Fact. One of the most common STDs in the male universe is not, in fact an STD. Is neither ST (sexually transmitted) or D (a disease).
It is, however, malodorous, unpleasantly green- or yellowish, potentially painful and, if I was ever to come across it in a partner, I would certainly be dispatching them for immediate medical treatment. And, probably, deleting his phone number as well.
Or I would have, before I discovered balanitis - a usually harmless, but again very distressing condition that Britain’s National Health Service declares is the reason why one in ten males visits a sexual health clinic.
To learn more about balanitis, we must first learn about smegma. Yes, yuk. And double yuk. Except for one thing. It’s important.
Smegma is that white, and sometimes cheesy-smelling ... there’s no other word for it... goo that collects around the glans of the penis. It is especially noticeable in uncircumcized males, and especially fragrant on warm days. It is also the similarly white and sometimes cheesy smelling goo that gathers between the labia, and around the clitoral hood, and is often regarded as a sign that somebody is perhaps not washing as frequently, or as thoroughly, as they should.
Which is true.
But, contrary to what many people believe, it is also a natural by-product of our own bodies as opposed to... let us put this politely... the residue of uncleaned-up ejaculatory fluid. There may be some of that involved, but the lion’s share of smegma comprises a cocktail of shredded skin cells and largely dead epithelial cells, mixed with sundry skin oil secretions, sweat and our old friend pre-cum (in males) and natural vaginal lubricants (in females). None of which sounds at all appetizing. Largely because it isn’t.
It is, however, harmless and it is also necessary. Those dead cells need to go somewhere and, although it sounds somewhat oxymoronic, the debris is a sign that your genitals are cleaning themselves as nature intended them to. You just have to remember to then clean up afterwards. Because if you don’t....
Smegma is sticky. Very sticky. Many adolescent circumcisions are the result of a child not being taught the correct way of cleaning beneath his foreskin, allowing the smegma to build up to such levels that the foreskin literally becomes glued to the penis head - a condition known as phimosis. It will not budge, and no amount of after-the-fact cleaning will shift it. Masturbation and intercourse become painful as the foreskin remains doggedly cemented in place, and the only solution is its removal.
Women, too, can suffer from this, smegma collecting around the clitoral hood and, again, cementing it into place. Indeed, one study suggests that around one in four women suffer from clitoral phimosis, as the condition is called, and while it is generally regarded as relatively painless, it can be the cause of a number of other sexual problems, most commonly an inability to become fully (or even slightly) aroused. A hoodectomy, the same procedure employed to excise excessive prepuce tissue, is the usual remedy.
Where women differ from men in this respect, however, is in what can happen next. They do not develop balanitis. (I don’t know why, and I cannot find any explanation... so if someone out there can supply one, please do.)
Bacteria finds a happy home in accumulated smegma, and balanitis (from a Greek word meaning “acorn”) is often an end result of that. The head, or glans of the penis becomes inflamed. There may be a rash, or small lesions appearing. The foreskin might follow... balanoposthitis. Rolling back the foreskin reveals a film of the aforementioned smelly liquid; pushing it forward causes the fluid to exude.
Hot water and plenty of soap will generally clear it up fairly swiftly, but it is worthwhile getting it checked-out anyway. Thrush and psoriasis can also cause balanitis and so can a sensitivity to soap, washing detergents and other chemicals. Certain medications may set it off. So can any irritation caused by condoms. So can diabetes. And, of course, you want to make sure that it is balanitis in the first place, because there’s a lot of other STDs out there that cause swelling and discharges all of their own.
Nevertheless figures supplied, again, by the NHS suggest that one in twenty male children, infants and pre-adolescents alike, will suffer from balanitis at some point, often before they become sexually active (or even aware) - meaning, mothers of even the youngest boys need to be as diligent in their son’s hygiene as they trust him to be once he begins washing himself.
And you will hopefully have noticed that I did not specify uncircumcised children. Even those who have undergone the procedure can develop balanitis (although not, for obvious reasons, balanoposthitis); indeed, studies have shown that while it is more common in uncut males, the statistical difference is just a handful of percent. A 1986 study (see bibliography) revealed, “balanitis (6% vs 3%) and irritation (4% vs 1%) were more frequent among the uncircumcised [boys], but the difference [between them and the circumcised subjects] was not statistically significant."
So, plenty of washing, plenty of unscented soap, and plenty of rolling back the foreskin as the boy advances towards manhood. Diligent personal hygiene means that balanitis will hopefully not become an issue. But, if it does - straight to the doctor. It’s probably not a serious problem. It could, however, be a symptom of one.