Phimosis happens when the foreskin gets stuck in place over the glans (or head) of the penis because it’s too tight.
Phimosis can only affect you if you have a foreskin (if you’re uncircumcised). Phimosis is a common (and relatively normal) condition in babies and young children until around 7 years old.
When it happens to older kids or adults, it’s typically the result of one of the following:
- poor hygiene
- infection, inflammation, or scarring (pathologic phimosis)
- genetic predisposition (physiologic phimosis) that usually resolves itself by the time a child reaches 5 to 7 years old
Phimosis isn’t always a major cause for concern, and you may be able to gently stretch your foreskin until it returns to its normal position.
But if phimosis results in swelling, redness, irritation, or trouble peeing from the foreskin squeezing the head of the penis, you may need treatment for the underlying cause.
Before you try
- Be gentle. Don’t pull the foreskin back too hard, and stop pulling when it starts to hurt.
- Use a topical steroid cream to help massage and soften the foreskin so that it’s easier to retract. A prescription ointment or cream with 0.05 percent clobetasol propionate (Temovate) is usually recommended for this.
- Don’t wait too long to get medical help. If the cream doesn’t help within four to eight weeks, see your doctor for treatment. Seek immediate medical help if you have painful swelling or difficulty peeing.
Here’s how to safely stretch your foreskin back in place:
- Apply a thin layer of steroid cream around the entire foreskin. It should cover all the way around from the area at your penis tip down to where your foreskin meets the skin lower on your penis shaft.
- Gently massage the cream into the foreskin, rubbing the foreskin tissue slowly until the cream has been fully absorbed into the skin.
- Carefully try to pull your foreskin back, stopping when you start feeling discomfort or pain. Try applying some cream to the tip of your penis, too, once it’s exposed enough.
Repeat these steps two to four times a day until you can fully retract your foreskin without any pain or discomfort. This can take anywhere from four to eight weeks, so don’t be concerned if your foreskin doesn’t budge after a few days.
You can also massage your foreskin while you’re taking a hot bath or shower. The high water temperature helps loosen the skin and makes it easier to stretch.
Combine stretching in the bath with the steroid cream method to help you fully retract your foreskin sooner.
The same steps apply to pulling your foreskin back when you’re erect. But you may want to be a little gentler and more careful, as the foreskin might be even tighter or more uncomfortable during an erection.
If you experience painful erections while you have phimosis, see a doctor as soon as possible. Painful erections, especially with symptoms like swelling and discharge, can be signs of an infection or sexually transmitted disease (STD).
Keep the following in mind when you’re trying to pull back your foreskin:
- Don’t pull too hard or quickly, as this can damage the foreskin or cause injury.
- Don’t keep pulling if you start to feel pain, even if you’re pulling gently.
- Stop pulling if your foreskin starts to crack or bleed, as this can expose you to infections.
- Don’t have sex if a tight foreskin causes you pain or can’t be retracted enough to expose the head.
In some cases, stretching the foreskin won’t work. See a doctor if this happens — they may recommend alternative home or medical treatments, such as:
Other steroid creams for foreskin stretching may include 0.05 percent betamethasone (Celestone Soluspan).
If a bacterial or fungal infection is causing phimosis and other symptoms like swelling or discharge, a doctor may prescribe antibiotics to kill the infectious bacteria or fungi.
Some antibiotics, such as flucloxacillin (Floxapen), are taken by mouth. Others, such as clotrimazole (Canesten), are applied as creams or ointments.
Circumcision consists of surgically removing the foreskin. This treatment is usually a last resort if other home or medical treatments haven’t worked.
But circumcision can also be done for young children, teenagers, or adults if the foreskin remains too tight, even after treatments.
Circumcision may also be recommended if you consistently have infections (especially urinary tract infections) or conditions like balanitis, which is associated with having a foreskin.
Practicing good penis hygiene can help you avoid phimosis or other conditions that can happen with a foreskin:
- Wash under your foreskin regularly, pulling it back and gently rinsing it with soap and water every time you bathe to prevent buildup of urine, dirt, bacteria, and other substances that can cause smegma or fungal infections.
- Always clean the entire penis, including the tip, shaft, base, and scrotum.
- Wear loose, breathable underwear so that excessive moisture doesn’t build up under your foreskin.
- Trim your pubic hair to help prevent bacterial or fungal infections that may cause phimosis.
Stop trying to treat the foreskin yourself and see a doctor if you experience any of the following:
- trouble urinating
- burning sensation or pain when you pee
- painful redness, irritation, or itching
- abnormal white or cloudy discharge from the penis
- swelling of the head of the penis (balanitis)
- inability to pull the foreskin over the penis head after you stretch it back (paraphimosis)
Having a tight foreskin isn’t usually a big deal, and foreskin stretching is often an easy, successful way to treat it at home.
But if it doesn’t work after a few weeks and you start to notice new or worsening symptoms, see a doctor for treatment to prevent any complications that a tight foreskin or an associated infection can cause.