Our bodies are covered with skin. The skin on our noses goes to their tips and the skin on our fingers and toes goes to their tips. The penis, too, is covered with skin. The fold of skin that covers and protects the glans (head) of the penis is sometimes called the prepuce, but is more commonly known as the foreskin.
The inside fold of the foreskin is mucous membrane and keeps the surface of the glans soft, moist and sensitive.
The foreskin contains a concentrated number of blood vessels and nerve endings. The frenum which secures the foreskin in its forward position, is continous with the frenar band. This band of specialized tissue encircles the foreskin where the inside and outside folds meet (at the mucocutaneous junction) and is extremely sensitive.
The intact penis of an infant or child needs no special care.
A child's foreskin should never be retracted by force.
During the first few years of life, the foreskin and glans are connected by a common membrane called the synechia (just as the fingernail is attached to the finger). This connective tissue dissolves naturally - a process that should never be hurried.
The foreskin can be retracted when its inside surface separates from the glans and the opening widens. This usually happens by age 18. Even if the glans and foreskin separate naturally in infancy, the foreskin still may not be retractable because the opening in an infant's foreskin may be just large enough for the passage of urine.
The first person to retract a child's foreskin should be the child himself. Once a boy discovers that his foreskin is retractable (a wondrous discovery for an intact child), he can easily learn to care for himself. A simple explanation of "how to" may be helpful:
When bacteria in the feces react with urine, they produce ammonia, which burns the skin and causes ammoniacal dermatitis, commonly known as diaper rash.
Common reasons for a reddened foreskin are:
Drinking water, soaking in warm baths, and letting children run around with bare bottoms to air their genitals helps healing.
Tearing the foreskin from the glans leaves an open wound which can lead to infection.
Raw surfaces touching each other can heal together and form adhesions between the foreskin and the glans.
Small tears in the opening of the foreskin can heal to form non-elastic scar tissue, passibly causing acquired phimosis.
The foreskin can get "stuck" behind the glans (paraphimosis). By squeezing the glans, the foreskin can be brought forward again, without circumcision.
When a young boy pulls at his foreskin, he usually pulls it outward. This is normal and natural and no cause for concern; he won't hurt himself. One day, he'll pull his foreskin back, and you can discuss retracting, washing, and returning the foreskin to its forward position over the glans. Telling your son about retractablility beforehand will keep him from becoming alarmed the first time his foreskin retracts.
At puberty, you can let him know what with hormonal activity comes new responsibility, including genital hygiene.
NOCIRC has information about hygiene written especially for intact boys.
Many doctors don't know how to care for an intact penis and recommend circumcision for any and every problem. The National Organization of Circumcision Information Resource Centers, which is dedicated to preserving and protecting children's normal natural wholeness, will be happy to direct you to a doctor who understands the foreskin's functions and importance.
Circumcision Information Resource Centers
Post Office Box 2512 San Anselmo, CA 94979-2512 USA
Phone: 415-488-9883 Fax: 415-488-9660
The information in this pamphlet is not intended to replace the advice and care of your pediatrician.