Penile Itching: Why Your Penis Itches

Common causes of an itchy penis

Yeast infection (candidal balanitis)

Candidiasis is the most common infectious cause. It typically causes:

• itching or burning on the head of the penis and under the foreskin
• red, blotchy patches or small red spots
• a white, cottage cheese-like substance under the foreskin
• a shiny, sometimes sore glans

It is more likely if you are uncircumcised, have diabetes, have recently taken antibiotics, or your partner has a vaginal yeast infection. Recurrent yeast infections warrant a blood sugar test.

Balanitis from irritation

Balanitis, meaning inflammation of the head of the penis, is often not an infection. It can come from:

• over-washing with soap or shower gel
• under-washing, letting smegma build up under the foreskin
• not drying properly
• spermicides, lubricants, latex condoms
• urine left under the foreskin

Jock itch (tinea cruris)

Jock itch is a fungal infection of the groin with an itchy red rash with a raised, scaly edge on the inner thighs. It can spread to the base of the penis and scrotum, though it usually spares the scrotum compared with yeast. It is common with sweating, tight clothing and athlete's foot.

Eczema and contact dermatitis

Dry, itchy, red skin on the shaft or groin can be atopic eczema, or contact dermatitis from a product such as detergents, fragrances, latex or topical medicines.

Psoriasis and lichen planus

Genital psoriasis appears as smooth, well-defined red patches without much scale. Lichen planus causes flat, purple-tinged bumps or white lacy patches, sometimes itchy.

Sexually transmitted causes

Anyone with possible STI symptoms, or a new or untested partner, should get tested. Many STIs have no symptoms but can still be passed on.

Less common but important causes

• Lichen sclerosus: white, shiny, thin patches on the glans and foreskin, with itching, splitting and a tightening foreskin. It needs a strong steroid cream and follow-up, because it slightly raises the risk of penile cancer.
• Zoon's balanitis: a persistent orange-red shiny patch in uncircumcised older men.
• Penile intraepithelial neoplasia and penile cancer: a red, velvety patch, lump or sore that does not heal. Rare, but needs a biopsy.
• Diabetes: high sugar in urine feeds yeast. Itching may be the first sign.

How doctors find the cause

A doctor or sexual health clinic will ask about the itch, rashes, discharge, sexual partners, hygiene products and medical conditions such as diabetes. They will examine the penis, foreskin, groin and other skin. Tests may include:

• a swab of the glans for yeast and bacteria
• urine tests (NAAT) for chlamydia, gonorrhea and trichomoniasis
• a swab of sores for herpes
• blood tests for syphilis and HIV when appropriate
• blood sugar
• a skin biopsy for persistent patches

Treatment

Gentle care for all causes

• wash the penis once a day with warm water only. If uncircumcised, gently pull back the foreskin to wash and dry underneath, then return it
• use an emollient (soap substitute) instead of soap
• dry thoroughly after washing and urinating
• wear loose cotton underwear
• avoid perfumed products, bubble baths and talc
• avoid sex until symptoms settle, or use condoms

Specific treatments

• Yeast infection: an antifungal cream such as clotrimazole or miconazole twice daily for 1 to 2 weeks. Oral fluconazole for severe or recurrent cases. Partners with symptoms should be treated too.
• Irritant balanitis and eczema: emollients and, if advised, a mild steroid cream for a short time. Some products combine a mild steroid and antifungal.
• Jock itch: an antifungal cream such as terbinafine or clotrimazole for 2 to 4 weeks. Treat athlete's foot too, to stop it spreading back.
• STIs: specific antibiotics or antivirals. Partners need testing and treatment.
• Scabies and lice: permethrin cream or other prescribed treatments, with washing of bedding and clothing.
• Lichen sclerosus: a potent steroid ointment. Circumcision may help some men.

Do not use over-the-counter steroid creams on an itchy penis without advice: they can make fungal infections worse.

Frequently asked questions

Why is my penis itchy but no discharge?

Itching without discharge is most often a yeast infection, irritation from soaps or sweat, jock itch, eczema or contact dermatitis. Pubic lice and scabies also cause itching without discharge. If it does not improve within 1 to 2 weeks of gentle care and antifungal cream, see a doctor.

Can an STI cause penile itching?

Yes. Trichomoniasis, herpes, pubic lice, scabies, chlamydia and gonorrhea can all cause itching. Blisters, sores, discharge or burning when urinating make an STI more likely. Get tested if you have symptoms or a new or untested sexual partner.

What cream is best for an itchy penis?

It depends on the cause. A clotrimazole or miconazole cream treats yeast infections. Terbinafine or clotrimazole treats jock itch. A mild steroid helps eczema but can worsen fungal infections. If unsure, get a diagnosis first rather than guessing.

Can a yeast infection on the penis be passed to a partner?

Yeast can pass between partners during sex, though it is not classed as an STI. If you have repeated infections, your partner may also need treatment. Avoid sex until symptoms clear, or use condoms.

Can diabetes cause penile itching?

Yes. High blood sugar increases sugar in urine and on the skin, which feeds yeast. Recurrent candidal balanitis can be the first sign of undiagnosed type 2 diabetes. A simple blood test can check.