Q: I have suffered fungal infection for years - penile, originally diagnosed as thrush - but it has persisted for years. I am married and we both have it. It has now moved to other parts of the body - skin becoming dryer, itchy sometimes red, then goes after awhile. The penile area skin has been damaged after years, seems it is drying in areas. Have used variety of antifungals to no long lasting avail. Have been living in tropical environment for 10 years. Please advise.

A:You could be suffering from recurrent balanitis. Balanitis is an inflammation of the glans (head) of the penis. It usually causes redness or a blotchy rash on the glans, sometimes with a discharge. The condition may be itchy or uncomfortable but often feels completely normal. It results from an overgrowth of organisms which are normally present on the skin of the glans. The condition most commonly 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 often favour the growth of the organisms that cause balanitis. One common organism associated with balanitis is a yeast known as Candida albicans. Balanitis may occur because of excessive growth of Candida, due to moisture and warmth under the foreskin. MANAGEMENT:

1. The aim of treatment is to keep the glans and foreskin clean and dry to make it difficult for organisms to grow under the foreskin. Medication (e.g. cream or ointment) is rarely necessary, and is usually less effective than good hygiene measures.
2. Wash the end of your penis and foreskin thoroughly using warm water only. Use any good emollient like glycerine.
3. After washing, dry the end of the penis and foreskin thoroughly. If convenient, sit with the glans exposed to the air for 10 minutes.
4. When you urinate, slide the foreskin back so that urine does not wet the foreskin. After urination, dry the end of the penis and replace the foreskin.
5. Medication has a limited role in the long run as compared to the beneficial effects of keeping the area clean and dry.
6. If none of these works kindly go to a reputed dermatologist in your area. Also get your blood sugar checked.