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 your child’s foreskin during infancy or childhood. You don’t need to pull it back for cleaning. But it’s OK if your child does pull back the foreskin in the bath or shower.

Once the foreskin moves easily over the penis, it’s good for your child to pull it back in the bath or shower for cleaning. If your child can’t pull back the foreskin or has concerns about it, you should take your child 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 your child can start to pull it back. But even at 10 years, your child might not be able to pull back the foreskin fully if its opening is still very tight.

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

Skin cells can build up under the foreskin and form a whitish substance called smegma. It might cause firm lumps under the foreskin. Smegma is common and can happen at any age.

Your child can wash away smegma with water, but they can also leave it. Smegma doesn’t cause any problems. By puberty, regular showering will clean away smegma.

Foreskins vary considerably in length.

It’s typical for boys to play with their penis and foreskin during early childhood.

Circumcision for boys is a surgical operation to remove the foreskin. Medical experts agree that the risks of circumcision for non-medical reasons outweigh the benefits.

Foreskin irritation and inflammation

Foreskins can get caught in hastily closed zips. This can be painful and distressing. If your child’s foreskin gets caught 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, purple or sore, or it might have a small amount of swelling. This might be caused by wet nappies, wet underwear or swimmers, 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 a simple ointment on the tip of your child’s foreskin – for example, a petroleum jelly like Vaseline
• adding salt to your child’s bathwater or using a cup with salty water to bathe the penis – aim for about 1 tablespoon of salt per litre of warm water.

Balanitis is an inflammation of the foreskin and penis. There’s usually swelling and a red, purple or grey appearance, and there might be discharge. Urinating might be painful. Try salt baths morning and night for 1-2 days, or use a cup of salty water to bathe the penis. If the problem doesn’t go away, see your GP, who might prescribe a special ointment 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 ointment.

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.