What Does Uncircumcised Really Mean?

Learn Fact From Fiction When It Comes to Caring for an Uncircumcised Penis

With the rates of circumcision on the downturn, more parents are wondering about the meaning of being uncircumcised. An uncircumcised penis is the natural default state, present at birth, with the foreskin intact. Circumcision removes the foreskin and is performed for a variety of cultural reasons on newborns, and as a treatment for some conditions for older boys and men.

Parents (and their sons) often have heard confusing, conflicting, or just plain wrong information about how to care for the uncircumcised penis. Let's set the record straight on what's normal, what's a problem, and what's an emergency.

A Normal Uncircumcised Penis

When a male child is born, his penis still has an extra layer of skin protection over the head (glans). This layer is called the "foreskin" or "prepuce." At birth, the foreskin is still attached to the head of the penis. This is completely normal and does not mean there is something wrong. As the boy gets older, the foreskin begins to separate naturally from the head of the penis.

As the foreskin starts to separate from the head of the penis, sometimes a white material builds up under the foreskin. This can look like white pearls under the foreskin. The material is called "smegma," which is made up of the skin cells that slough off during the separation process and is completely normal.

But the Skin is Stuck!

Parents are often concerned that the foreskin isn't separating fast enough, and will make the mistake of pulling on it to “loosen” it from the head.

Never pull hard on the foreskin to separate it from the tip of the penis.

Trauma caused by pulling on the foreskin can cause a kind of scar tissue to form between the foreskin and the head of the penis. This scar tissue can interfere with normal and natural separation. Basically, you are creating a permanent problem by forcing the foreskin back, instead of letting nature take its course.

The foreskin should completely separate from the head of the penis by the time puberty hits, although it usually happens by the time the boy is 5 years old.

Uncircumcised Penis Care

As your son was growing up, you probably told him to keep his penis clean. The best advice for parents is to encourage your son to keep the outside of the penis clean in general. He can pull the foreskin back to where it feels comfortable and clean the head of the penis that is visible. Make sure that the penis is clean, with no soap residue left over. The soap can be irritating to the sensitive skin on the head of the penis.

How Should You Care for an Uncircumcised Penis

When to Call the Doctor

If your son has hit puberty and the foreskin is still stuck to the head of the penis, it may be time to call your pediatrician or family healthcare provider. Your provider can prescribe a steroid cream that can speed up the process of separation. It is a simple treatment that has good results.

If the foreskin looks red and/or swollen, or if it is painful for your son to urinate, he may have an infection of the foreskin, or a urinary tract infection. It's important for a provider to treat this infection as it can get worse without treatment.

If the foreskin will not retract (move back over the head) at all, it can be one of two problems. One issue is that the foreskin is still attached to the head, which can be normal depending on the child's age. Additionally, the end of the foreskin can become too tight for it to come back over the head of the penis. These issues, called phimosis, can also be treated by your provider with a steroid cream or, if necessary, by circumcision depending upon the situation.

Paraphimosis is another problem that can be an emergency. With paraphimosis, the foreskin has been pushed back over the head of the penis, but it becomes stuck behind the head. This can be quite painful, and the tight skin can begin to cut off normal blood flow to the head of the penis. If your son has this problem, it's important for him to see a doctor or provider right away.

If your doctor isn't immediately available, a trip to the emergency room will be necessary. With some lubrication, a provider can help get the foreskin back over the head of the penis or sometimes an emergency circumcision is necessary.

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