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Tight foreskin

Tight Foreskin: Causes, Treatment, Prevention

What is Tight Foreskin?

Tight Foreskin or also known as phimosis is a medical condition that is common to uncircumcised males. It occurs when the male’s foreskin or prepuce is not able to retract fully from the head of the penis or glans. If there is flaccid retraction it is termed partial phimosis and it is termed as full phimosis if there is no retraction at all. 

Other people would medically define it as the perpetual ring undergoes stenosis or tightness. In a layman’s language, the foreskin becomes tight and cannot be pulled back for the glands to be disclosed.

What are the causes of tight foreskin or phimosis?

Phimosis or tight foreskin can be either physiologic or pathologic.

  • Physiologic phimosis

This describes a foreskin that is tight from birth and this condition usually resolves by age 6 or 7.

  • Pathologic phimosis

Pathologic phimosis is usually caused by:

  • Infection
  • Inflammation
  • Scarring

Conditions that might cause pathologic phimosis to include:

  • Balanitis

Balanitis or inflammation of the head of the penis can lead to a tight foreskin, painful urination, and several other symptoms. Some people will also see a thick discharge beneath their foreskin.

  • Balanoposthitis

Balanoposthitis is a situation when both the glans and foreskin are inflamed. Several types of infections are the possible cause of balanoposthitis, including the yeast infection known as Candidiasis.

Infections might also lead to scarring, which can contribute to the further tightness of the foreskin.

  • Sexually transmitted infections (STIs)

Some Sexually transmitted infections can cause inflammation of the glans, which might lead to tightness and discomfort. Common STIs that might be responsible for tightness of the foreskin include:

  • Genital herpes
  • Gonorrhoea
  • Syphilis
  • Skin conditions

Some skin conditions that might cause or worsen your symptoms are:

Eczema is a common condition that leads to dry and scaly patches on the skin.

Lichen planus is a rash characterized by shiny, flat bumps.

Lichen sclerosis is a condition that causes white patches to form on the foreskin and glans. It can also cause scarring on the foreskin.

Psoriasis is a chronic condition characterized by crusty, dry patches of skin.

  • Age

As you age, it may lead to the development of phimosis. As skin loses its elasticity, it can become stiffer and less pliable.

What are the Causes of Para phimosis?

Physical injuries to the penis like injuries sustained in contact sports might cause Para phimosis.

Para phimosis might be caused by:

  • Phimosis
  • Infection
  • Physical trauma to your penis
  • Pulling the foreskin back for extended periods
  • Pulling the foreskin back too roughly

Para phimosis can also occur when a medical expert fails to return the foreskin into position after an examination or procedure.

What are the symptoms of the tight foreskin?

Some commonly observed symptoms are associated with this condition and are symptoms that are commonly manifested by a person having this medical condition include the following:

  • Foreskin Bulges
  • Urinating is difficult
  • Pain
  • Your penis’ tip is swollen
  • There is an inability of pulling back the foreskin

Symptoms that indicate a serious condition includes:

  • High Fever
  • Unable to urinate
  • Unable to reposition the foreskin
  • Discoloured or bruising of the foreskin
  • Tenderness

Tight Foreskin Diagnosis

To diagnose tight foreskin or phimosis, the physician will usually need:

  • Medical History
  • P.E or Physical Examination
  • Swab test that is done to confirm or test for any prevailing infection

Treatment options for Tight Foreskin

The way a tight foreskin is treated depends on its cause and severity. In a few cases, no treatment is required. But if a tight foreskin causes any symptoms, you must consult your doctor about your treatment options.

  • Exercises

As both a treatment and preventive measure will help you to gently pull back and move the foreskin. This should be done while cleaning the penis which starts at a very young age.

Be careful not to pull back the foreskin that is still adhered to the glans. If you are unsure of whether the foreskin is still attached or whether it is safe to pull back, you must consult your doctor. You should never forcefully retract the foreskin.

  • Over-the-counter (OTC) medication

Over the counter corticosteroid creams and ointments like hydrocortisone can be effective for many skin conditions that cause or worsen phimosis. Even though there are no other conditions present, your doctor might recommend using topical steroids on your foreskin.

Massaging the ointment into your foreskin and manually retracting the skin twice per day might help make the foreskin more supple. Pain relievers like ibuprofen (Advil) might also be helpful, depending on the types of symptoms.

  • Prescription medication

Some topical steroids like betamethasone (Celestone) and triamcinolone (Aristopan) will require a prescription.

A prescription for different antibiotics like erythromycin (Ilotycin) or antifungal medications such as miconazole (Lotrimin AF) might also be necessary to treat infections affecting your penis and foreskin.

You should be sure to take the medications as prescribed and for the length of time recommended by your doctor. Stopping antibiotics too soon might allow a bacterial infection to continue and sometimes develop resistance to those antibiotics.

  • Surgery

A surgical option may be necessary if other treatments are not effective for the tight foreskin issue. Your options will typically include:

1. Circumcision:

This is the surgical removal of all or part of your foreskin. Even though circumcision is typically done during infancy, it can also be done at any age. It is usually recommended for cases where males are experiencing severe phimosis or chronic foreskin infection.

2. Preputioplasty:

This procedure includes the cutting and stretching of the foreskin. It is a less comprehensive surgery than circumcision. It is an option for men who still want the appearance of an uncircumcised penis.

3. Frenuloplasty:

Just like preputioplasty, a frenuloplasty involves the surgical cutting of your foreskin on the underside of the penis. This will loosen the foreskin enough to make it easily retractable.

As with any surgery, these procedures might carry a slight risk of bleeding and infection.

Take Away

In most males, a tight foreskin will resolve before their adulthood. In other cases of phimosis that persist into adulthood might cause pain, discomfort during intercourse, increased risk of any infection or difficulty urinating.

If these symptoms are present at any age, it is important to consult a doctor. In particular, Para phimosis requires prompt medical attention to prevent further complications.

There are many treatments options available that can successfully resolve both phimosis and Para phimosis. If you want to prevent tightness of the foreskin, you must practice good hygiene and stretching techniques.

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