Why is Foreskin Care Necessary?
Foreskin care is necessary to prevent foreskin infection and/or irritation. The penile foreskin produces a secretion called smegma. Smegma is produced by the sebaceous glands on the inner surface of the foreskin. There is smegma buildup whether or not your son has been circumcised. Smegma acts like glue if left uncleaned. The foreskin always wants to re-adhere to the penile head. This is also true for the uncircumcised penile head. As the foreskin naturally lowers, it’s important to maintain good hygiene. The smegma will slowly be exposed as the foreskin slowly retracts. At that point, if the smegma is not cleaned away, the loosened foreskin will also want to re-adhere to the penile head. It’s good hygiene to clean the penile head daily regardless of circumcision or not.
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Foreskin Care for Circumcised Boys
Many parents believe that since the foreskin has been removed, there’s not much else to do. Even though your son’s foreskin was circumcised, there is some that intentionally remains at the time of the surgery. The purpose behind this is to allow for skin stretching due to growth and erections over time as your son grows. Much of the foreskin is removed during circumcision. However, it can’t all be removed. Otherwise, there would be much pain whenever there is penile growth or an erection. If the foreskin is not gently lowered and cleaned well, smegma will build up and the foreskin will naturally re-adhere to the penile head. This would lead to an increased risk of infection. If the foreskin becomes completely re-adhered, it also leads to a potential need for another circumcision.
It’s important to thoroughly clean the penile head daily. This involves gently lowering the foreskin to beyond the base of the penile head. I often tell parents that when it’s lowered correctly to clean it, this should look like a mushroom cap with a stalk. Notice I’m saying gently lower. Do not force the foreskin down ever. The area should be cleaned once daily with either a wet wipe, plain soap and water, or a washcloth with soap and water. Wyou see smegma, make sure to clean it off.
If the foreskin becomes re-adhered, get an evaluation from your son’s pediatrician. If it is safe to do so, the pediatrician may reduce the adhesions. Then, there will be a discussion regarding follow-up care and prevention. It is important to know that there is a limited age by which your pediatrician can reduce the adhesions. Typically, somewhere between 12-18 months, the adhesions can no longer be manually reduced. At that point, you will need to have a discussion about whether or not your son needs to or can have another circumcision. This is truly a case-by-case basis. Medical decision making and personal choice may be involved.
Foreskin Care for Uncircumcised Boys
It’s important to thoroughly clean the penile head daily. You should lower the foreskin to the point where you feel natural resistance. Notice I’m saying gently lower. Do not force the foreskin down ever.
The important difference from a circumcised penis, is that with the uncircumcised penis, you will most likely barely be able to lower the foreskin. Typically, you may be able to gently lower it by about one millimeter. You will most likely only see the urethral opening. That’s perfectly normal. Over time, as your son’s penis grows and has erections, the opening will continue to expand. And you will be able to lower the foreskin gently more and more. The area should be cleaned once daily with either a wet wipe, plain soap and water, or a washcloth with soap and water. When you see smegma, make sure to clean it off.
You will most likely see the smegma trapped under the foreskin. Again, do not force the foreskin to remove the smegma. While this can be done, there will be a lot of pain and some bleeding. It’s even possible that the foreskin may get stuck at the base of the penile head which would be an emergency. So, just don’t do it. Your pediatrician will let you know if anything needs to be done with trapped smegma.
Teaching Self-Cleaning Takes Time
Boys are well known for taking years until they learn how to clean themselves. I have long heard many parents sharing stories with me about their little boys being fine with poop smears in their underwear and an itchy butt. This also holds true for cleaning their penis. This means you will have to do this for them for many years.
Typically, they are not ready until after they have been fully potty trained. Boys should be potty trained by 4 years old. At that point, I’d recommend starting to teach them by talking to them as you clean their penis. Boys will start showing they are capable of self-cleaning between 5 and 6 years old.
Independent Self-Cleaning Takes More Time
However, in my personal and professional experience, it takes them about until they are 8 years old until they can truly self-clean well. And then, come the teenage years! This is when many boys revert to a lack of self-cleaning. You will need to repeatedly check with them. It’s important to prevent foreskin infection. Common questions to ask your teens are, “Did you wash your hair? Did you scrub your back? Did you clean your penis?” They will get annoyed that you will repeatedly ask this. However, that’s your role as the parent. Rinse and repeat, literally.
What’s Next?
Stay tuned the nest blog post, “Autism & Genetic Testing: Why & When?” Don’t forget to check out the video for more in-depth information on today’s topic! Watch the full video on my YouTube channel!
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