Foreskin problems

The foreskin is not fully developed at birth and continues to develop during childhood. By about 5 years of age, however, most boys can pull the foreskin back over the head of the penis. There are 2 principle reasons why there might be difficulty doing this: a narrow opening (known as a phimosis) and attachments between the inside of the foreskin and the underlying head of the penis (referred to as prepucial adhesions). Difficulty in pulling the foreskin back can lead to problems with hygiene and cause infections underneath the foreskin – so-called balanitis.

If a child has a tight foreskin but this is not causing any symptoms then it is perfectly reasonable to wait and see if the problem will get better by itself. If, however, they are suffering from repeated infections then usually some intervention is required. Sometimes treatment with topical steroid ointment will resolve the problem but in other cases a small operation might be needed. Boys with prepucial adhesions may simply require these separated under a short general anaesthetic but if the problem is a phimosis then a circumcision is normally appropriate.