What is phimosis?
Phimosis is the medical term for a tight foreskin that will not pull back over the glans (head of the penis).
It's normal in babies and toddlers, but in older children, it may be due to a skin condition that has caused scarring.
Phimosis can also affect adults. When this happens, it's usually because of prolonged irritation to or repeated inflammation of the foreskin and head of the penis. It can increase the risk of urinary tract infections, and cause problems when peeing or having sex.
When is phimosis normal?
Almost all uncircumcised babies have a foreskin that doesn't pull back because it's still attached to the head of the penis. But at this age phimosis is perfectly normal, and the foreskin should be left alone.
Generally, the foreskin stays like this until the child is about 2 years old. By this time, the foreskin separates naturally from the glans.
In some children, it may take longer for the foreskin to become unstuck, but this doesn't necessarily mean there's a problem.
You should never try to force your child's foreskin back when it is not ready, as this can damage the foreskin and make the problem worse.
When is phimosis a problem?
Phimosis is not usually a problem unless it's causing symptoms. If symptoms, this suggests that the underlying problem is irritation from pee or an infection and you'll need to see your doctor. Treating the irritation or infection will usually clear the problem.
If there's swelling, soreness and redness around the glans and foreskin, sometimes with a thick discharge under the foreskin, the cause is probably balanitis. Balanitis is not serious and can usually be treated by bathing. A steroid cream may need to be applied and antibiotics are sometimes necessary.
The most common cause of balanitis in children is not getting rid of excess pee from the end of the penis after peeing.
Balanitis can sometimes be confused with a urinary tract infection, which causes pain when peeing, needing to pee urgently and blood in the urine. This will need treatment with antibiotics.
What to do about persistent balanitis
When phimosis is caused by regular episodes of balanitis, surgery may be necessary. This may either be circumcision (surgical removal of the foreskin) or surgery to release where the foreskin has become stuck to the head of the penis. But while surgery usually releases the foreskin, it may not prevent the problem recurring.