • Balanitis and balanoposthitis: a review., PubMed
  • 2013 European guideline for the management of balanoposthitis., PubMed
  • European guideline for the management of balanoposthitis., PubMed

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 11 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Feel free to send him an email at Hello@HelloPharmacist.com! You can also connect with Dr. Brian Staiger on LinkedIn.

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