Soreness and redness of the glans. Commonly thrush or soap irritation — and if it recurs, a reason to check for diabetes.
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Balanitis is inflammation of the head of the penis. Where the foreskin is involved as well — which is common — it is called balanoposthitis.
It is a genuinely frequent problem, and an under-discussed one. Most men who develop it assume it is a sexually transmitted infection and delay seeking help because of that. It usually is not. The two commonest causes by a distance are Candida and simple irritation from soap.
Two things do matter clinically. Recurrent balanitis is a well-recognised way undiagnosed diabetes first presents — sugar in the urine feeds yeast. And a small number of persistent cases are not infection at all but a skin condition needing dermatological treatment.
What points away from simple thrush: ulceration, a rash elsewhere on the body, a well-defined shiny white area, or bleeding — each of which changes the assessment.
Diabetes — the most important, and the one worth testing for. Also being uncircumcised, a tight foreskin, obesity, incontinence, and a weakened immune system.
Largely on appearance and history, and it assesses reasonably well by photograph — though this is understandably a consultation many men would rather have by video with a doctor than by uploading images, and either is fine.
The finding that should never simply be reassured is a persistent, non-healing lesion or ulcer on the glans. That needs examining in person and, where it does not settle, referral.
This is treatable remotely in most cases, and it is the kind of problem people put off precisely because of embarrassment — which a private video consultation removes fairly effectively.
Go to A&E immediately if the foreskin has been pulled back and will not return, and the glans is swelling. That is paraphimosis, it is a surgical emergency, and it worsens with time.
Seek same-day advice for inability to pass urine, severe pain with rapidly increasing swelling, spreading redness with fever, or any black or dusky discoloration of the skin.
Arrange a prompt appointment for an ulcer or sore that has not healed in three weeks, a persistent lump, bleeding, or white thickened shiny skin — the last of which suggests lichen sclerosus and should not be treated repeatedly as thrush.
The commonest self-inflicted cause is over-washing with soap. Soap, shower gel and bubble bath strip the natural oils from skin that is thin and sensitive, and the resulting irritation looks exactly like an infection.
Never force a tight foreskin back, and always return it to its normal position afterwards. A foreskin left retracted can swell and become trapped, which is paraphimosis and needs emergency treatment.
Your NHS GP treats balanitis free of charge, and a pharmacist can supply clotrimazole cream over the counter without any appointment. For a first, straightforward, clearly thrush-like episode, the pharmacy is a perfectly reasonable and cheap first step.
NHS sexual health clinics are free, walk-in in many areas, expert, and entirely confidential — and for anything with a possible STI element they are genuinely better resourced than a private GP. We will say so rather than take a fee.
What paying gets you is speed and privacy for a problem people delay over. A same-day consultation, tests arranged without a wait, and a proper assessment of whether this is thrush or something — like lichen sclerosus — that has been mistreated as thrush for years. That last distinction is where a private consultation adds real clinical value.
BASHH (British Association for Sexual Health and HIV) guidance on the management of balanoposthitis is the principal UK reference, covering the differential diagnosis, when to swab, and the indications for biopsy and referral.
NICE Clinical Knowledge Summary, Balanitis, covers assessment and first-line management, including the role of soap avoidance and topical antifungal treatment.
NICE NG28 and associated CKS guidance identify recurrent candidal infection as a presenting feature that warrants assessment for diabetes — the basis for the testing recommendation on this page.
British Association of Dermatologists guidance on lichen sclerosus covers its management and the rationale for long-term follow-up, given the small associated risk of penile malignancy.
Usually not. The two commonest causes are thrush and soap irritation, neither of which is sexually transmitted.
Some sexually transmitted infections can present this way, though — so if there is a relevant history, an ulcer, or a partner with symptoms, screening is sensible rather than alarmist.
Candidal balanitis can pass between partners, and where a partner has recurrent thrush, treating both is sometimes reasonable. Irritant balanitis is not transmissible at all.
Not from a single episode. From recurrent episodes, it is a genuine possibility worth excluding.
Raised blood sugar means sugar in the urine, which feeds yeast under the foreskin. Recurrent balanitis is a recognised first presentation of type 2 diabetes, and an HbA1c is a reasonable and quick check.
Almost certainly not with soap. Over-washing with soap and shower gel is itself one of the commonest causes. Retract gently, rinse with warm water only, and dry properly.
Candidal balanitis usually settles within a week of starting an antifungal. Irritant balanitis improves within days of stopping soap. If there is no improvement in two weeks, the diagnosis needs revisiting — lichen sclerosus in particular is often missed for years.
Very rarely, and not as a first response. It is considered for genuinely recurrent severe balanitis, for lichen sclerosus that has not responded, or for a tight foreskin causing repeated problems — and that is a urology decision, not one to make from an online consultation.
September 5, 2026
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It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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