Foreskin

What is the foreskin?

The foreskin is an outer layer of skin that covers the head of the penis (the glans). The penis is part of the reproductive system traditionally described as male. The foreskin is also called the prepuce.

What does the foreskin do?

The purpose of the foreskin has been a subject of debate. Some researchers believe that the foreskin protects your penis and helps in reproduction by increasing pleasure. Other researchers believe that the foreskin may increases the likelihood of certain disease.

These conflicting points of view are often given in debates about the need for circumcision, or the removal of the foreskin, which is often performed on infants. Circumcision is considered a religious rite within some groups of people and a beneficial medical procedure among others.

Where is the foreskin located?

The foreskin refers to a somewhat loose volume of extra skin that covers the head of the penis while the penis is in a flaccid state (not erect). The foreskin is movable. It can be pulled back (retracted) so you can clean the head of your penis.

What color is the foreskin?

The foreskin is slightly darker in color than the skin color of your body.

What are the common conditions and disorders that affect the foreskin?

Common conditions that affect the foreskin may also affect your whole penis. Some of these conditions include:

• Balanitis: Inflammation of the glans penis (head). This is sometimes from an infection of the foreskin. You can help to prevent this from happening by keeping the area under the foreskin clean. If you have diabetes, you’re at a higher risk of getting infections here because the glucose that comes out in urine (pee) is a good breeding ground for bacteria and fungi.
• Balanoposthitis: Inflammation of the glans and the foreskin. This can happen due to smegma and the fungi and bacteria that may breed there. Continued and repeated inflammation can lead to scarring and repeated urinary tract infections.
• Long foreskin (redundant prepuce): This refers to an excess amount of foreskin. In some people, the foreskin is so long that it completely covers the head of a flaccid penis. If the foreskin can’t be retracted, you could have some health issues.
• Paraphimosis: This is a medical emergency. It happens when your foreskin becomes stuck behind the ridge of the head of your penis. If your foreskin is stuck for a long time, it can cause pain and swelling. It can also block blood flow to your penis, which can cause tissue to die (gangrene). In extreme cases, your healthcare provider may have to amputate your penis.
• Phimosis: This is a condition in which the foreskin of your penis is so tight that it can’t be pulled back (retracted) to reveal the penis head (glans). Sometimes trying to move the foreskin can result in tears or cuts.
• Posthitis: This condition refers to an infection of the foreskin. This is due to the build-up of secretions and bacteria under the foreskin. The thick and oily substance that forms under the foreskin has an unpleasant smell and is called smegma. You can help to prevent this by cleaning under the foreskin.
• Skin rashes and irritation: Your foreskin can have the same type of allergic reaction as other parts of your skin. This can be due to harsh chemicals like in some soaps or spermicides. Your foreskin might itch, turn a reddish or darker color, or develop a rash. In some cases, your skin may be dry or cracked.
• Sexually transmitted diseases (also called sexually transmitted infections): These conditions include gonorrhea, syphilis, herpes simplex type 2 and HIV/AIDS. They can be transmitted while having unprotected sex.
• Trauma: This can happen if you get your foreskin stuck in a zipper or if you’re hurt in some kind of accident. You might have pain with this or other conditions of the foreskin.
• Tumors of the penis, including cancerous tumors: Penile cancer is rare, but it does happen. It occurs most often in people who haven’t been circumcised.

What are the common signs or symptoms of conditions that affect the foreskin?

Signs or symptoms of diseases that affect the foreskin may include:

• Itching.
• Swelling.
• Rash or discoloration.
• Pain.
• Discharge or pus.
• Inability to move the foreskin.

What are the common tests to check the health of the foreskin?

Your provider will do a physical examination and ask you questions about what’s bothering you. They will look at your penis and foreskin. If necessary, your provider may swab any discharge or smegma to see if there’s an infection.

What are the common treatments for conditions that affect the foreskin?

Treatments for conditions that affect the foreskin will depend on the actual condition. Therapies may include:

• Steroid creams, antibiotic creams or antifungal creams for irritations or infections.
• Oral antibiotics.
• Gentle massage or stretching for problems with retractions.
• Surgery, radiation and/or chemotherapy for penile tumors.
• Surgery to make a slit, widening the foreskin, to treat phimosis.
• Circumcision for paraphimosis and sometimes for phimosis.

What can I do to make sure that my foreskin stays healthy?

There are some tips for making sure that you and your reproductive system, including your foreskin, stay healthy. You probably know about the usual recommendations — eating healthy, staying hydrated, exercising and not smoking.

Tips that are more specific to your foreskin include:

• Staying clean. Gently pull back your foreskin to clean the glans underneath it with mild soap. If you have a child, wait until the foreskin separates from their penis to do this. Teach your child how to keep the glans clean when they’re old enough to do it on their own.
• Know what your foreskin looks and feels like when it’s healthy and continue to check its status. If something looks or feels wrong, contact your healthcare provider.
• Practice safe sex.
• Wear protective equipment if you participate in sports.

How far back should the foreskin retract?

Usually, you can retract your foreskin behind the ridge of your penis. You should move it far enough back while you’re peeing to see the meatus (the hole where urine comes out).

How can I pull back my foreskin without it hurting?

Retracting your foreskin isn’t supposed to hurt. Everyone’s foreskin is different, and retraction becomes possible at different ages.

You should gently pull the skin of your penis back toward your belly. This should make the foreskin open up and begin sliding backward.

If you can’t get your foreskin to retract once or twice, it’s not a problem. If it happens often, or if it hurts to try to move the skin of your penis, contact your healthcare provider.