Health Centres - Foreskin contraction (phimosis)
How the foreskin develops in the first couple of years
The foreskin of a newborn boy is always closely contracted around the penis head (glans). Only a small passage allows the urine to pass through. In the first months the foreskin is stuck to the glans and cannot be pulled back and one should not attempt to do so.
During the first couple of years, the foreskin will become gradually looser and in many boys it can in time be pulled back without trouble. Half of all three-year-olds can pull back their foreskin.
It is not advisable to try pulling the foreskin back using force, since this may cause small cuts in the foreskin with scars which could finally cause a regular foreskin contraction.
Who can help?
A health visitor or GP will be able to give advice. If the foreskin is very contracted and stays so, causing recurrent infections and problems when urinating, then it may be necessary to operate.
Which problems may follow foreskin contraction?
Foreskin contraction - also called phimosis - can last throughout life and not cause any trouble at all. It is a voluntary decision whether to have an operation or not. If any problems do arise they happen after puberty. The contraction may occur for the first time as an adult and usually requires an operation (circumcision).
- There might be trouble urinating.
- Infections may occur under the foreskin.
- When infections are recurrent under the foreskin, a GP or health visitor should be consulted.
- In many cases an infection can be avoided by cleaning regularly under the foreskin with lukewarm water.
- At erection, a contracted foreskin may cause trouble by hurting when an attempt is made to pull the foreskin back. It may not go back over the glans before the penis is limp again.
- Men may be able to have intercourse with a contracted foreskin but would probably manage better without this condition.
- Very rarely, a malignant growth can occur in a long-standing foreskin contraction.
How is a contracted foreskin treated?
Many boys can be treated with a cream that contains a weak corticosteroid.
- A GP can provide this treatment. The tip of the penis should be treated with the cream two to three times a day for two to three weeks at a time.
- The foreskin must be pulled as far back as possible without using force before the cream is put on.
- If this treatment does not work, an operation can help.
The operation for phimosis is usually done under general anaesthesia without any serious problems. The doctors may try to retain the foreskin in the operation where often a small cut is enough to loosen it up sufficiently for it to be pulled back without trouble.
An actual circumcision where the foreskin is removed completely is more often required in adults where the foreskin is thickened and scarred.
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