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What is Phimosis?

Medically approved by
Dr Earim Chaudry
Last updated
26th May 2021

In 30 seconds…

What is phimosis? Most commonly found in young boys, phimosis is the condition where your foreskin is too tight to be pulled over the head of the penis (or glans). In adults, it may be caused by a sexually transmitted infection, poor hygiene, psoriasis, or scarring of the foreskin. Sometimes, it can be a symptom of diabetes too.

Usually, it’s not a problem. However, it can in some cases cause swelling or soreness. Meanwhile, your foreskin may not return to its original position after being retracted. This is known as paraphimosis and can be more serious. It can cause pain, swelling, and may restrict blood flow to the penis.

Good hygiene is usually enough to avoid phimosis. Meanwhile, your treatment – antifungal creams, antibiotics, lubricants, and moisturisers – will depend on the cause. However, in some cases, circumcision will be recommended by healthcare professionals.

Let’s Talk Penile Health and Hygiene

Sometimes, things down there aren’t always as you expect them to be. We know this can be a little uncomfortable, unsettling, and even downright scary. 

Yet, it needn’t be. You’re doing great already. If you’ve noticed that something isn’t quite right, then you are on the right track to finding the solution. 

In this article, we answer a question that might be more common than you realise: what is phimosis? Well, the simple answer is a tight foreskin. However, there is a bit more to it than that. Let’s take a look at what you need to know.

What is Phimosis?

Phimosis is a condition in uncircumcised males in which the foreskin of the penis (or prepuce) is too tight to be pulled over the tip of the penis. No, in most cases it isn’t painful – unless you experience some of the symptoms or complications.

In children and young teenagers, phimosis is completely normal. For the first few years of life – and sometimes longer – the foreskin is usually attached to the glans (that’s the technical term for the tip of your penis). In 99% of cases, it resolves itself completely by the age of 16.

However, phimosis can occur in adults too. If you have noticed a tight foreskin where previously you didn’t have one, there might be something up. You might find that you have difficulty urinating or a bit of pain during erections.

In these cases, phimosis probably won’t be the result of natural development. Instead, there may be an underlying cause.

What Causes Phimosis in Adults?

Let’s take a look at some of the possible reasons for developing phimosis. 

  • Sexually transmitted infection. STIs including gonorrhoea and genital herpes can both cause tightening of the foreskin.
  • Poor hygiene. When men don’t keep themselves clean beneath the foreskin, bacterial or fungal infections can develop. These can prevent the foreskin from retracting as smoothly as it should.
  • Psoriasis. It’s a condition that can cause flaky, scaly patches of skin. Yep, you can develop it on your penis. Genital psoriasis is thought to develop in 63% of psoriasis patients.
  • Eczema. Similarly, eczema’s dry, red skin can develop on the penis and can interfere with the retraction of the foreskin.
  • Lichen sclerosus. This one is a skin condition that tends to affect the genitals specifically. In men, it is most often on the tip of the penis.
  • Diabetes. Phimosis can be caused by infection, and high blood sugar levels make infections more likely. In one study of phimosis incidence in the British Journal of Urology, a third of men with diabetes experienced phimosis – and 12% of men presenting with phimosis were diagnosed with a glucose control disorder.

Associated Conditions

Phimosis doesn’t always occur by itself. It’s common to experience phimosis alongside other conditions. However, these can be both causes and symptoms – and it’s worth a trip to the doctor to find out which needs to be solved first.

  • Balanitis. This is the inflammation of the glans penis. If the glans becomes inflamed, the foreskin can become too tight. However, an excessively tight penis can cause balanitis too. Urine may stay trapped beneath the foreskin, where it can cause infection.
  • Balanoposthitis. Similarly, balanoposthitis occurs when both the glans and the foreskin are inflamed.

In both cases, your penis may be sore – and there may be a thick discharge beneath the foreskin that you may or may not be able to see. Urinary tract infections can be caused by phimosis too.

What is paraphimosis?

While you may find that your foreskin does not retract properly, the opposite effect may occur too: you may struggle to return it to its original position. This is known as paraphimosis.

Paraphimosis is usually more serious than phimosis. It can be painful and can lead to your glans swelling. Emergency treatment is usually required to prevent complications, including restricted blood flow.

What’s Best for the Treatment of Phimosis?

In cases where phimosis is caused by infection, treatment options include antibiotics and antifungal medications. A doctor will be able to talk you through these.

Sometimes topical steroids are prescribed for phimosis. Ointments, steroid creams, and gels containing corticosteroids can help to soften the skin and may in some cases make it easier to retract.

Meanwhile, surgery can be an option in certain circumstances – where phimosis is chronic or recurring, for example. Circumcision will be the most common. However, emergency procedures in cases of paraphimosis, for example, can involve cutting part of the foreskin to release pressure. That’s known as preputioplasty.

One of your best options for prevention, however, is good hygiene, including good sexual hygiene. This should prevent any infections that may cause inflammation of the glans.

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Key Takeaways

Phimosis is a condition in which your foreskin is too tight to be retracted over the tip of the penis. While common among young boys, if you have it after about 16 years of age, it may be the sign of a problem. This might be an infection, a skin condition, or, in some cases, diabetes.

While it can seem quite concerning, there are ways to treat the condition. Doctors can prescribe you antibiotics or antifungal medication, for example. Or, in certain circumstances, surgery is a possibility. Usually, though, prevention is the best cure – and good hygiene is your best option.

References

  1. Sukhbir Kaur Shahid (2012). Phimosis in Children: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3329654/

  2. Thomas B. McGregor, John G. Pike, Michael P. Leonard (2007). Pathologic and physiologic phimosis Approach to the phimotic foreskin: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1949079/

  3. Kristen M. Beck, Eric J. Yang, Isabelle M. Sanchez, and Wilson Liao 9 (2018). Treatment of Genital Psoriasis: A Systematic Review: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6261118/

  4. Stephen J. Bromage, Anne Crump, Ian Pearce (2007). Phimosis as a presenting feature of diabetes: https://bjui-journals.onlinelibrary.wiley.com/doi/abs/10.1111/j.1464-410X.2007.07274.x

While we've ensured that everything you read on the Health Centre is medically reviewed and approved, information presented here is not intended to be a substitute for professional medical advice, diagnosis, or treatment. It should never be relied upon for specific medical advice. If you have any questions or concerns, please talk to your doctor.

Further reading

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