Q: Over the past 3 days, I have noticed that the penile skin is peeling off. There are small cuts on the skin due to this, which are very painful. I suspect this to be some form of skin infection. What could this be?

A:You could be suffering from balanoposthitis. Balanitis - inflammation of the glans penis, Posthitis - inflammation of the foreskin & Balanoposthitis - inflammation of the glans penis and foreskin. While any man can develop balanitis, the condition is most likely to occur in men who have a tight foreskin that is difficult to pull back, or who have poor hygiene. Diabetes can make balanitis more likely, especially if the blood sugar is poorly controlled, because this makes it harder for the body to fight infections. 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. These organisms are especially likely to multiply and cause inflammation if moisture is allowed to persist under the foreskin for a while. This may occur if you have not washed for a couple of days, or sometimes after sexual activity (vaginal, oral or anal - with or without a condom). 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. Presentation is with irritation or pain in the penis and discharge from beneath the foreskin. Inflammation is visible. Recurrent balanitis may cause a phimosis (inability to retract the foreskin) with disturbance in passing urine. If you have an infection with skin bacteria - use an antibiotic cream and make sure you clean the area thoroughly. Occasionally antibiotic pills may be necessary especially for balanitis caused by sexually transmitted infections. If your problem is caused by a yeast infection, you will be advised to use an antifungal cream. When the skin is inflamed, but not infected, you will be advised to keep the area clean and dry and to avoid any soaps or skin lotions that may be aggravating the condition. Sometimes a cortisone cream can help to improve the problem more quickly. However, cortisone can make certain infections worse, so it is best to avoid this type of medication unless it is prescribed by a physician. Circumcision often prevents repeated infections, especially in uncircumcised men who have a tight, difficult-to-retract foreskin. Once effective treatment begins, you usually do not need to avoid sex, although sexual contact can chafe or inflame the affected area. Rarely, sexual contact can pass an infection back and forth between partners. If this occurs, both partners may require treatment at the same time to prevent further episodes.