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What's Normal?
All boys are born with a protective layer of skin to cover the end of their penis. This is known as the foreskin. This layer of skin is present at birth and provides protection from rubbing and infection. It is natural for the foreskin to be tightly stuck to the end of the penis. This is known as physiologic phimosis. Often the opening of the foreskin is narrow and white buildup of shedding skin may be trapped close to the opening. Known as smegma, this buildup of shedding skin will naturally go away with gentle washing. The foreskin should never be forced back. Around age 5 years, the foreskin will begin to pull back from the end of the penis in most uncircumcised boys. This occurs through normal erections and regular cleaning. For some boys, the foreskin may not pull back from the end of the penis until age 16 years. Good hygiene is highly recommended to prevent infection or damage to the penis.
Tips for Daily Hygiene
- During daily baths or showers, gently pull back the foreskin to rinse the end of the penis with water. Avoid forcing the foreskin back. It should not be painful to pull back. Too much force may cause scarring, swelling, pain, and increase the risk for unwanted health issues. Allow the area to dry and use a towel to remove extra moisture. This helps prevent bacteria from growing. Then, replace the foreskin back over the head of the penis. This allows the foreskin to protect the end of the penis from rubbing.
- For boys that wear diapers, change soiled diapers regularly to prevent skin irritation, risk of infection, and moisture buildup.
- As boys get older, teach them to gently pull back the foreskin when they shower or before they pee. After they are done, they should also make sure the end of the penis is dry. Then they should replace the skin over the end of the penis.
When Should I Seek Medical Help?
Good hygiene is important to prevent unwanted health issues. However, it is important to know the signs of when to get medical help. One problem is pathologic phimosis. This is when the foreskin of the penis cannot be pulled back after age 12 years and the end of the penis is stuck behind the narrow opening of the foreskin. Another problem is when the foreskin is pulled back and gets stuck above the end of the penis. If it cannot be pulled down to cover the end of the penis this is a problem that can cause serious health issues. This is known as paraphimosis and requires a prompt visit with the doctor. Additionally, if your child has repetitive urinary tract infections, problems peeing, painful erections, or swelling, redness, pain, or severe color changes of the penis please seek medical help.
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