Childbirth Educator Today

Care of the Intact Penis

by James E. Peron, Ed. D.

In a society where routine circumcision has been common for many years, even parents who choose to protect their sons from routine circumcision may have questions regarding hygiene of the intact penis.

Should the young child's foreskin be retracted for proper cleaning? At what age should the child's foreskin be retractable?

Leave the foreskin alone; wash only what is external and readily visible.
Never forcibly retract your son's foreskin and don't permit anyone else to do so.
Make certain your son's medical attendants understand his foreskin is not to be retracted or tampered with.
Always stay with your son during his doctor visits and exams.
When teaching the child to bathe and care for himself, let the child retract his own foreskin if he wants to. He will not retract it beyond the point of discomfort.
A child's foreskin does not need to be retracted regularly for cleaning until the end of puberty. It should not be retracted during early childhood.*

What about "smegma" and hygiene?

Parents are frequently told that the foreskin must be carefully cleaned to remove "smegma" from under the foreskin. Smegma is a natural oily, waxy lubricant formed between the foreskin and the glans. Rarely does it exist in the uncircumcised child whose foreskin has not been forcibly retracted; the substance we are warned to carefully wash away is rarely produced during childhood. During puberty, these natural secretions tend to increase, providing a natural lubricant between the foreskin and glans for protection and to permit the foreskin to slide easily over the glans as nature intended for this age. By mid-teenage, the foreskin is retractable and hygiene is a simple matter. Any accumulation of these natural lubricating substances can easily be cleansed during the boy's shower or bath.

What about irritation or itching of the foreskin?

If the infant boy has redness or irritation of the foreskin area and tip of his penis, simply apply a protective healing ointment such as A&D ointment, Oil of Vitamin E, anti-biotic ointemnt, etc. Don't try to retract his foreskin. The irritation will usually clear up in a few days.
Some baby boys develop little "pearls" under the foreskin between the glans and the foreskin. These are shed cells from the glans and foreskin gradually separating that will eventually work their way to the opening and be discarded. Rarely do they present a problem.
An older uncircumcised child may complain of foreskin irritation or itching. Interestingly, this seems most common with those boys whose foreskin has been regularly retracted from early childhood.
Active young boys playing outside may occasionally get dirt or sand in the foreskin opening. It may lodge between the inner foreskin and glans tip causing minor irritation. If the foreskin is partially or fully retractable, you may very gently retract his foreskin and rinse the area with warm water.
If the foreskin will not retract or is swollen, do not force it. Wash the area and apply a soothing lubricant to the tip and exposed surfaces. Remember always return the foreskin to its normal resting position.

(*Improper retraction by force can cause small tears in the foreskin and the mucosal fold under the foreskin where it is normally adherent to the glans. This may cause bleeding and considerable pain, and open the route for potential infection and irritation. If this is a regular practice, restrictive scar tissue may form around the opening of the foreskin or between the foreskin and the glans.)

James E. Peron, Ed. D. is a medical research writer and founder of Childbirth Education Foundation, P.O. Box 251 Oxford, PA 19363 Phone: (717) 529-2561 Email: jperon@epix.net