Foreskin: Its types, causes, symptoms, diagnosis, and treatments

What is the foreskin?

The foreskin is a flap of tissue that covers the head of the penis, also called the glans penis.  At birth, the foreskin is completely attached to the penis. However, by puberty, it separates and becomes fully retractable. 

All men need not possess a penis foreskin. Due to certain religious or medical requirements, many men undergo circumcision, which is the surgical removal of the foreskin. This is typically defined by a ridge of scar tissue in the penile area.

When can foreskin surgery be needed?

Foreskin surgery may be undertaken due to religious or medical concerns. Apart from that, many men may need surgery in case of:

• The foreskin that does not retract at puberty is called phimosis
• Too tight foreskin which cannot be pulled back also called paraphimosis
• Chronic infections of the foreskin due to poor hygiene
• Zipper trauma causing tears
• Sexually Transmitted Diseases (STDs)
• Tumors where surgical removal is the first line of treatment

How to treat foreskin?

• If you are struggling with an infection of the foreskin, practicing good hygiene is the preferable method of foreskin care. 
• If you are suffering from an unnaturally tight foreskin,  you can try gentle massage exercises of the foreskin or OTC medications. 
• For other foreskin problems, do reach out to a men’s specialist at Yashoda hospitals for detailed instructions as they can be aggravated by unsupervised treatments.

What are the symptoms and signs of foreskin problems?

Foreskin problems usually manifest as:

• Pain and soreness in the foreskin and penile area
• Pain while urinating
• Red, inflamed skin of the penis
• Foul-smelling and thicker discharge from the penis
• Blood in the urine
• Discoloration of the penis

What are the causes of foreskin problems?

If your foreskin is still intact, then you may be susceptible to common foreskin problems such as smegma, phimosis, or paraphimosis. Usually, foreskin problems are caused by infections brought about by poor hygiene. Any previous injury may also lead to tightening of the foreskin. The foreskin may also get inflamed due to too much friction or fungal infections in the area.

What are some foreskin care tips?

As a general rule of thumb, for uncircumcised men, it is imperative to practice good hygiene to keep foreskin infections at bay. It is also recommended to wear loose clothing that reduces friction and prevents the buildup of smegma under the foreskin. Showering regularly and cleaning the foreskin carefully, allowing it to dry out, is also necessary to prevent fungal infections. To prevent zipper trauma, it is recommended to wear underpants at all times. 

When should you call a doctor for foreskin problems?

If you face intense pain during urination or observe foul-smelling discharge, you should reach out to a doctor immediately for possible foreskin disorders. Please do not try treating them with unprescribed medicines as they can aggravate the infections. Reach out to a men’s specialist at Yashoda hospitals for a free second opinion today!

How is the cause of foreskin problems diagnosed?

Depending on the type of foreskin issue, the diagnostic modality will differ. If the doctor suspects an infection, they will swab the area and send it across for the necessary diagnostic test. They may also ask you to submit blood or urine samples if required. Accordingly, they will assess the infection and prescribe an antibiotic for bacterial infections, an antiviral drug for viral infections, or topical ointments for fungal infections. 

How many types of foreskins are there?

The foreskin is either present or absent. For research purposes, doctors have proposed five types of foreskins:

1. Normal Foreskin (retractable foreskin)
2. Redundant Prepuce (adhered foreskin)
3. Partial Prepuce (where childhood foreskin separates partially)
4. Phimosis (childhood foreskin does not separate at all)
5. Circumcised Foreskin (Foreskin has been removed)

How to pull back the foreskin without it hurting?

Gently pushing back the foreskin will help prevent any pain. If you feel your foreskin is too tight, try stretching it out slowly over the head of the penis. Do not pull or push too hard, as it may cause unwanted injury.

How far should the foreskin retract?

Ideally, the foreskin should naturally retract enough for you to see the meatus (this is the hole from which your urine and semen come out). This will prevent the buildup of any urine or semen under the skin flap, effectively preventing any possible infection or smegma in the region.

How to heal foreskin cuts?

1. If you have suffered from foreskin trauma, the first step is to clean the region out thoroughly with an antiseptic to prevent the entry of pathogens. 
2. Cover with a clean and sterile cloth to stop the bleeding. Apply mild pressure.
3. With clean hands, apply an antibiotic ointment over the region and wrap it with a bandage.

For severe cuts, do reach out to a doctor and avoid treating them at home. 

Is pulling the foreskin back necessary?

If the foreskin retracts naturally, you can pull it back gently as per your convenience during urination and intercourse. However, if it does not retract on its own, do not force it to prevent unwanted tears and injuries. 

Is it normal to have a foreskin?

Yes, it is absolutely normal to have a foreskin. It is a natural covering of your penis. Although, many men opt to have it removed due to various cultural, religious, or medical reasons. Having a foreskin will require you to be a bit more careful about hygiene.

Which doctor to consult for foreskin problems?

If you do not have access to specialists, you can consult any general practitioner for their advice and avoid home remedies as they may aggravate the infections. A men’s specialist, or a urologist, is the best doctor to consult for your foreskin problems. You can reach one at Yashoda Hospitals today!

References:

• Foreskin Problems: Dryness, Swelling, Infection, Irritation, and More (no date). Available at: https://www.healthline.com/health/foreskin-problems 
• Hsieh, T. F., Chang, C. H. and Chang, S. S. (2006) ‘Foreskin development before adolescence in 2149 schoolboys’, International Journal of Urology, 13(7), pp. 968–970. doi: 10.1111/J.1442-2042.2006.01449.X.Tight foreskin (phimosis and paraphimosis) – NHS (no date). Available at: https://www.nhs.uk/conditions/phimosis/ 
• Foreskin problems: what is it, symptoms and treatment | Top Doctors (no date). Available at: https://www.topdoctors.co.uk/medical-dictionary/foreskin-problems 
• Phimosis and Paraphimosis: Causes, Symptoms, Treatment and Prevention (no date). Available at: https://www.webmd.com/men/phimosis-paraphimosis 
• Tight Foreskin Problems, Solved (no date). Available at: https://www.menshealth.com/uk/health/sexual-health/a746657/tight-foreskin-problems-solved-354820/
• 6 Foreskin Problems (Phimosis) Symptoms, Definition & Treatment (no date). Available at: https://www.emedicinehealth.com/foreskin_problems/article_em.htm 
• Foreskin Problems: Dryness, Swelling, Infection, Irritation, and More (no date). Available at: https://www.healthline.com/health/foreskin-problems 
• Foreskin care – Better Health Channel (no date). Available at: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/foreskin-care 
• Tight Foreskin: Causes, Treatment, and More (no date). Available at: https://www.healthline.com/health/mens-health/tight-foreskin#causes

Disclaimer:

“The content of this publication has been developed by a third party content providerwho are clinicians and/or medical writers and/or experts. The information contained herein is for educational purpose only and we request you to please consult a Registered Medical Practitioner or Doctor before deciding the appropriate diagnosis and treatment plan.”