Q: I got married two months back. My penis foreskin was swollen before marriage. I consulted a dermatologist, he gave me fortan 150. After that there has been some ribs on the skin and it was difficult to move easily. He also prescribed candida ointment. Upto last week there was no problem but now it has begun slightly. What should I do?

A:By your description you could be suffering from Balanitis. Balanitis is an inflammation of the glans (head) of the penis. It usually causes redness or a blotchy rash on the glans and inside the foreskin, sometimes with a discharge or odour. Balanitis may be itchy or uncomfortable but often feels normal. Balanitis results from excessive growth of organisms which are normally present on the skin of the glans. The condition usually occurs in men who have a foreskin (i.e. have not been circumcised). The environment under the foreskin is warm and moist, and these conditions favour growth of organisms that cause balanitis. This may be more likely to occur if you have not washed for a couple of days,or sometimes after sexual activity. A common organism associated with balanitis is a yeast called Candida albicans. Balanitis can result from overgrowth of Candida, but it is important to remember that Candida is normally present under the foreskin in small quantities. In normal amounts, it doesn't cause any problems and does not require treatment. The aim of treatment is to keep the area clean and dry, to make it difficult for organisms to grow under the foreskin. Once a day, ideally when you have a shower, slide your foreskin back towards your body until the glans is completely uncovered. After cleaning you can keep the glans exposed to the air for 10 minutes. When you urinate, slide the foreskin back so that urine does not wet the foreskin (use a toilet paper to dab the glans dry!) If you are prone to develop balanitis a few hours after sex, wash the penis as described shortly after having sex. Medication (cream or ointment) is rarely necessary, and is usually less effective than good hygiene.