Foreskin problems

Foreskin too tight, stuck, or harbouring a mound of gunk that’s beginning to smell a bit funky? We asked Dr Ranj Singh what to do if things aren’t quite right down there.

"Is it supposed to be doing that?"

What is a foreskin?

A foreskin is a bit of skin that covers the head (helmet or glans) of the penis. It may not be the prettiest bit of your body, but it has vital functions: to protect the top of your penis and keep it lubricated.

A healthy foreskin should be easy to pull back over the head of the penis and put it back again without feeling too tight or painful. “This is important so that you can clean underneath it – so a good time to try it is in the shower,” says Dr Ranj Singh.

Ouch, my foreskin is too tight

If you can’t pull the foreskin back over the widest part of your penis you could have a condition called phimosis. It’s a common complaint for men where the foreskin is excessively long, or if the skin has been torn and healing has led to the foreskin contracting.

“Phimosis may not cause you any problems, but it can get worse and cause difficulties peeing – and you won’t be able to clean underneath it,” says Dr Ranj.

Try pulling the foreskin back really slowly. This will take a lot of patience (it may take a few weeks to build up to doing it fully), so don’t be tempted to yank it back. If your foreskin is very tight, it’s advisable to speak to your GP. There are creams available on prescription, but if these don’t work you might need a circumcision.

I have too much foreskin

There’s no medical need to get rid of excess foreskin – providing it slides freely over the head and the area exposed can be kept clean.

“Different people have different ‘amounts’ of foreskin and we’re all individual – you’d be surprised at the variety out there!” says Dr Ranj. “It’s important to accept that we’re all different and it’s nothing to be ashamed of.”

If you’re really upset by it and it’s affecting your confidence you could speak to your doctor about circumcision. “But this should only be used as a last resort,” says Dr Ranj.

My foreskin is stuck

Called paraphimosis, this occurs when a tight, uncircumcised foreskin gets pulled back and stuck behind the head of the penis (the glans). When this happens the end of the penis swells up, which can be eye-wateringly painful.

“Paraphimosis needs to be sorted out if you can’t get it back again, so that might mean a visit to the doctor sooner rather than later,” says Dr Ranj.

A professional pair of hands should be able to squeeze out the fluid and return the foreskin to its original position. If it’s too inflamed, however, then the skin may be slit to allow the foreskin to return back over the head.

Once the swelling had subsided, and the incision healed, a circumcision may be advised to prevent it happening again.

Help, my foreskin is bleeding

Had a particularly vigorous sesh? You may have ripped your frenulum – the tiny ridge of skin that connects the foreskin to the underside of the penis. As alarming as this is, it’s nothing to worry about. Just keep the area clean and dry for a few days and avoid sex.

Once you’re back in the game take it easy at first and make sure your partner’s well lubricated.

If it’s not down to sex and has happened before, you may have a short frenulum which will need to be looked at by your GP.

My foreskin stinks

Medically known as smegma bacillus, this is a naturally occurring white or waxy deposit that is secreted by the penis glands.

If left unwashed, it can collect under the warm, moist hood of the foreskin and become a breeding ground for bacteria. One word: stinky. “This is sorted out by pulling it back and cleaning underneath it when showering to make sure the stuff doesn’t collect under there,” says Dr Ranj.

A word of warning: only use mild soap and water and be sure to dry the head, as over washing and leaving your penis damp can open the door to infections such as thrush.

It hurts when I peel back my foreskin

If your foreskin and penis head is red and inflamed then there’s a chance you may have thrush – a condition caused by a harmless yeast-like fungus which occurs naturally in the vagina.

It’s controlled by the presence of certain bacteria, but this bacterial balance can be easily upset, however, by anything from antibiotics to stress, tight-fitting clothes or over washing. As a result the fungus multiplies.

Thrush can be easily treated with over-the-counter creams like Canesten. Applying natural yoghurt can also relieve the pain.

Circumcision – what’s involved?

Circumcision involves the removal of the hood of loose skin that houses the penis head.

• An adult circumcision is usually carried out under local anaesthetic (which means the patient is conscious throughout).
• The foreskin is cut away, using one of several surgical methods, and the incision stitched. A sterile dressing may then be applied.
• The patient may also be prescribed over-the-counter painkillers to manage any discomfort for a few days.
• The freshly-exposed penis head may be sore or sensitive for some time.
• Sex is discouraged until the stitches have been removed (often a week after the procedure) and any pain has subsided.