Foreskin care and penis care

The loose skin covering the end of the penis is called the foreskin. It covers the glans (head) of the penis.

You don’t need to do anything special to care for the foreskin during infancy or childhood. You don’t need to pull it back for cleaning. If your child does pull back the foreskin in the bath or shower, that’s fine – but it’s not needed.

Once your child goes through puberty and can easily pull back the foreskin, it’s good for your child to do this in the bath or shower for cleaning. If your child can’t pull back the foreskin or has concerns about it, you should take them to see your GP.

At any age, it’s important for your child to know that the foreskin always needs to be put back to cover the head of the penis.

Foreskins: what to expect in typical development

The foreskin usually won’t pull back at all at birth, so you can’t see the glans of the penis. This is because the underside of the foreskin hasn’t yet separated from the surface of the glans and the opening at the end of the foreskin is too tight.

During childhood, the foreskin gradually starts to separate from the glans, so children can start to pull it back. But even at 10 years, the foreskin often can’t be fully pulled back because the opening at the end is too tight.

The foreskin might not fully separate from the glans until after puberty.

In the years before the foreskin separates fully from the glans, skin cells can build up under the foreskin and form a whitish substance called smegma. It might cause firm lumps under the foreskin. This happens in about 10% of older children.

Your child can wash away smegma with water, but it can also be left without problems. By puberty, regular showering will clean it away.

Foreskins vary considerably in length. When unfolded, the foreskin is about 40-70% of the skin along the penis.

It’s typical to see some penis and foreskin play during early childhood.

Medical experts agree that the risks of circumcision for boys for non-medical reasons outweigh the benefits.

Foreskin irritation and inflammation

Foreskins can get caught in hastily pulled up zips. This can be painful and distressing. If your child’s foreskin gets stuck in a zip, your child will probably need to go to a hospital emergency department.

Other problems include the tip of the foreskin getting irritated, which is common. It might be red or sore, or it might have a small amount of swelling. This might be caused by wet nappies or a build-up of soap residue. It might also happen if the foreskin is forced back.

Treatment for irritation involves avoiding the cause of the irritation. You could try:

• giving your child some nappy-free time
• putting nappy barrier cream or nappy rash ointment on the tip of your child’s foreskin
• adding some salt to your child’s bathwater or using a cup with salty water to bathe the penis.

Balanitis is an inflammation of the foreskin and penis, with swelling and redness. There might be a discharge, and urinating might be painful. Try salt baths for 1-2 days, or use a cup with salty water to bathe the penis. If the problem doesn’t go away, see your GP, who might prescribe a corticosteroid cream or antibiotics.

Tight foreskin

In some children, the end of the foreskin might be tight – this is called phimosis. Sometimes phimosis can cause the foreskin to balloon when urinating.

Phimosis is very common in younger children and usually settles without any treatment as they get older. But if you or your child has concerns about phimosis, check with your GP. The GP might prescribe a corticosteroid cream to help treat the phimosis.

If the foreskin is still tight after puberty, it’s best for a doctor to check it.

If the foreskin gets pulled back when it’s still tight or isn’t replaced after being pulled back, it might get stuck. It can act like a rubber band, forming a tight ring around the shaft of the penis. This is called paraphimosis. It causes considerable swelling, which can make it difficult to replace the foreskin over the head of the penis.

If the foreskin can’t be replaced in its usual position, paraphimosis requires urgent medical attention. A doctor can usually bring the foreskin back to its usual position using firm pressure. It rarely needs circumcision, either at the time or later.