What is phimosis?

Phimosis is a condition in which the foreskin can’t be retracted (pulled back) from around the tip of the penis. A tight foreskin is common in baby boys who aren’t circumcised, but it usually stops being a problem by the age of 3.

Phimosis can occur naturally or be the result of scarring. Young boys may not need treatment for phimosis unless it makes urinating difficult or causes other symptoms. As these boys grow up, the need for treatment may increase.

Symptoms of phimosis

The main symptom of phimosis is the inability to retract the foreskin by the age of 3. The foreskin usually loosens over time, but this process can take longer in some boys. By around the age of 17, a boy should be able to easily retract his foreskin.

Another common symptom of phimosis is a swelling of the foreskin while urinating.

Causes of this condition

Phimosis can occur naturally. It’s unclear why it occurs in some boys but not others. The condition can also occur if the foreskin is forcibly retracted before it’s ready. This can harm the skin and cause scarring, making it more difficult to retract the foreskin later on.

Inflammation or an infection of the foreskin or the head of the penis (glans) may cause phimosis in boys or men. Balanitis is an inflammation of the glans. It’s sometimes the result of poor hygiene or an infection of the foreskin.

Treatment for phimosis

A physical exam and a review of your son’s symptoms are usually enough to diagnose phimosis or an underlying condition, such as balanitis.

Treating balanitis or another type of infection usually starts with a swab of the foreskin to be studied in a lab. A bacterial infection will require antibiotics, while a fungal infection may require antifungal ointments.

If there is no infection or other disease causing phimosis, and it appears that the tight foreskin is simply a naturally occurring development, there may be several treatment options available. Depending on the severity of the condition, daily gentle retraction may be enough to treat the problem. A topical steroid ointment can be used to help soften the foreskin and make retraction easier. The ointment is massaged into the area around the glans and foreskin twice a day for several weeks.

Phimosis versus paraphimosis

A condition called paraphimosis can also result when the foreskin is retracted, but can’t be moved back into its normal position. This may require emergency medical attention. One complication of paraphimosis is a reduction in blood flow to the end of the penis.

The treatment options for paraphimosis are similar to those for phimosis. Lubricating the glans and the foreskin may help slide the foreskin back up. Before trying this at-home treatment, you should discuss it with a doctor. Have the doctor recommend brands and types of ointments or lotions that are safe. If the paraphimosis continues for several hours, color changes occur, or there is pain, you need to get a medical evaluation immediately.

Circumcision or partial circumcision can eliminate the concerns of foreskin retraction. Be sure to discuss the risks and benefits of this procedure with a doctor. Being uncircumcised places a man at a higher risk of HIV and other infections.