Phimosis (Tight Foreskin)

Phimosis, or a tight foreskin, is a condition that can cause both physical and emotional distress. There are several treatments available.

What is phimosis? 

Phimosis is the medical term used to describe a tight foreskin (the fold of skin covering the head of the penis) that cannot be pulled back (retracted) without causing discomfort or at all.

Phimosis is normal in young children, and the condition usually resolves by around 10 years of age. However, if you have phimosis that persists into adolescence or adulthood, it can cause problems such as pain, difficulty having sex and infections. 

Phimosis varies in severity. If your phimosis is mild, you may be able to retract your foreskin with some tightness, but in severe cases, you may not be able to retract your foreskin at all. 

While not all cases of phimosis need treatment, we recommend having your condition assessed by a specialist to prevent long-term problems from occurring. 

There are 2 types of phimosis: physiologic phimosis and pathologic phimosis.

  • physiologic phimosis is normal and is often present from birth. Most boys are born with a non-retractable foreskin, which usually becomes retractable by age 10

  • pathologic phimosis develops later in life and is caused by infection, inflammation or scarring. The condition can lead to pain, hygiene problems, and a higher risk of infections, so specialist treatment is required

At our state-of-the-art Men’s Health centre, our expert urologists can diagnose phimosis and recommend the most appropriate treatment.

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The primary symptom of phimosis is tightness of your foreskin, making it difficult or impossible to pull your foreskin back (retract it) over the head of your penis. 

Other symptoms of phimosis include:

  • redness, swelling, pain, or tenderness 

  • pain while urinating

  • weak urine flow

  • blood in your urine

  • frequent urinary tract infections (UTIs) 

  • balanitis – an infection under the foreskin leading to bleeding, thick discharge or an unpleasant smell 

  • smegma – a build-up of a thick, strong-smelling secretion under your foreskin 

  • painful erections, which can make sex difficult

Everyone's body develops differently, and changes to the foreskin can occur at different stages of life. Phimosis can happen for several reasons, including:

  • natural development (physiological phimosis) – this is most common in children under the age of 5 and normally resolves with age 

  • infection, scarring, or inflammation (pathological phimosis) – can occur due to conditions like balanitis, eczema, psoriasis, lichen planus, lichen sclerosus, and sexually transmitted infections (STIs) 

  • poor hygiene – lack of or improper cleaning can lead to infections, which can cause scarring or tightness

  • repetitive trauma or forced retraction – forcibly pulling back the foreskin can cause microtears in the tissue, which can lead to scarring and tightening

At your first Welbeck consultation, you’ll be seen by a consultant urologist. They’ll ask you about your symptoms, general health, medical history, and any medications you take regularly. They’ll also perform a physical examination. In some cases, your consultant may check for infection by testing your urine or any discharge from your penis.

Physiologic phimosis cannot be prevented, but there are steps you can take to reduce the risk of developing pathologic phimosis, including: 

  • fully retracting your foreskin every time you urinate

  • pulling your foreskin back to gently clean underneath it whenever you take a shower or bath 

  • avoiding forcibly retracting your foreskin

Phimosis isn’t usually dangerous, and complications are rare; however, in some cases, untreated phimosis can lead to long-term problems, including: 

  • inflammation of the foreskin, glans, or both 

  • frequent urinary tract infections (UTIs) 

  • difficulty urinating 

  • tears in your foreskin

  • poor hygiene

  • painful erections and difficulty having sex 

  • paraphimosis – a medical emergency where your foreskin gets stuck and can’t be moved back to its original position, causing pain and swelling in your penis

There are both surgical and non-surgical treatments available for phimosis. Your consultant will create a personalised treatment plan for you based on your comfort, personal goals and medical needs.

Non-surgical treatments for phimosis include:

  • topical steroid creams to help soften and loosen your foreskin

  • antibiotics if there’s an infection present 

  • gentle stretching exercises, which may improve retraction over time

  • good hygiene practices – regular cleaning can prevent infections that worsen the condition

If non-surgical methods have not been effective, or if your phimosis is severe, you may need surgery to remove your foreskin (circumcision). This is performed as a day-case procedure, which means you’ll be able to go home on the same day.

At Welbeck, our urologists are experts in their field and are dedicated to providing world-class care to every patient.

With access to colleagues across other specialities, our consultants are also able to refer within the Welbeck ecosystem if required to ensure you receive the treatment you need as quickly as possible, all under one roof.  

All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments.

Your health is important to us, so we strive to offer same-day appointments whenever possible.

Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.

Get in touch today to book an appointment.

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London

1 Welbeck Street
Marylebone
London
W1G 0AR

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Frequently asked questions

You can have sexual intercourse if you have phimosis, but it might be painful or uncomfortable, and in some cases, may cause your foreskin to tear. Using a condom and plenty of lubricant can reduce this risk.

If you have phimosis, it’s important to keep your penis healthy and reduce the risk of complications such as infection or tearing of your foreskin. 

You can do this by: 

  • cleaning your penis every day using mild soap and warm water, and patting the area gently dry with a clean towel 

  • making sure your hands are clean before you touch your penis

  • wearing clean underwear

  • using a condom and plenty of lubricant to reduce friction during sex and lower the risk of your foreskin tearing

The main danger of phimosis is that it can lead to a condition called paraphimosis, which is a medical emergency and needs immediate treatment. 

Paraphimosis occurs when your foreskin becomes stuck behind the head of your penis (glans) and can’t be moved back to its original position.

This results in severe pain and swelling and can cut off the blood supply to the head of the penis, leading to tissue death (necrosis).

Make an appointment with a consultant if: 

  • your foreskin is painful or causes discomfort

  • you experience recurrent infections

  • you have difficulty urinating, including a weak stream or ballooning of your foreskin

  • you have scarring or white patches on your foreskin

  • you have symptoms of a urinary tract infection (UTI)

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