Care of the Uncircumcised Penis

The exact cause of cancer of the penis is not known. It is thought to be related to general hygiene and is much less common in men who have had all or part of their foreskin removed (been circumcised) soon after birth. This is because men who have not been circumcised may find it more difficult to pull back the foreskin enough to clean thoroughly underneath. Infection with a type of virus that causes penile warts also increases the risk of cancer of the penis.

Some skin conditions that affect the penis can go on to develop into cancer if they are left untreated. If you notice white patches, red scaly patches or red moist patches of skin on your penis, it is important to see your doctor so that you can get any treatment you need.

At birth, a boy's penis, including the shaft and head (glans), is covered by a double fold of skin. This is called the foreskin. Circumcision removes the foreskin over the glans. If a boy is not circumcised, his foreskin is left intact. During the first several years of life, the intact foreskin will naturally separate from the glans. This is called foreskin retraction.

What is foreskin retraction?

Foreskin retraction occurs when the foreskin can be pulled away from the glans toward the abdomen. This process happens on its own. Most boys will be able to retract their foreskins by the time that they are 18 years old.

What is smegma?

When the foreskin separates from the glans, skin cells are shed. This begins in childhood and continues through the teen years. New skin cells regularly replace the ones that are shed. Since this shedding takes place in a closed space - with the foreskin covering the glans - the shed skin cells may look like whitish lumps, resembling pearls, under the foreskin. These whitish lumps are called smegma. Specialized glands, called Tyson's Glands, located under the foreskin are largely inactive in childhood. At puberty, Tyson's Glands produce an oily substance, which when mixed with skin cells, make up adult smegma. Adult smegma serves as a protective lubricator for the glans.

Diagrammatic Representation of the Inner and Outer Foreskin Layers.

Does my foreskin need special cleaning?

The uncircumcised penis is easy to keep clean. You do not need to do any special cleansing, such as with cotton swabs or antiseptics. Simply wash the head of the penis and the inside fold of the foreskin with soap and warm water. Remember, do not try to forcibly retract the foreskin.  Consult your doctor if:

• the stream of urine is never heavier than a trickle

• you have some discomfort while urinating.

If the foreskin becomes inflamed, a common cause is the fungus monilia, which can cause redness and itching. This can be easily treated with antifungal cream. If the foreskin becomes considerably red or swollen, see your doctor. If your foreskin is fully retracted before puberty, an occasional retraction with cleansing beneath will do. Once you start puberty, you should retract the foreskin and clean beneath it on a daily basis. It should become a part of your total body hygiene, just like shampooing your hair and brushing your teeth. Clean your foreskin by:

• gently pulling it back from the glans

• rinsing the glans and inside fold of the foreskin with soap and warm water

• pulling the foreskin back over the head of the penis.

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