Every man falls prey to an itchy penis at one time or another, inevitably finding themselves caught while scratching away when they thought they were in a private situation. Often that itchy penis is caused by some penis health condition, hopefully one that is fairly minor and basically benign. In that category is plasma cell balanitis, a penile issue often accompanied by some degree of itchiness.
Plasma cell balanitis
Also known as Zoon balanitis (after the man who described it in the medical literature in 1952), plasma cell balanitis is usually considered as distinct from “regular” balanitis. The latter is an inflammation of the penis, usually spread out over much of the glans (or head). Plasma cell balanitis differs in that it almost always presents in a much more localized form; rather than being spread out, it appears as a smaller, more concentrated area, looking like one plaque or rash. Sometimes the red plaque may also have smaller pin-sized dots of a different shade.
Plasma cell balanitis is much more common in men who are intact than in men who are circumcised. Although it can occur at any age, it is almost always found in middle-aged or older men. (A female variant, plasma cell vulvitis, can occur in women.)
Although it was first described in 1952, not a lot is known about this condition. The cause, for example, is not well-defined. The fact that it often occurs in intact men suggests some connection with the foreskin, and indeed one of the primary accepted causes has to do with irritation to the glans caused by smegma building up. (Urine sneaking under the foreskin and drying may also be partially to blame.) As the foreskin rubs back and forth across the glans, this creates an inflammatory irritation.
This would imply that the disorder occurs only in intact men who do not practice adequate penis hygiene. However, it has been noted in some intact men with superior hygiene, as well as in a much smaller number of circumcised men. In such cases, friction, heat or some form of external irritating factor may be to blame. Some doctors theorize that bacterial infection, or possibly even HPV, could be causes as well.
Although many men mistake plasma cell balanitis for an STI, it is in fact a benign condition that is not sexually transmitted. It may cause a red, itchy penis – and may in some cases be accompanied by some minor pain – but it is essentially harmless.
In some cases, initiating and maintaining proper penis hygiene may result in the disappearance of the balanitis. Topical steroids are often recommended, as are topical calcineurin inhibitors (TCIs). Photodynamic therapy (using drugs which are then exposed to special lights) has been used by some doctors. In many cases, circumcision may be recommended.
With treatment, most cases resolve within 4-8 weeks, although an individual may find that the period is longer or shorter.
Plasma cell balanitis is considered a rare dermatological issue, but its exact rate is unknown; many doctors believe it is significantly underreported and that there may be more cases than is generally thought.