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Foreskin problems

Understanding Foreskin Problems: Causes, Signs, and Treatment

The foreskin, a protective fold of skin covering the penis in uncircumcised individuals, requires proper care to prevent potential issues later in life. Here's a comprehensive guide to foreskin problems, their causes, signs, treatment, and preventive measures.

What is the Foreskin?

The foreskin is a layered fold of skin that shields the end of the penis in uncircumcised individuals. While it requires no special care in early childhood, attention to hygiene becomes crucial as one grows older to prevent problems like swelling, infection, tightness, irritation, and dryness.

Causes of Foreskin Problems:

In young children, the foreskin is naturally attached to the penis head by the synechia membrane, which dissolves over time. Forcing it back prematurely can lead to issues. Phimosis, where the foreskin is too tight, is another cause, usually resolving between ages two and six. STIs, infections, BXO (lichen sclerosis ) or injuries can trigger problems in teenagers and adults.

Signs of Foreskin Problems:

Look out for pain during urination, itchiness, inability to retract the foreskin, pain during intercourse, redness, soreness, swelling, dryness, or split and bleeding skin. Consult our specialist Urologist if you experience these symptoms.

Treatment for Foreskin Problems:

Treatment varies based on the issue. Dryness may be managed with creams or ointments like steroid cream, while infections like balanitis can be treated with medications. In some cases, procedures may be required, such as moving back the foreskin in children with phimosis or circumcision in adults with persistent issues. Our approach with circumcision with glue is the best option.

Prevention of Foreskin Problems:

Proper care is crucial. Change underwear regularly, opt for loose underwear, avoid heavily scented hygiene products, clean the foreskin daily with warm water, and use protection during sex to reduce STI risks.

Specialists for Foreskin Problems:

A urologist, or a pediatric urologist for children, is the specialist to consult for foreskin problems. We provide these services in the London Circumcision Centre.

When to Consider Circumcision:

Circumcision is only considered when foreskin problems are severe and impact daily life, causing persistent pain or frequent urination issues. Phimosis with a scared or cracked foreskin will require circumcision.

When to Seek Medical Advice:

Call us if you experience difficulty urinating, a burning sensation, increasing pain, or inability to return the foreskin to its original position.

Understanding and addressing foreskin problems early is essential for maintaining male reproductive health. Regular hygiene practices and prompt medical attention can make a significant difference in preventing and managing foreskin-related issues.

Cracks on the foreskin

Cracked foreskin presents with mild burning, itching, swelling and red patches, and with tight foreskin (phimosis)

Cracks or fissures on the foreskin may be due to Inflammatory conditions of the foreskin (called posthitis) or head of the penis (balanitis) or both (balanoposthitis). These cracks could be painful and associated with fungal or bacterial infection, scarring conditions called lichen sclerosus (BXO), and tight foreskin (phimosis and Paraphimosis).

Fungal infections are usually responsible, most commonly involving the yeast called Candida albicans, which is associated with a bacterial infection. Foreskin yeast infection is generally called “candidiasis” or “thrush” and is not common in healthy individuals but in cancer, immunocompromised, and diabetic individuals.

Bacterial infections, especially Streptococcus organisms, are the second most common cause of balanitis. The sexual health clinic needs to exclude sexually transmitted infections (STIs). The most common STIs are Chlamydia trachomatis, genital mycoplasmas, and Neisseria gonorrhoeae. These can produce cracks and red foreskin.

Poor hygiene due to a tight foreskin can cause cracks on the foreskin and irritant balanitis.

Diabetic patients with uncircumcised men have a high (35%) prevalence of balanitis, which gives them cracks to the foreskin. Among men with an acquired tight foreskin, 26% had a history of diabetes. Tight foreskin (phimosis) in men with diabetes increases the risk of infection of the foreskin and glans.

Balanitis xerotica obliterans (BXO) is a chronic, progressive, and sclerosing inflammatory foreskin disease of unknown cause. BXO will produce scars and cracks.

Treatment of the cracks is medical (antifungal, antibiotics and steroids) and surgical (dorsal slit, preputioplasty or circumcision). Control of sugar in diabetes patients is critical to managing the above treatment.

If cracks of freoskin are associated with tight foreskin (phimosis)

The treatment of phimosis depends on several factors, including age and the degree of tightness. Here are the available options:

1. Steroid Cream or Ointment: These reduce inflammation and improve foreskin elasticity.

2. Stretching Exercises: Beneficial, especially in the early stages of Phimosis.

 3. Stretching Rings (Phimostretch): Devices that aid gentle foreskin stretching.

If cracks of freoskin are associated with diseased freoskin (BXO)

We provide circumcision, dorsal slit or preputioplasty at our centre
Please get in touch with us for professional and expert advice by calling the mobile number below to the doctor directly.

Please call us at +447527314081 to discuss this further and get advice from our specialist team.

  • Dr Nkwam: Consultant Urologist

  • Dr Sanndher: Consultant Urologist

  • Dr Khan: Paediatric Surgeon/Urologist

  • Dr Safdar: Experienced Surgeon

London Circumcision Centre, Leyton and South Woodford Clinics, London

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