The foreskin is the skin that covers and protects the end of the penis.
Three things to know:
- A child’s foreskin should also never be pulled back by force.
- A child’s foreskin needs no special care
- There is no need to clean inside the foreskin of young boys
How to clean the foreskin and penis?
There is no need to clean inside the foreskin in infants and children. Just wash the penis the same as any other part of your child’s body. Once the foreskin can be pulled back, you can teach your child to:
- gently slip the foreskin back
- rinse the head of the penis and the inside fold of the foreskin with warm water
- slip the foreskin back in place over the head of the penis
- rinses off any soap before pulling the foreskin back.
When can the foreskin be pulled back?
During the first few years of life, the foreskin is stuck to the head of the penis by a membrane. It will dissolve naturally as the child grows.
The foreskin can be pulled back when it’s inside surface separates from the head of the penis, and the foreskin’s opening widens. This process happens naturally in childhood or during puberty and has usually happened by the age of 18.
What happens if the foreskin is pulled back too early?
Forcing the foreskin back before the natural separation can cause tearing of the connective tissue. This is painful and can lead to problems, such as an open wound which can lead to infection.
What is the white lump under the foreskin?
The white lump (smegma) is made up of the cells that once attached the foreskin to the head of the penis. As new cells form, the old cells come up to the tip of the foreskin where they can be wiped away. It is a sign that the separation from the head of the penis is occurring naturally.
Why does the foreskin ‘balloon’ when a child pees?
This is an indication that the natural separation of the foreskin from the head of the penis is occurring, but the opening of the foreskin is still narrow. Here is what you can do when this happens:
- Consult with your doctor. If it is severe so the flow of wee is restricted. Sometimes a course of steroid cream is needed.
- Encouraging your child to gently try and pull back the foreskin as part of daily hygiene can help.
What causes the foreskin to be red ?
Sometimes the tip of the foreskin becomes red (balanitis). This indicates the penis is irritated. If children are still in nappies, it may be part of nappy rash. When bacteria in the poo react with wee, they produce ammonia, which burns the skin and causes nappy rash. Here is what you can do:
- Change nappies more frequently
- Allow more nappy-free times
- Soak your child in warm baths
- Avoid things that can irritate the skin (such as bubble baths, soap, highly chlorinated water, certain laundry powders)
- Encourage your child to drink more so the pee is more dilute
- Consult with your doctor if the foreskin or penis is red, painful and swollen. There may be an infection
What if the foreskin can’t be pulled back (phimosis)?
Phimosis refers to a foreskin that cannot be pulled back because its opening is too small to expand over the head of the penis. If that happens, consult with your doctor if your child is still unable to retract the foreskin in his later childhood
What is circumcision?
Circumcision is an operation to remove the foreskin. There is no medical reason for routine male circumcision. It’s usually done due to purely religious customs.
Dr. Piyawut Kreetapirom, MD. (1 July 2020)